Provider Notice issued 12/19/2025

Ground Ambulance Cost Reporting Requirements

The purpose of this notice is to inform privately owned ambulance providers that in accordance with Public Act 103-0102 and Provider Notice issued 05/17/2024, privately owned ambulance providers shall annually complete and submit cost reports to the Department of Healthcare and Family Services (HFS). Non-filing of the cost report may affect the enrollment status of the provider with the Department.

The cost report template with detailed information is available on the Illinois Department of Healthcare and Family Services’ Cost Report webpage. This template will be used to report cost data specific to each ambulance provider. 

The reported cost information will be analyzed for the purpose of understanding ground ambulance transportation services cost structures and their impact on the Medicaid program.

The information submitted must include costs over a continuous 12-month period. Providers may use a continuous 12-month data collection period running from January 1, 2026, through December 31, 2026, or, for providers with a regular fiscal year that differs from the calendar year, the continuous 12- month data collection period that overlaps with provider’s regular fiscal year that begins in calendar year 2025 and ends in 2026. 

The cost report for private ambulance providers is due within five months after the end of the provider’s data collection period, but no later than May 31, 2027. No extensions will be granted.

Enrolled Publicly Owned Ground Emergency Medical Transportation (GEMT) providers are not required to complete this cost report if submitting the required annual GEMT cost report. 

The completed cost report (in both Excel format and scanned PDF format with signed page 1) should be submitted via email through HFS.PrivateAmbulance@illinois.gov.  If there are any questions, contact the Bureau of Professional and Ancillary Services (BPAS) toll-free at 877-782-5565 or through email at HFS.PrivateAmbulance@illinois.gov.

Laura Phelan, Administrator
Division of Medical Programs