The CARE Act of 2025 creates a new pilot program that allows Medicare to pay for ground ambulance services in a different way. Instead of only paying when an ambulance actually transports a patient to a hospital, Medicare will now also pay for ambulance dispatch and response to emergency calls even if the patient doesn't need to be transported. This is designed to test whether having ambulances respond to emergencies—potentially with remote medical guidance through video or phone—can help patients get faster care and avoid unnecessary hospital trips.

The program applies to Medicare beneficiaries (people 65 and older, plus some younger people with disabilities) who call 911 or request emergency medical services. Ground ambulance providers can respond, assess the situation, and provide treatment without necessarily taking the patient to a hospital. The payment for these services will be set at roughly the same level as if a transport had occurred. The program will run for 5 years, and during that time, ambulance services must follow all state and local rules and can use video or phone consultations with doctors to guide their care.

After 4 years, Congress will receive a detailed report analyzing how well this program works. The report will examine whether patients are getting better outcomes, how the program affects healthcare costs, whether it works differently in different regions, and what challenges ambulance services face in implementing it. This pilot is essentially testing whether we can use ambulances more flexibly to respond to emergencies in ways that might reduce unnecessary emergency room visits and hospital admissions while still keeping people safe.