The Commission on Accreditation of Ambulance Services (CAAS) today announced an updated application fee structure that will take effect on January 1, 2026. This adjustment marks the first fee change since CAAS was founded in 1992 and reflects the organization’s continued commitment to setting the national standard for ambulance service accreditation.
To better align with today’s EMS environment and ensure equitable costs across a broader range of agency sizes, CAAS will transition from its current three-tiered fee model to a more scalable five-tiered fee structure based on annual transport volume:
| Annual Transport Volume | Current Application Submission Fee | New Application Submission Fee (Effective Jan 1, 2026) |
| Tier 1: 1 – 4,999 transports | $3,500 | $3,750 |
| Tier 2: 5,000 – 19,999 | $7,500 | $8,250 |
| Tier 3: 20,000 – 49,999 | $10,000 | $11,000 |
| Tier 4: 50,000 – 99,999 | $10,000 | $12,000 |
| Tier 5: 100,000+ | $10,000 | $13,000 |
For agencies in Tier 1 and Tier 2, the minimum deposit for anticipated Reviewer site visit fees will increase from $5,000 to $6,000. For agencies in Tier 3, Tier 4, or Tier 5, the minimum deposit will increase from $6,000 to $8,000. These increases better align with increased travel costs and Reviewer Honorarium.
The new fee structure will apply to both new and reaccrediting agencies submitting under CAAS Standards Version 4.0. It will be required for any agency whose accreditation expires on or after July 31, 2026, and therefore has a submission deadline of January 31, 2026 or later.
Why Now?
For over three decades, CAAS has maintained a consistent fee structure while expanding its services, technology systems, and standards development processes. With the upcoming implementation of CAAS Standards Version 4.0, the organization is introducing a comprehensive, modernized framework that reflects advances in EMS operations, technology, safety, and community needs.
“This fee update ensures we can continue to provide best-in-class accreditation services while adapting to the evolving EMS landscape,” said CAAS Board Chair Troy Hagen. “Our goal is to remain accessible and responsive to agencies of all sizes while upholding the highest standards of patient care and organizational excellence.”
Looking Ahead
Offering the only ANSI-accredited standards for emergency medical transportation services in North America, CAAS remains committed to transparency, quality, and continuous improvement. The new application fees support these goals by enabling CAAS to:
- Expand reviewer training and quality assurance processes
- Increase reviewer honorariums
- Invest in tools to streamline application and review workflows
- Support education and outreach related to Standards Version 4.0
- Maintain affordability for smaller agencies while aligning costs with service scale
About CAAS: The Commission on Accreditation of Ambulance Services (CAAS) is an independent accrediting agency dedicated to establishing, promoting, and verifying compliance with the highest standards for ambulance services and medical response systems. CAAS aims to benefit the public by ensuring quality mobile patient care through the development and support of EMS organizations in adhering to essential, consensus-driven standards.
About ANSI: The American National Standards Institute (ANSI) is a private, nonprofit organization that oversees the creation, promulgation, and use of thousands of standards and guidelines across a wide range of industries in the United States. ANSI facilitates voluntary consensus standards to enhance product quality, safety, and interoperability, while also ensuring that U.S. standards are globally recognized.