Marfa EMS to update patient fees, acquire new ambulance

MARFA — Marfa City Council members voted to increase fees for EMS services and heard updates on a new ambulance arriving this month during a council meeting held Tuesday. 

City EMS Director Bert Lagarde presented council members with an updated fee schedule — an outline of costs for services Marfa EMS provides — explaining that fees had not been updated in at least four years. Lagarde said the increases, which average 20 to 25%, were recommended by the department’s billing company, Emergicon. 

“Pretty much all of our billing lines were below the industry standard,” said Lagarde.

Emergicon recommended Marfa EMS increase its cost for basic life support from $1,200 to $1,400, and its advanced life support — instances where a paramedic is involved and may need to administer an I.V., intubate and more — from $1,250 to $1,600. 

It was also suggested that Marfa EMS increase its mileage — patient time spent physically riding in the ambulance — from $17.50 to $24.00 per mile. Marfa EMS will also up its charge for disposable medical materials by $100, amounting to $450 for advanced life support and $350 for basic life support cases. 

Lagarde said that the changes will primarily impact how their billing company charges Medicare, Medicaid and private insurance for services rendered to patients. However, those not fully covered by insurance or paying out of pocket will be directly impacted by the increased costs. 

City Manager Mandy Roane said Marfa EMS saw very few self-pay customers, with most patients utilizing some form of medical insurance. 

“This is what’s going through Medicare, Medicaid and private insurance,” said Roane. “We’re just asking to raise the rates to what Emergicon is suggesting.” 

Councilmember Eddie Pallarez said he thought that the increases were reasonable considering how long it had been since fees were updated. Other council members agreed, and ultimately voted to approve the increases.  

Council members decided to continue the city’s policy of not charging for “treat, no transport,” situations where Marfa EMS is called to a home to assess a patient but does not end up transporting them to the hospital. 

Lagarde said considering Marfa EMS customers are often elderly, on fixed income, or from out of town, he preferred to evaluate patients at no cost and recommended they take their own vehicle to the hospital if appropriate in order to free up the ambulance for life threatening emergencies. 

“We would rather catch them actually having something happen and then transport them as opposed to going over there for a cut finger,” said Lagarde. 

Marfa EMS will also acquire a brand new $230,000 ambulance this month that is being grant-funded with the help of Big Bend Regional Hospital District, the City of Marfa, Presidio County, and the area regional advisory council that helps support trauma care systems. 

In a follow up interview with The Big Bend Sentinel, Lagarde said the new ambulance will be outfitted with UV light technology that will allow for ambulances to be easily sterilized as well as improved seat belts so EMTs and paramedics have the flexibility to care for patients while in motion — features lacking in the old ambulance.

Council members voted to declare the old ambulance, a 2001 Dodge with an obsolete patient care compartment, according to Lagarde, surplus and will soon put it up for sale. 

“We just want to get it declared [surplus] so we can move it out of the way so when it’s time for the shiny new ambulance to show up, it will have a home,” said Roane.