CAAS and CAMTS both accredit ground ambulance services, and both publish fee schedules. This page sets scope and published fees side by side, shows how each fee is built, and works arithmetic for stated example fleets. The figures come from each body's own pages, opened October 3, 2026, and nothing here recommends one body over the other.
Last reviewed: October 2026.
What each body accredits for this program
The Commission on Accreditation of Ambulance Services (CAAS) accredits ambulance systems regardless of who owns them. Its Standards Version 4.0 has 147 standards, and accredited status runs three years (CAAS FAQ and home page, pages opened October 3, 2026). Specialty Care Transport is its own section of Version 4.0, which a service moving high-acuity patients from one facility to another would read on top of the base sections (CAAS Version 4.0 standard summaries, page opened October 3, 2026).
The Commission on Accreditation of Medical Transport Systems (CAMTS) uses its Medical Transport Accreditation Standards, 12th Edition (2022), for helicopter, airplane and ground programs. A ground service files under the ground application, which names BLS, ALS and critical care. Special operations, mobile integrated healthcare and medical escort each have their own standards (CAMTS standards and CAMTS apply page, pages opened October 3, 2026). Its open drafts page (opened October 3, 2026) targets January 1, 2027 for a 13th Edition, dates subject to change.
Side by side
| Item | CAAS | CAMTS |
|---|---|---|
| Who it covers | Ambulance systems, whoever owns them | Air medical, ground and other surface transport, with escort and special operations under separate standards |
| Standards in use | Version 4.0 (ANSI/CAAS v4.0-2024), 147 standards | 12th Edition (2022), with a 13th Edition targeted for January 1, 2027 |
| Care levels named | Specialty Care Transport section within the standards | Ground application lists BLS, ALS and critical care |
| Process | Application and fee, off-site review, on-site review, Panel of Commissioners decision | Application and fee, online Program Information Form (PIF), site visit, Board decision |
| Time markers | On-site review within six months of application | Up to one year for the PIF, a site visit 4 to 6 weeks after it, and a Board that meets three times a year per the apply page (the FAQ says quarterly) |
| What the fee depends on | Annual transport volume | Vehicles in service, plus surveyor days |
| Standards price | $50 for Version 4.0, or $275 for the package that includes it (CAAS accreditation fees, and verify current fees with CAAS) | Free 12th Edition download that leaves out the index, glossary, quick reference, references and education matrix, plus a separate full edition |
The published fees in detail
CAAS
The CAAS fee page states a five-tier application fee by annual transport volume, effective January 1, 2026. It also states a minimum deposit toward reviewer fees and expenses. The last column adds the two as arithmetic on the published figures. It is not a bill, because the page states no final reviewer charge.
| Annual transports | Application fee | Minimum reviewer deposit | Application fee plus minimum deposit (arithmetic) |
|---|---|---|---|
| Tier 1: 1 to 4,999 | $3,750 | $6,000 | $9,750 |
| Tier 2: 5,000 to 19,999 | $8,250 | $6,000 | $14,250 |
| Tier 3: 20,000 to 49,999 | $11,000 | $8,000 | $19,000 |
| Tier 4: 50,000 to 99,999 | $12,000 | $8,000 | $20,000 |
| Tier 5: 100,000 or more | $13,000 | $8,000 | $21,000 |
The page also lists postponement penalties of $500 (written notice 60 or more days before the on-site review) and $1,000 (30 to 59 days), with none allowed inside 30 days. On withdrawal, the schedule returns a shrinking share of the application fee: 80 percent before the off-site review is complete, 20 percent after it, and 10 percent after the on-site review, each net of reviewer expenses incurred. The same page also lists a no-refund row for the period after the on-site review and before Panel review, and it does not say how that row sits beside the 10 percent row, so ask CAAS which applies. Source: CAAS accreditation fees, page opened October 3, 2026. Verify current fees with CAAS.
CAMTS
The CAMTS FAQ lists its fees as line items and states no effective date. The page metadata showed a last-published date of September 1, 2026. The application fee is $1,000. The site survey starts at a $6,500 base fee. An asset fee follows: $1,000 for each helicopter or airplane and $150 for each ambulance or other surface vehicle, boats included, that is in service, with back-up vehicles left out. Each surveyor adds $600 a day, and travel and expenses arrive as a bill after the visit. CAMTS decides how many surveyors come and for how many days, and a partial day on site is billed as a whole one. Source: CAMTS FAQ, page opened October 3, 2026, and CAMTS apply page, page opened October 3, 2026. Verify current fees with CAMTS.
How each fee is built
A CAAS fee follows transports per year. The deposit changes only between Tier 2 and Tier 3, and fleet size does not appear in the schedule.
A CAMTS fee follows the shape of the service. Vehicle count drives the asset fee. Several sites, long distances between them, more than one transport mode or specialty teams can add surveyor days beyond a normal one-site, two-day visit, and the FAQ says its criteria are not limited to those. Transport volume does not appear in the schedule.
Reading the schedule: arithmetic on the published figures
The assumptions below are chosen here for illustration. This is arithmetic on the published figures, not an estimate of any bill. The CAMTS figures come from the CAMTS FAQ, page opened October 3, 2026. Verify current fees with CAMTS.
| CAMTS example: ground-only service, 10 ambulances in service, one site | One surveyor, 2 days | Two surveyors, 2 days each |
|---|---|---|
| Application fee | $1,000 | $1,000 |
| Site survey base fee | $6,500 | $6,500 |
| Asset fee: 10 ambulances at $150 | $1,500 | $1,500 |
| Surveyor days at $600 each | $1,200 (1 x 2 days) | $2,400 (2 x 2 days) |
| Sum of published line items | $10,200 | $11,400 |
| Travel and expenses | Billed separately, no amount published | Billed separately, no amount published |
In the published CAMTS schedule, fleet size appears only in the asset line, at $150 per ambulance. CAMTS decides surveyor days and surveyors separately.
For CAAS, the example is one row of the tier table, set by transports whatever the fleet: a 10-ambulance service with 30,000 transports a year reads Tier 3, and one with 3,000 reads Tier 1.
What drives the choice
- Ground or air. A service that also flies falls within the CAMTS standards. A ground-only service falls within both, according to the pages opened.
- Level of care. CAAS addresses specialty care transport as a section of its standards, and CAMTS lists critical care on its ground application. A service with a mix of BLS, ALS and high-acuity work reads how each body treats that mix.
- Payer, state or contract language. A contract, bid or state rule that names an accreditor is the text to read first for that contract. CAMTS's FAQ lists contracts awarded only to CAMTS-accredited services as a reason to seek accreditation, and IHS has not reviewed any such contract.
- Fleet size and volume. Volume sets the CAAS fee. Vehicle count and surveyor days set the CAMTS fee. A large fleet with low volume, or the reverse, reads the two schedules differently.
Where the sources are silent
The pages opened state no CAMTS postponement or refund schedule for the site survey fee, no CAMTS reaccreditation fee and no final CAAS reviewer charge beyond the minimum deposit. They do not say which CAMTS edition applies to a PIF in progress on January 1, 2027, or that any payer requires either accreditation.
Where this fits
The CAAS ground ambulance accreditation page covers the CAAS standards, the process and what IHS drafts for it. The CAMTS medical transport accreditation page covers the CAMTS standards, the PIF and what IHS drafts for it. This page adds the side-by-side reading.
What this is not
This is not a quote of either fee page, not a statement of what a service will be billed, and not IHS pricing. IHS does not set or collect accreditor fees. IHS scopes each engagement after a free introductory call.
Frequently asked questions
Which accreditor is right for a ground ambulance service?
This page does not pick one. The deciding inputs sit outside the accreditors: what a payer, state or contract names, whether the service flies, and the level of care it delivers.
Do both bodies publish fee schedules?
Yes. CAAS publishes tiers by annual transport volume, and CAMTS publishes per-vehicle and per-surveyor-day fees in its FAQ. Verify current fees with CAAS and CAMTS.
Are the totals on this page what a service would be billed?
No. They are arithmetic on published figures for stated examples. CAMTS sets the surveyor days and surveyors and bills travel separately, and CAAS states only a minimum reviewer deposit. Only each body can state a bill.
Does CAMTS accredit ground-only services?
CAMTS lists a ground application for BLS, ALS and critical care services. Whether a particular service fits is a question for CAMTS.
Is the CAMTS application fee refundable?
The CAMTS FAQ calls the $1,000 application fee non-refundable. The pages opened state no postponement or refund schedule for the site survey fee, so ask CAMTS for its written policy.
What does IHS do on a ground ambulance accreditation?
IHS drafts administrative, personnel and quality documentation for your agency to review and submit. Clinical and field operations stay with your medical director and field leaders. IHS scopes each engagement after a free introductory call.