Ambulance Billing

Fees for Emergency Medical Services

The City and County of San Francisco assesses fees for the delivery of pre-hospital emergency medical care, in accordance with the current San Francisco Ordinance posted below. Although emergency services are performed by the San Francisco Fire Department, billing operations and the collection of fees are performed by a private billing company.

Providing or Updating Account Information

Account information can be provided or updated by:

Completing the insurance information on the billing invoice and mail to:

San Francisco Fire Department
Ambulance Billing
P.O. Box 059745
Los Angeles, CA 90074-9745


Accessing the Patient Portal. You will need your account information to access and update your insurance information online.

Calling the Billing Customer Service Line at 888-980-9218.

Making Payment

Payments can be made with a personal check, cashier's check, or money order, and include the account number on the payment. Make check payable to: "San Francisco Fire Department". PLEASE DO NOT SEND CASH. Please send payment to the following address:

San Francisco Fire Department
Ambulance Billing
P.O. Box 059745
Los Angeles, Ca 90074-9745


Payment can also be made online via the Patient Portal. You will need your account information to access and pay your bill online. To make a payment over the phone or to set up a payment plan, please call Billing Customer Service at 888-980-9218.

Disputes and Financial Hardship

If you feel you received a bill in error, you may submit a dispute letter for review. Disputes must be submitted in writing and must be delivered via U.S. Mail (phone, fax or e-mail protests will not be accepted). Protest letters must be sent to the address listed below. Reviews may take up to 30 days. Once a determination is made, the decision will be final and shall not be subject to further protest.

If you are not covered by insurance, cannot obtain Medi-Cal or Medicare coverage, and you do not have sufficient funds to pay the invoice, you may apply for the Fire Department's Financial Hardship Program. This program covers emergency medical services provided by the San Francisco Fire Department only and has no bearing on any other City services that may have been provided.

Applicants must sign and complete the Financial Hardship Program Application and provide required documents. Please download a copy of the Financial Hardship Application available here as a PDF or Word Document:

Send application and all documents via U.S. Mail to the address listed below:

San Francisco Fire Department
Disputes and Hardship
P.O. Box 059745
Los Angeles, CA 90074-9745


Requesting Medical and Billing Records

If you wish to obtain a copy of your medical record or billing record, please follow the instructions concerning Medical & Billing Records. Please note that only the patient or other authorized person may obtain a copy of these records. For any questions, contact the Custodian of Medical Records.

Notice of Privacy Practices

Important Information

Fees for Fire Department Emergency Medical Services (Effective 7/1/2019)

As of July 1, 2011, fees are increased annually to reflect changes in the Medical Consumer Price Index as determined by the SF Controller's Office.

Due to various reasons, an account may be forwarded to the Bureau of Delinquent Revenue, which is the official collection agency for the City and County of San Francisco.