San Antonio police and EMS investigate the scene where a pedestrian was struck and killed by a pickup that was rushing a man who had been stabbed to an area hospital just before 3 a.m. in the 4700 block of Northwest Loop 410, near Callaghan Road.
Ken Branca/21 ProVideo
San Antonio police and EMS examine a scene where a suspected drunken driver crashed into two vehicles at an intersection, leaving an adult in life-threatening condition and a child wounded Friday afternoon at the intersection of North Foster Road and East Houston Street.
Jacob Beltran
An EMS rushes a teen to an area hospital to be treated for a gunshot wound to his torso early Tuesday in the 8500 block of Broadway.
Ken Branca/21 ProVideo
EMS transports a woman with possibly life-threatening injuries to an area hospital after she was stabbed several times early Wednesday in the 2600 block of Vance Jackson Road.
Ken Branca/21 ProVideo
If you have to be rushed by ambulance to a San Antonio hospital, you’re going to feel an acute pain in your bank account or be stuck with a stack of insurance paperwork.
The city’s new $4.4 billion budget, which kicked in Oct. 1, includes numerous fee hikes. Several of them are for emergency medical services.
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San Antonians will have to cough up $1,700 for an ambulance — a 70% increase over the cost in 2024.
The city last raised the EMS transport fee to $1,500 in fiscal year 2025, in part, to help cover the costs of pay raises for firefighters and paramedics. Before that, the rate had held steady at $1,000 since 2019.
Don’t get the idea that the new $1,700 fee is all you or your insurer have to pay for an ambulance ride. There’s also a $12 fee per mile, which didn’t change from the last fiscal year, and a new flat fee of $49 for medical supplies. Previously, you only had to pay for supplies that paramedics used on you en route to the hospital.
Even people who aren’t transported to the hospital will get a higher bill if they receive any medical attention from the city, including an assessment of a patient’s condition and treatment of minor injuries. The so-called “aid only” fee is increasing from $100 to $150.
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The city has also started charging private assisted-living facilities, nursing homes and independent-living facilities almost $1,300 each time EMS has to assist a patient who has fallen.
The combination of transportation, aid, medical supply and lift assist fees are expected to rake in more than $3 million this fiscal year.
“Several of these haven’t been adjusted in quite some time, and the goal is really to bring them more in line with what it actually costs us to provide the service,” Fire Chief Valerie Frausto told City Council in September.
About 71% of EMS transportation fees are paid by health insurance companies, and 26% are covered by Medicare and Medicaid. Only 3% of patients pay the fees out of their own pockets, Budget Director Freddy Martinez told council members this summer.
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The city raised or introduced more than 100 fees and permit costs in the fiscal year 2027 budget to help fill a $158 million deficit over the next two years. City Council also OK’d a property tax hike and about $40 million in cuts.
Metal recycling licenses, for example, soared from $1,000 to $5,000. Those licenses had cost $250 from 2012 through 2025.
Permits to run a short-term rental property — such as an Airbnb — had cost owners $300 if they lived onsite and $450 if they didn’t. The permit fees jumped to $450 and $1,000, respectively.
Metal recycling companies and short-term rentals had recently undergone intensive review processes by the city, which came with stricter rules and higher fees, to tighten the regulations surrounding the industries.
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Trash pickup will also cost San Antonians an additional $1.25 this year.
Bexar County residents who live outside of the San Antonio city limits will have to pay $30 a year for a library card. The city blamed the hike on the county’s longstanding unwillingness to increase its contribution to the library system.