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Emergency services billing data call

Political subdivisions may submit to TDI billing rate sets for emergency medical services that are set, controlled or regulated by the political subdivision. TDI will publish these rates on the Texas Open Data portal.

This page has the following sections:

Background information

Insurance Code Section 38.006 provides that political subdivisions may submit rates to TDI related to emergency medical services and that TDI shall publish the rates on its website. 

TDI first collected and published EMS rate data in 2024 to implement Senate Bill 2476 (88th Legislature, 2023) and adopted rules in Title 28, Texas Administrative Code, Chapter 21, Subchapter PP, Division 8. New Senate Bill 916 (89th Legislature, 2025) took effect September 1, 2025, and allows a political subdivision to annually adjust rates submitted to TDI, subject to a statutory limit. 

Under SB 916, a political subdivision may annually adjust a rate submitted to TDI under Insurance Code Section 38.006 by not more than the lesser of:

(1) the Medicare Ambulance Inflation Factor; or

(2) 10% of the provider's previous calendar year rates. 

Based on the Medicare Ambulance Inflation Factor for 2025, a rate adjusted for 2025 cannot be more than 2.4% greater than the rate submitted for 2024.

A rate adjusted for 2026 cannot be more than 2% greater than the rate that applied in 2025.

Reporting and publication schedule

A political subdivision that chooses to submit new or adjusted EMS rate data to TDI for 2026 must do so between February 5 and March 23, 2026.

  • TDI published 2025 EMS rate data on the data portal on September 15, 2025, following an opportunity to report announced in Commissioner's Bulletin # B-0011-25 published July 31, 2025.
  • On November 3, 2025, TDI published additional information in the rate dataset that included the results of a compliance audit, which indicated:
    • A Validation Rate that reflects the maximum rate for 2025 that would be compliant with the statutory limit. The Validation Rate is calculated by multiplying the 2024 rate by 1.024. This reflects the Medicare Ambulance Inflation Rate of 2.4% for 2025.
    • A Compliance field indicating whether each rate reported for 2025 is Compliant or Noncompliant. A rate is Noncompliant if it exceeds the Validation Rate. 
  • On January 30, 2026, TDI adopted rule updates and published a simplified rate dataset that replaces noncompliant 2025 rates with the Validation Rate, as explained above.
  • TDI will publish 2026 EMS rate data on the data portal no later than April 6, 2026.

Data reporting application

Political subdivisions reporting emergency medical services rate data should go to https://appscenter.tdi.texas.gov/emergservicesbilling/p/login. The application will be available for reporting from February 5 to March 23, 2026

Data portal

Emergency medical services data reported by political subdivisions will be available on the Texas Open Data Portal.

FAQ

Will I need to set up an account to submit emergency medical services data for a political subdivision?

Yes, an account must first be set up before data can be reported.

Can more than one person submit data for a political subdivision?

Yes, a reference number will be provided when an account is first set up and data is entered. This number must be used by others reporting on behalf of the political subdivision.

What does “Resident rate” mean when the reporting forms asks “Is the nonresident rate the same?” in the “Unlisted codes” section?

If your political subdivision charges the same rates for patients who live within the political subdivision and those who do not, the answer is “Yes,” the nonresident rate is the same. If there are different rates depending on where the patient lives, the answer is “No.”

Can EMS providers that are not affiliated with a political subdivision also submit rate data?

No, only those authorized under Insurance Code Section 38.006 may report EMS rates to TDI.  

If an ineligible entity has submitted data based on a misunderstanding, they should contact TDI  so their data can be removed from the database.

 

When does SB 916 go into effect? What is the impact on claims for services provided before TDI has published updated rate data?

The payment standards amended by SB 916 apply to claims incurred on or after September 1, 2025. TDI will publish data submitted by September 1, 2025, no later than September 15, 2025.

TDI expects health plans to work in good faith to pay claims consistent with SB 916. If a provider has submitted a rate adjustment for 2025, they could wait to submit claims for EMS services provided in early September until after the updated data has been published. If a health plan pays a claim incorrectly, the provider should follow the health plan appeal processes. Providers can complain to TDI if they believe health plans are not working in good faith to follow the new payment standards.

If a provider submitted rates in 2024 under SB 2476, does the rate increase limitation under SB 916 apply to the rates submitted on 9/1/25? Or does it only apply after the bill effective date when the rates are updated again in 2026?

Effective September 1, 2025, the statute allows a political subdivision to “annually adjust a rate submitted under Section 38.006 by not more than the lesser of: (1) the Medicare Ambulance Inflation Factor; or (2) 10 percent of the provider’s previous calendar year rates.” Since rates submitted under SB 2476 were submitted under Section 38.006, the limit on an annual rate adjustment (as amended by SB 916) applies to the rates submitted on 9/1/25.

If a provider did not submit rates in 2024 but wishes to submit rates by 9/1/25, do they have that option? Or can a provider only submit rates by 9/1/25 if they submitted rates in 2024 under SB 2476?

Insurance Code Section 38.006 permits a political subdivision to “submit to the department, in the form and manner prescribed by the commissioner, a rate set, controlled, or regulated by the political subdivision.” It does not disqualify a provider from submitting a rate based on whether they submitted a rate in the past.

If a rate reported for a political subdivision for 2025 exceeds the statutory limit, is a health plan required to pay the noncompliant rate?

No. As of January 30, 2026, TDI has replaced noncompliant rates with rates that meet the limits of SB 916.

 

If a political subdivision submitted rates in 2024 and did not update the rate for 2025, does the 2024 rate still apply?

Yes. SB 2476 and SB 916 require health plans to pay EMS claims based on the rates submitted to TDI and allow, but do not require, political subdivisions to annually adjust those rates. Refer to 28 TAC §21.5071(b)(1), which clarifies that the most recent data submitted will continue to apply.  

When will 2026 rates be available? What about claims for services provided before TDI has published updated rate data?

Consistent with 28 TAC §21.5070(d) and (e), the deadline for submitting updates to rates for 2026 is March 23, 2026, and TDI will publish the data no later than April 6, 2026. For claims that are incurred between January 1 and April 6, 2026, a health benefit plan issuer is considered in compliance with SB 916 if they pay the rate that is published in the database at the time a claim is submitted.

Will I be able to update my data if my political subdivision updates its rates after March 23, 2026?

Yes, under SB 916, there will be an annual opportunity to adjust rates. Consistent with 28 TAC §21.5070(d), for rates to be used in calendar year 2027, data will be due by December 1, 2026. TDI will send an email to notify submitters when the reporting window opens.

For more information, contact: EMSBilling@tdi.texas.gov

Last updated: 1/30/2026