How Ambulance Fees Are Determined by Law in Turkey

One of the most common misconceptions about private ambulance services in Turkey is that operators can charge whatever they want. In fact, Article 27 of the 2025 Ambulance Regulation establishes a strict legal framework for ambulance fee determination. 1

The Provincial Fee Commission (Article 27)

Article 27 of the regulation requires that, in each province, a Fee Determination Commission be set up to determine the fees private ambulance services may charge. The commission operates under the Provincial Health Directorate. 1

Commission Membership

Under Article 27, the commission convenes under the chairmanship of the Provincial Health Director and is composed of the following representatives: 1

• The director responsible for emergency health services
• One representative appointed by the Provincial Police Directorate
• One representative appointed by the Provincial Directorate of Industry and Technology
• One representative appointed by the Provincial Directorate of Trade
• One representative appointed by the Municipal Authority
• One representative appointed by the Chamber of Physicians
• One representative each from the ambulance services and private health institutions providing ambulance services, as designated by the Directorate

This plural structure ensures the price-setting process does not rest on the perspective of a single party.

How the Commission Sets Prices

When determining fees, the commission evaluates several criteria listed in the regulation simultaneously: 1

1. Cost Analysis

The real costs of the ambulance service are reviewed: fuel and vehicle maintenance, personnel salaries and insurance, medical equipment and consumables, and operating expenses (parking, office, insurance, etc.).

2. Price Indices

Inflation indicators such as the consumer price index (CPI) and producer price index (PPI) are taken into account, keeping fees aligned with economic conditions.

3. Local Conditions

Each province's own dynamics are considered: traffic density and geography, population density and hospital distribution, and the competitive environment among ambulance services.

4. Comparable Fees

Fees applied in other provinces of similar size are used as a benchmark, helping to prevent excessive price differences between provinces.

Minimum and Maximum Limits

Rather than a single fixed price, the commission sets a minimum (floor) and maximum (ceiling). 1 Private ambulance services may set their own prices as long as they stay within these limits:

• The floor price prevents service quality from being undercut. A minimum amount is set because very low prices can mean compromising on personnel and equipment quality.
• The ceiling price protects patients from excessive pricing. No service may charge above the maximum set by the commission.

City vs. Intercity Transfers

In practice, the commission determines separate tariffs for different service types. The main distinctions are: 1

City (Intra-provincial) Transfer

The tariff set for patient transfers within the same province. It usually consists of:

• Opening fee: A fixed starting amount applied when the ambulance is dispatched
• Distance fee: A variable amount calculated per kilometre
• Medical intervention fee: An additional item based on medical interventions performed during transport

Intercity Transfer

A different tariff applies to transfers that cross provincial boundaries. Because distance is more decisive in intercity transfers, the per-kilometre rate becomes more prominent. Highway, bridge, and tunnel tolls may also be added to the total cost.

Tariff by Ambulance Class

The regulation divides ambulances into classes, and the tariff may also vary with the class of the vehicle: 1

• Emergency ambulance: Its crew size and advanced equipment are reflected in the tariff.
• Patient transport ambulance: Operates with fewer crew and basic equipment.
• Intensive care ambulance: Its advanced monitoring and treatment equipment is reflected in the tariff.

All 7 Nova Ambulans vehicles are Emergency Ambulances (ALS, ICU-equipped) as standard; a doctor can accompany the patient on request.