How Intercity Patient Transport Works in Türkiye: Hospital Referral, Private Ambulance and SGK

Official Distances: Common Destinations from Istanbul

According to the General Directorate of Highways (KGM) inter-provincial distance table dated March 2026, road distances from Istanbul to selected provincial centres are 4:

These are official road distances between provincial centres; the actual route can be shorter or longer depending on bridges, motorways and ferries. Travel time depends on traffic, weather and the stop plan, so we do not quote a single figure; when you call, we give you an estimate for your route. Nova Ambulans transfers patients between any two provinces of Türkiye, even when neither end is Istanbul.

What Can Happen on the Road? Why the Numbers Call for a Plan

Even short transfers carry risk. A 2026 study of 72 interhospital ambulance transfers from the emergency department of a Canadian university hospital found that 86.1% were for specialised treatment, the mean transfer time was 64.8 minutes, and 37 adverse events were recorded across the 57 transfers with complete data; relative to those 57 transfers, 49.1% were clinical, 12.3% logistical and 3.5% technical events 7. If that is the picture for journeys of about an hour, preparation cannot be left until the day of a five-to-ten-hour intercity transfer.

Turkish data also show how dominant road transport is. In a 2026 study by researchers from the Ministry of Health's General Directorate of Emergency Health Services and university hospitals, covering 313 children transferred across Türkiye for chest trauma, 98.1% of transfers were by road and 82.7% within the same province 8. Out-of-province transfers are rarer, but they are longer and need more planning.

The family's experience is a topic of its own. A 2025 US focus-group study with 39 participants from 13 hospitals listed communication with patients and families, and involving them in decisions, first among four core problems in interhospital transfers 10. That is why our crew explains the stops, the arrival time and the handover sequence to the accompanying relative before departure.

Does SGK Pay for Intercity Patient Transport?

SGK, Türkiye's Social Security Institution, treats an ambulance as a "non-standard vehicle" in its travel-cost rules and attaches conditions to reimbursement 3:

• The referral must be medical and compulsory. The patient must be referred to a facility outside their place of residence for reasons such as the lack of treatment equipment or of the relevant specialist.
• A report is needed. The referring facility issues a health board report stating the illness, why the patient cannot travel by the usual (standard) vehicle, and the vehicle type. The report covers a single outbound trip; the return needs a separate report.
• In an emergency, a signed note can be enough. For a patient referred without a report, travel costs are paid if the physician at the referring facility documents the medical reasons for the emergency transfer in a signed note and SGK accepts it.
• In-city transfers are excluded. In SGK's words: "travel costs and daily allowances are not paid for transfers within the place of residence." 3

A transfer the family arranges by choice, without a medically compulsory referral, does not meet these conditions, and the family pays. Ask the provincial SGK office or the referring hospital about reimbursement before the transfer. Private health insurance cover depends on the policy. For more detail, see our article on whether SGK covers a private ambulance.

How Is the Price Set?

Ambulance fees in Türkiye are not unregulated. Under Article 27 of the regulation, a commission chaired by the provincial health director meets by the end of February each year to set minimum and maximum fees, taking into account "in-city and out-of-city ambulance fees, the opening fee and distances" 1. For an intercity transfer the main price drivers are distance, crew configuration (whether a physician travels) and waiting time. The logic is explained in our intercity pricing article and current rates are on our pricing page; the price is shared in writing at the first call.

When Does an Air Ambulance Come In?

Public helicopter and aircraft ambulances are not something a family calls; they are tasked within the referral system on clinical and geographic grounds, while a private air ambulance is a paid option that depends on a physician's approval. A 2026 national registry study of 543 patients with infectious diseases carried by helicopter ambulance found that 27.1% were transferred between provinces; the median flight time was 115 minutes for out-of-province flights and 57 minutes within a province 9. The authors stress that air ambulance use is driven not only by distance but also by the need for advanced treatment. The full comparison is in our article on air versus ground ambulances.

Documents to Prepare

• Discharge summary (epikriz) and the physician's note on the transfer
• Medication list, doses and the time of the last dose
• Recent test results and imaging (CD or an e-Nabız printout)
• ID, SGK or private insurance details; the health board report if you will claim reimbursement
• Acceptance confirmation from the destination hospital, or contact details of the person taking over care at home
• Personal medications, incontinence pads and a change of clothes for the journey

Older, Paediatric and Device-Dependent Patients

In older patients staying in one position for hours raises the risk of pressure sores; repositioning is planned at the stops, and for patients with dementia a familiar relative in the front cab reduces agitation. For children, age-appropriate equipment and feeding times are agreed in advance. For patients on a ventilator, oxygen concentrator or infusion pump, battery and oxygen capacity is calculated to cover the whole journey; we recommend requesting a physician for these patients. If the patient develops chest pain, breathlessness or a change in consciousness during the journey, the crew intervenes; if needed, the ambulance stops at a safe point or heads to the nearest hospital on the route.

Example Scenario: A Discharge Transfer from Trabzon to Kadıköy

This scenario is fictional; it combines situations we see often and does not describe a real patient.

A 78-year-old mother is about to be discharged in Trabzon after hip-fracture surgery, and her daughter wants to bring her to her home in Kadıköy, Istanbul. This is not a hospital referral but a family-arranged transfer. The daughter gets a fitness-to-travel note and the discharge summary from the ward physician. According to the General Directorate of Highways (KGM) table, the distance between the two provincial centres is 1,057 km 4; with the UK Intensive Care Society (ICS) three-to-four-hour threshold long exceeded, stops, painkiller times and repositioning are planned before departure 6. The transfer date is set once a hospital bed and a carer are ready at home. Because the patient does not use oxygen and is stable, a standard crew is enough; the family can add a physician if they wish. SGK reimbursement is not expected here, because the transfer is the family's choice rather than a medically compulsory referral 3.

Intercity Transfers with Nova Ambulans

For a transfer of more than a thousand kilometres, such as this Trabzon discharge, on the first call we ask whether the patient is bedbound, about oxygen and device needs, the address and floor details at both ends and whether the destination hospital has accepted the patient; from that we work out the crew, the stop plan and a written price. Call 0216 339 00 39 or send the patient's discharge summary to our WhatsApp line, 0549 461 34 00. Service details are on our intercity patient transport page.

Our operations system records more than 10,500 patient transfers since March 2022 and more than 1,600 interhospital transfers since 2025; at least 26 provinces appear in our Istanbul-linked transfer records. Source: transfer and job counts come from our operations system and Ministry of Health Emergency Health Automation System (ASOS) records (March 2022 – October 2026); cancelled jobs and cases passed to other providers are excluded, figures are rounded down, and the province count is a lower bound. Data as of October 23, 2026. How we calculate our figures

This article was reviewed by the Nova Ambulans Medical Board.