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EMS Billing and Financial Assistance

EMS Billing

Tacoma Fire Department provides Basic Life Support and Advanced Life Support services and medical transportation for the City of Tacoma, the City of Fircrest, and Pierce County Fire District 10 (FD10) – which includes the City of Fife – under a service contract.


Frequently Asked Questions

What is the difference between Basic Life Support and Advanced Life Support? 

Basic Life Support (BLS) is an emergency transport provided by certified Emergency Medical Technicians (EMTs). Advanced Life Support (ALS) is provided when a patient is in a more critical condition, and a certified Paramedic is needed to assist in treating the patient before and/or during transport to the emergency facility. ALS means that our emergency personnel can:

  • Start intravenous lines
  • Administer lifesaving medication
  • Provide advanced airway management to help patients breathe
  • Interpret EKG readings of a heart attack patient, among other lifesaving pre-hospital care

Is there a charge for being transported by the Tacoma Fire Department?

Yes, both BLS and ALS transportation services have a cost. The current rate for a BLS patient transport is $1,030 and $25 for each mile traveled from the scene of your incident to the medical facility; ALS patient transport is $1,300 and $25 for each mile traveled from the scene of your incident to the medical facility. Most, and sometimes all charges, are covered by your insurance provider; however, there may be a balance after your insurance has paid. If you have questions about what your insurance covers, please contact them directly.  


Will I have any out-of-pocket costs for my TFD transport?

It depends. 


If you are a resident of the City of Tacoma, the City of Fircrest, or the City of Fife/Fire District #10, any balance remaining after your insurance has paid could be covered by the EMS Levy. *Any out-of-pocket charges from BLS transports before December 18, 2023, are not eligible for the EMS Levy benefits. Please contact us - through email at tfdbilling@cityoftacoma.org or phone at (253) 591-5844 - to confirm we’ve billed all appropriate insurance coverage(s) to access the levy for your balance; otherwise, you will receive an invoice.


If you are not a resident of our service area, you will be billed for any balance not covered by your insurance provider(s).


Please contact us at tfdbilling@cityoftacoma.org or (253) 591-5844 to confirm we have all your appropriate insurance coverage(s) in our records.   


What is the EMS Levy, and how does it relate to my cost for being transported by the Tacoma Fire Department?

The EMS Levy is a voted property tax that can cover unpaid portions of your medical transport bill, depending on your area of residence and type of transport (ALS or BLS). The EMS Levy can be used for only what is outlined in the ballot language provided for that levy election. You are eligible to use that levy only after allowing TFD to access your insurance benefits (with your signature on our release form). 


Why does TFD charge transport fees?

To reduce the cost to residents for the EMS system, we set a charge for transport services that pays for the program's expenses. This allows us to have a rate to bill your insurance and try to recover our costs through those payments. Also, numerous patients using EMS in our area do not reside or pay taxes here, and this charge allows them to help pay their portion of the service they are using.  


How do I pay?

You will receive an invoice from the Tacoma Fire Department that will provide our current payment options. These include:
  • Calling (253) 591-5844 to make a credit card payment over the phone during business hours; or
  • Visiting our Headquarters building at 901 Fawcett Ave., Tacoma, WA 98402 during business hours to make a payment by cash, check, or card, or;
  • Delivering payment (check or cash) to our Headquarters building dropbox (a large blue box outside the 2nd-floor door) at 901 Fawcett Ave., Tacoma, WA 98402, or;  
  • Mailing a check to Tacoma Fire Department PO Box 111630, Tacoma, WA 98411.

Please make checks payable to City of Tacoma and send them to:

Tacoma Fire Department
PO Box 111630

Tacoma, WA 98411


Be sure to note your account or invoice number on your check and provide a current phone number where you can be reached. 


Our office hours for phone payments or questions are Monday through Friday, 8 AM – 5 PM, excluding holidays.  

When do I pay?

All outstanding charges are due within 30 days of receiving your invoice. Please note your invoice may be delayed as we wait for your insurance company to provide payment. Charges not paid after 120 days of receiving your first invoice will be reviewed for submittal to a collection agency.


We offer payment plans and financial assistance, so please contact us at (253) 591-5844 or tfdbilling@cityoftacoma.org to make arrangements for your particular situation.


Why am I getting a bill after the No Surprises Act went into effect on January 1, 2022?


The No Surprises Act does not currently apply to ground ambulance transportation in Washington State.  


EMS Financial Assistance

Tacoma Fire Department offers options if you cannot afford to pay the full balance of your transport. First, we will bill any insurance providers you have for covered ambulance services. This will decrease your out-of-pocket amount, in some cases, to $0. If you have a balance after insurance payments, we offer an installment Payment Plan: a minimum of $25 monthly.


Financial Assistance Discount: if you meet certain income limits, you may qualify for a partial or full discount on your invoice. We use the Tacoma Housing and Urban Development Income Limits to determine your eligibility and discount. Rates are effective 5/15/2023. 


 Low 25% 75%
 Very Low 50% 50%
 Extremely Low 100% 0%


Current Tacoma Housing and Urban Development Income Limits, annualized 

 1 $60,200 $37,650 $22,600
 2 $68,800 $43,000 $25,800
 3 $77,400 $48,400 $29,050
4 $86,000 $53,750 $32,250
5 $92,900 $58,050 $35,140
 6  $99,800 $62,350 $40,280
 7 $106,650 $66,650 $45,420
 8 $113,550 $70,950 $50,560


Documents submitted that demonstrate a grant of financial assistance from the receiving medical facility for medical care on the date of transport will be deemed evidence of qualification for financial assistance. Upon presentation of such documentation and an application through EMS Billing Services, TFD will grant proportionally equivalent financial assistance.


You will be notified of the determination within 14 days of us receiving the completed application and all supporting documents.


If you have questions about the program, please contact us at (253) 591-5844 or tfdbilling@cityoftacoma.org. Our office hours are Monday through Friday, 8 AM to 5 PM, excluding holidays.


Applications are available to download or can be submitted online. 

  1. Download the Financial Assistance Application.

    Complete your application and mail it, along with all supporting documents, to:

    Tacoma Fire Department

    PO Box 111630

    Tacoma, WA 98411


  2. Complete the online Financial Assistance Application