TASA's Report on the State of Tennessee EMS
Cost • Utilization • Readiness • Sustainability
Prepared by the Tennessee Ambulance Service Association
Reporting Year 2025
Executive Summary
During 2025, Tennessee ambulance services completed more than 1.2 million ground ambulance transports, responding to emergencies, supporting hospitals, and providing medically necessary transportation across urban and rural communities throughout the state.
Why this matters
EMS agencies must maintain trained personnel, equipped ambulances, medical supplies, communications systems, and operational readiness every hour of every day. Understanding utilization and reimbursement together is essential to evaluating the long-term sustainability of Tennessee's EMS system.
Tennessee EMS by the Numbers
Transport Mix
Payor Transport Volume
Equipment Snapshot
Where Every EMS Dollar Goes
The financial story of EMS is not captured by gross charges alone. Gross transport revenue reflects billed activity, while net transport revenue reflects the resources available after contractual allowances and bad debt.
Why Readiness Matters
EMS readiness exists before the 911 call. Ambulance services invest continuously in the people, vehicles, equipment, communications, technology, and training required to respond immediately when emergencies occur.
Purchased, equipped, maintained, fueled, and replaced.
EMTs, AEMTs, Paramedics, dispatchers, supervisors, educators, and support staff.
Cardiac monitors, stretchers, airway equipment, medications, and supplies.
Dispatch systems, radios, ePCR platforms, and data reporting infrastructure.
Continuing education, clinical oversight, simulation, and quality improvement.
Insurance, regulation, documentation, cybersecurity, and operational standards.
Commercial Insurance & EMS
Commercial insurance plays an important role in supporting Tennessee's EMS system. Ambulance providers respond to emergency calls based on medical need, not insurance network participation.
EMS Is Different
Ground ambulance providers must respond to emergency requests, treat patients regardless of insurance status, and maintain continuous readiness. These obligations limit the ability to negotiate care at the point of service.
Reimbursement Gap
Fair Health data provided to TASA shows average allowed amounts for common out-of-network ambulance service codes in Tennessee at roughly 43% to 57% of average billed charges.
Emergency Response Comes First
Strengthening Tennessee EMS
The statewide data identify practical opportunities to strengthen Tennessee EMS while preserving access to timely emergency medical care for every community.
Support reimbursement policies that recognize the cost of maintaining EMS readiness.
Promote approaches that reduce unexpected financial burdens while supporting EMS sustainability.
Expand EMS education, recruitment, retention, and leadership development opportunities.
Continue statewide reporting through Project Pulse to guide planning and policy decisions.
| Opportunity | Public Benefit |
|---|---|
| Sustainable reimbursement | Maintains readiness and supports long-term planning |
| Balanced commercial reimbursement | Protects patients while preserving EMS access |
| Workforce development | Builds capacity to answer tomorrow's calls |
Looking Ahead
Project Pulse is TASA's annual report on the state of Tennessee EMS. It is designed to provide EMS leaders, healthcare organizations, policymakers, local governments, and the public with a concise overview of statewide EMS utilization, financial trends, operational readiness, and emerging opportunities.
Tennessee's EMS system is built on preparation, professionalism, and partnership. By investing in readiness, supporting the EMS workforce, and making informed decisions based on objective data, Tennessee can strengthen emergency medical care for years to come.
Prepared by the Tennessee Ambulance Service Association
PROJECT PULSE • 2026 Edition