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COVID-19 posed numerous issues for ambulance service companies. As COVID-19 increased the need for emergency ambulance services, operating expenses climbed due to increased safety precautions and salary pressures, lowering profits.

Meanwhile, the suspension of non-emergency procedures reduced service volume, resulting in a loss in revenue for that segment. These effects emphasized the potential benefits of industry-wide reorganization, better cost management, and more government backing.

Fortunately, despite the hurdles, industry-wide revenue has increased at a 1.3% CAGR over the last five years. It is predicted to reach $21.2 billion in 2024, with sales increasing by an estimated 1.3%.

Top 8 Biggest Ambulance Services in the US - 2024 Report
Top 8 Biggest Ambulance Services In The US Today

How many enterprises will exist in the Ambulance Services industry in the United States today?

There are 24,713 Ambulance Services enterprises in the United States as of 2023, a 0.1% decrease from 2022.

Has the number of Ambulance Service businesses in the United States increased or decreased over the last five years?

The number of enterprises in the Ambulance Services industry in the United States has been stable over the five years from 2018 to 2023.

Which states have the most Ambulance Service businesses in the United States?

The states having the most Ambulance Services businesses in the US are Texas (3,029 businesses), Pennsylvania (2,400 businesses), and California (2,166 businesses).

Top 8 Biggest Ambulance Services In The US Today

1. MTM

Revenue range: $500 million to $1 billion USD

For over 25 years, MTM has worked with our clients to realize our ultimate goal: barrier-free communities. From statewide non-emergency medical transportation (NEMT) brokerage to scheduling and dispatching for major transit agencies, our services are designed to improve health outcomes while aligning with client goals, lowering program costs, and boosting satisfaction.

MTM, founded in 1995, is a privately held, woman-owned firm.

2. Rural/Metro Corp.

Revenue: 80 million USD

Rural Metro Corp, founded in 1948, is an American private nearby gathering of firemen that provides fire protection and emergency clinical benefits to specific home loan holders and business associations in unincorporated areas across the United States, primarily through an enrollment-based model. Rural Metro is also contracted by municipalities and fire departments to provide fire safety, evasion, and emergency medical services.

Lou Witzeman, a journalist, discovered the connection in 1948, and subsequently witnessed a home fire in front of his house just outside Phoenix, Arizona. There was no local assembly of firefighters set up for space. So, feeling compelled to act, Witzeman acquired a fire engine and went door to door, informing residents that they would be bound by the new fire organization by paying a yearly enlistment fee (in lieu of responsibilities).

3. American Medical Response

Top 8 Biggest Ambulance Services in the US - 2024 Report

American Medical Response has 29,000 employees, with a revenue per employee ratio of $29,655. American Medical Response's greatest sales was $860.0 million in 2023.

American Medical Response is a clinical transportation organization in the United States that provides and operates local clinical transportation services, including crisis, non-crisis, and supervised transportation, fixed-wing air rescue vehicle, and disaster response. In 1991, Paul Verrochi devised a marketable approach to standardize the sectioned emergency vehicle business, using a similar "packaging" methodology used by executives.

The association was formed by the merger of Region Ambulance (California, Contra Costa, and Alameda), Vanguard Ambulance (California, Santa Clara County), and Buck Ambulance (Oregon, Portland). Laidlaw acquired American Medical Response in 1997 after previously acquiring MedTrans, a San Diego-based great EMS supplier that operates in California, Washington, Nevada, and Texas. Prior to acquiring AMR, Laidlaw acquired 138 separate firms and increased its revenue to more than $1 billion.

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4. Air Evac EMS Inc.

Top 8 Biggest Ambulance Services in the US - 2024 Report

Annual revenue: $881.5 million

Employees: 2,332

Air Evac EMS, Inc., formerly known as Air Evac Lifeteam (now simply Air Evac), is the most significant organization within Air Medical Group Holdings (AMGH). Air Evac is the largest freely owned and operated HEMS (Helicopter Emergency Medical Service), or air rescue vehicle operator. Air Evac currently operates helicopters from 131 locations, which cover the vast majority of the center and southern half, the Service zone. While they are primarily a HEMS supplier, they also operate two fixed-wing airplanes in Missouri and Kentucky. The central command, dispatch (CenComm), and a few other offices were relocated to O'Fallon, Missouri, in 2013, from its original location in West Plains.

5. Rural/Metro Corporation

Revenue: 80 million USD

Rural/Metro Corporation is a major provider of wellness and security services in the United States. The company is a unique crisis management organization that provides "911" emergency vehicle and general vehicle administrations, fire security and preparation administrations, and other health and medical care-related administrations and hardware to metropolitan, private, business, and mechanical clients.

The firm is one of the few multi-state providers of emergency vehicle and fire assurance services in the United States. It is one of the largest private-area providers of emergency vehicle and fire insurance administrations in the world, covering over 450 networks in 26 states and the District of Columbia.

6. Acadia Ambulance Service Inc

Revenue: $55.0 million

Acadian Ambulance is a private representative claimed rescue vehicle administration that covers the majority of one state in Tennessee and Mississippi, as well as a substantial amount of Louisiana and Texas. In 1995, it was regarded as the largest exclusive emergency vehicle administration in the United States. Today, the group responds to both crisis and non-crisis situations across Louisiana.

Southeast, Central, and Northern Texas; Jackson County, Mississippi; Memphis, Tennessee. Aside from crisis clinical benefits, Acadian provides airplane contract management, individual clinical alarm administration, thief and alarm administration, mechanical clinical personnel, fire and security specialists, clinical and current training, and charging programs.

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7. National EMS Service

Top 8 Biggest Ambulance Services in the US - 2024 Report

Revenue: $36.2 million per year

In the United States, crisis clinical benefits (EMS) provide out-of-clinic intensive clinical consideration and transportation to complete review for those in need. They are governed at the most fundamental level by the National Highway Traffic Safety Administration, which establishes the fundamental principles that all EMS providers in each state must adhere to, and more stringently by individual state governments, which frequently demand higher standards from the administrations they regulate.

Significant differences in population density, geology, and other variables can necessitate the use of different EMS frameworks; as a result, there is a wide range of Emergency Medical Services provided in one state vs another.

8. Air Methods Corporation

Revenue: $1.2 billion

Air Methods Corporation is an American helicopter administrator. The clinical air division provides crisis clinical advantages to around 70,000 to 100,000 patients on a constant basis. It operates in 48 states and Haiti, using air clinical as its primary business center.

Its corporate headquarters are located in the Denver Technological Center in Greenwood Village, Colorado, inside the Denver metropolitan area. Roy Morgan founded the organization, which began conducting air clinical activities in 1980. From 1991 to 2017, the company was traded on the open market under the NASDAQ ticker "AIRM." In 2017, it was acquired by a private value firm. Sundance Helicopters, the organization's first helicopter visit activity, was completed in Las Vegas, Nevada in 2012.


Ambulances are easily accessible vehicles that serve as best buddies in critical situations. Ambulances in the United States, like those in other nations, respond to a variety of situations and are always attentive in times of danger.

The Ambulance Services industry in the United States is labor-intensive, which indicates that enterprises rely on labor rather than capital. Wages (46.4%), Purchases (8%), and Rent & Utilities (1.8%) are the three greatest costs for businesses in the Ambulance Services industry in the United States in terms of revenue.

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