News

Ambulance fee frozen since 1997: the effect on the system

$125 since 1997: the user's share fell from 36% to 13% of the cost of a transport. What the Auditor General found, and no GST or QST.

October 20, 2026 · By the Agent Ambulancier editorial team · Lire en français

News

The ambulance fee in Quebec has been frozen since 1997: $125 for the pick-up and $1.75 per kilometre. According to the May 2025 report of the Auditor General of Québec, the share of the average cost of a transport paid by this fee fell from 36% to 13% in 2023-2024. The Government of Québec makes up the difference. What the person transported pays is detailed in our page on the ambulance price. This text applies to women and men paramedics alike, and paramedics never receive the bill. In an emergency, call 911.

The fee set in the ministerial order

The rates are set by section 5 of the ministerial order L-0.2, r. 2, up to date as of July 1, 2026 on LégisQuébec. There are three.

$125 for taking charge of a patient
$35 for taking charge of each additional patient
$1.75 for each kilometre travelled by ambulance with the patient

The last text that amended this section is Order in Council 185-97. These rates apply to all of Quebec, to all paying agents and to all permit holders. The Québec.ca page on the cost of ambulance transport, last updated August 20, 2024, states that these fees may be indexed annually.

What $125 from 1997 is worth today

The Bank of Canada inflation calculator, consulted October 20, 2026, compares the consumer price index of September 1997 (90.6) with that of September 2026 (170.0). The increase is 87.64%.

Rate in the order	1997 amount	Same purchasing power in 2026
Pick-up	$125	$234.55
Kilometre travelled	$1.75	$3.28

These amounts come from the Bank of Canada tool. They are not fees proposed by the government.

Average cost of a transport: from $433 to $1,214

Figure 8 of the Auditor General's report compares two years.

	1996-1997	2023-2024
Average cost of a transport	$433	$1,214
Average billing to the user	$157 (36%)	$154 (13%)
Funding from the ministry and other sources	$276 (64%)	$1,060 (87%)

The average bill has barely moved. The average cost, for its part, rose by $781 per transport, based on the two amounts in the figure.

For the 43 ambulance companies, fees brought in $85.2 million in 2023-2024. Of this amount, $18.7 million came from citizens and $66.5 million was paid mainly by the government, for users who qualify for free transport. The rest of their funding comes through contracts, as explained in our article on what ambulance companies cost.

More seniors eligible for free transport

The Auditor General notes that the government pays the full cost of transport in certain cases, for example for people aged 65 or over, social assistance recipients and transport between two hospitals. These main criteria for free transport date from the early 1990s.

From 1997 to 2024, the share of people aged 65 or over in Quebec's population rose from 12% to 21%. Their number went from 864,827 to 1,908,944.

A ministry analysis, no decision

The Ministère de la Santé et des Services sociaux (MSSS), Quebec's health ministry, began analyses in the fall of 2024. The report gives one example: a pick-up fee of $150 instead of $125, with free transport at 70 instead of 65, would reduce government spending by about $18 million a year. No decision had been made by the end of the Auditor General's work.

Its recommendation 4 asks the ministry to finalize these analyses and to propose, where appropriate, the necessary adjustments. In its response reproduced in the report, the ministry writes that it will continue its analyses while taking into account the importance of accessibility for the population. Dessercom, an audited company, writes for its part that the uniform fee does not reflect the real cost of services and proposes a revision aligned with real costs.

No rate without transport

The order sets no rate for a trip without transport. Its three rates cover taking charge of a patient and the kilometres travelled with that patient. The Auditor General notes that in some cases, such as when the patient refuses transport, the patient is not transported.

No GST or QST on the bill

Revenu Québec's page Services de santé taxables ou non taxables (taxable or non-taxable health care services) lists ambulance services among the health care services on which GST and QST must not be collected.

At the federal level, section 4 of Part II of Schedule V of the Excise Tax Act exempts the supply of ambulance services by a person whose business is to provide such services. Air ambulance services are excluded and referred to Schedule VI, the schedule of zero-rated supplies. No ambulance bill therefore sends any tax to Ottawa. This text is neither tax advice nor legal advice.

Did you like this article?

Share this article

Facebook LinkedIn Reddit X Email

Frequently asked questions

What will the ambulance fee be in 2026?

The ministerial order, up to date as of July 1, 2026, keeps the 1997 rates: $125 for the pick-up and $1.75 per kilometre. The ministry has been analyzing the fees since the fall of 2024. No decision had been made by the end of the Auditor General's work, in May 2025.

What does an ambulance transport cost?

The average cost of services is $1,214 per transport in 2023-2024, according to the Auditor General. The average billing to the user is $154. The ministry and other sources pay the remaining $1,060.

What is the price of an ambulance trip?

For a person who lives in Canada, the trip costs $125 for the pick-up, plus $1.75 per kilometre travelled to the hospital, according to Québec.ca. An additional patient in the same ambulance costs $35. For a person who does not live in Canada, the pick-up is $400.

How do you calculate an ambulance transport?

You add the $125 pick-up and $1.75 for each kilometre travelled by ambulance with the patient, according to section 5 of the order. A 20-kilometre trip therefore comes to $125 plus $35, or $160. This calculation comes from the fee schedule, not from an actual bill.

How much does ambulance transport cost for a senior?

For a person aged 65 or over, Québec.ca states that the hospital pays, subject to approval by the physician in charge. The same page warns that an eligible person could have to pay if the transport is not considered medically necessary.

Does the RAMQ reimburse ambulance fees?

No. The RAMQ (Quebec's health insurance board) writes that it does not cover the cost of ambulance transport.

Is transport taxable?

Ambulance transport is not. Revenu Québec writes that GST and QST must not be collected on ambulance services. The Excise Tax Act exempts them in section 4 of Part II of its Schedule V.