The Medicare ambulance add-on payment extension is now official. President Trump has signed the 2026 Consolidated Appropriations Act (H.R. 7148) into law, securing a 23-month extension through December 31, 2027. The legislation continues the 2% urban, 3% rural, and 22.6% super-rural increases to the ambulance fee schedule, providing much-needed stability for EMS providers nationwide. Previously, the temporary add-ons had been extended through January 30, 2026, allowing Congress time to enact a longer-term solution. During this period, AAA members actively engaged with lawmakers, submitting comment letters and advocacy support to ensure EMS priorities were represented.
The Senate approved the Consolidated Appropriations Act package on January 30, and the House passed it by a narrow 217-214 vote, finalizing the 23-month extension. Although there was a brief three-day lapse in the temporary add-ons, the mandatory Medicare claims hold period of ten days ensures there should be no disruption in payments. The Congressional Budget Office estimates that this extension will provide $197 million in continued relief to ground ambulance service organizations.
The legislation also includes report language directing the Administration for Strategic Preparedness and Response (ASPR) to make addressing EMS workforce shortages a priority. H.R. 7148 primarily funds HHS and four other federal agencies through the end of FY2026, while DHS funding is extended through February 13, resolving the recent partial government shutdown.
