Ambulance and Light Sanitary Vehicle (LSV)

Verified 16 April 2021 - Directorate for Legal and Administrative Information (Prime Minister)

Any private health transport company must have a prefectural approval. It may sign an agreement with the primary sickness insurance fund. Transport fares can take several forms (fixed price, short trip valuation, fares per kilometer). The crew on board must meet certain conditions.

Specially equipped vehicle

The specially equipped vehicles are:

  • Category A vehicle: Emergency Ambulance and Emergency Care (ASSU)
  • Category B vehicle: Asphyxiated and injured rescue car (VSAB)
  • Category C vehicle: Ambulance

They are the only sanitary transport vehicles that can intervene for emergency transport.

The choice of mode of transport should be prescribed by the physician according to the condition of the patient: sitting or lying down, monitoring or administration of oxygen for example.

Approved vehicles shall contain the following elements:

  • Warnings and special lights
  • Regular cross with 6 branches blue
  • Trade name of sanitary transport activity
  • Name of the natural or legal person holding the authorization

Warning  

a roadworthiness test must be carried out 1 year after the first entry into service (or at the time of the change of use of the vehicle). It has to be renewed every year.

The crew on board an ambulance, an ASSU or a VSAB must meet certain conditions of qualification and professional competence:

Tableau - Obligations concerning the crew of a medical transport operation

Obligations

Ambulance and ASSU

Asphyxiated and Injured Rescue Car (VSAB)

Number of persons on board

2 (full-time)

Minimum 2

Qualification/Diploma

For at least one of the 2 persons on board:

- State Diploma of Paramedic (DEA)

- or Certificate of Paramedic Capability (CCA)

The other diplomas and qualifications required are:

- Diploma as a Paris fire brigade or Marseille fire brigade or firefighter holding training to ensure emergency missions to victims of accidents, disasters or disasters

- Ambulance driver

- Holder of the level 1 civic prevention and relief teaching unit or the health auxiliary card

- Diploma of a medical profession, auxiliary medical practitioner, nursing assistant, childcare attendant or dental assistant

At least 2 persons must hold one of the following diplomas or certifications:

- Ambulance driver

- Holder of the level 1 civic prevention and relief teaching unit or the health auxiliary card

- Diploma of a medical profession, auxiliary medical practitioner, nursing assistant, childcare attendant or dental assistant

At least one person must have one of the following degrees:

- State Diploma of Paramedic (DEA) or Certificate of Paramedic Capability (CCA)

- Diploma as a Paris fire brigade or Marseille fire brigade or firefighter holding training to ensure emergency missions to victims of accidents, disasters or disasters

Driving license

Driving license B with certificate issued by the prefect following a medical examination of physical fitness. The license must be more than 3 years old (2 years in case of early learning to drive).

Vaccines required

Hepatitis B, diphtheria, tetanus, poliomyelitis

Professional outfit

Activity-specific outfits and changes consisting of white and/or blue trousers, blouses and jackets.

The wearing of the outfit is forbidden outside the activity.

Warning  

an ambulance driver should only drive ambulances (no VSL).

The crew must follow safety instructions. For example:

  • Ease of passage: use special warning devices (lights and sirens) in emergency situations
  • Priority: Specific Warnings
  • Number of persons carried: not to exceed the number of seating positions

The sanitary transport company must send the list of their personnel who are part of the crew of their sanitary transport vehicles to the Regional Health Agency (ARS) each year.

When the company hires a new employee or changes cars, it must immediately inform the LRA.

In order to carry out its health transport activity, the company must:

  • It must seek approval from the LRA territorial delegation (DTARS: titleContent). This must be done at least 2 months before the plan to create or take over a sanitary transport company
  • They have to register with theUrssaf: titleContent.
  • Once the authorization has been granted, it must register in the commercial and business register and transmit the extract Kbis to the DTARS: titleContent.

The application shall include details of medical facilities, personnel, physical facilities and the company applying for approval.

Company Information

The company must include in its application:

  • Name, address, trade name used, and a criminal record extract of the person responsible
  • If it is an association or a business, its statutes
  • Address and telephone number of each location of the land health transport activity
Vehicle information to be attached

The company must include the following information with its application for registration:

  • Carte grise Duplex photocopy of certificate of registration) and the certificate of conformity to the minimum standards drawn up by the manufacturer or the body builder
  • For vehicles hired, photocopy of the lease
  • List of on-board equipment conforming to the minimum standards and their approval number if available

FYI  

approval shall be granted only to vehicles authorized for placing in service. It is allocated on the basis of priorities (such as the needs of the population and local competition).

Crew information to be attached

The company must include the following information with its application for registration:

  • List of the names of persons crewing medical vehicles and their qualifications
  • Double-sided copy of driving licenses and required diplomas
Physical Facilities Information to Attach

The company must include the following information with its application for registration:

  • Address of the premises used for the health transport activity and its use
  • Declaration on honor attesting that these installations are in conformity with the required standards

FYI  

lack of response fromARS: titleContent if an application for approval is made for a period of four months, the application shall be rejected.

A company carrying out medical transport may sign an agreement with the primary sickness insurance fund. This agreement lays down the rates and the conditions for taking over. Without this prior agreement, no reimbursement to the insured person or waiver of advance payment of costs may be made.

The primary health insurance fund sends its agreement to the health carriers that depend on it geographically. The health carrier has one month to send its reply in writing to the primary health insurance fund. If he decides to sign the agreement, he must send an additional Urssaf certificate which indicates that it is up to date with the payment of its employee and employer contributions.

Failure to reply within 1 month shall be deemed to constitute a refusal to accede to the Convention.

In order to keep the agreement, the company must send the Urssaf's certificate each year during the second quarter.

It is also possible to stop accession. In the event of a change of situation, a period of 1 month is necessary to amend the accession to the Convention.

The trader can see all the information about his activity on his Ameli account.

Enhanced account for healthcare professionals

Rates

Health transport charges exist in several forms: flat-rate, short-haul pricing, kilometer rates.

Tableau - Conventional sanitary transport fares (in effect in 2021)

Ambulance

Departmental Package

€51.30

Agglomeration package

€57.37

Support

€64.30

Mileage rate

€2.19

Short trip valuation

≤ 5 km driven

€7

Short trip valuation

> 5 km and ≤ 10 km traveled

€5.50

Short trip valuation

> 10 km and ≤ 15 km traveled

€4

Short trip valuation

> 15 km and ≤ 19 km traveled

€2.50

The kilometric rate is based on the distance between the departure and the place of arrival, less the first 3 km included in the departmental package (or from 1er km traveled in case of billing of the support).

In the departmental package, the fare applicable to each sanitary transport company (ETS) is that of the department where the company is located, including when traveling to another department.

The billing can be made as a direct payment by the patient or as a paying third party. The reimbursement of costs by the Health Insurance may be carried out in part or at 100%.

Support

Support cannot be invoiced by companies only in certain municipalities in the Paris region.

Répondez aux questions successives et les réponses s’afficheront automatiquement

Paris (75), Val-de-Marne (94), Seine-St-Denis (93), Hauts-de-Seine (92)

Companies in all these departments and for transport in these areas are billable for the cost.

Essonne (91)

Companies in certain communes of this department and for transport in these communes may be charged for the cost.

The municipalities concerned are:

  • Beers
  • Bures-sur-Yvette
  • Igny
  • Gif-sur-Yvette
  • Marcoussis
  • Nozay
  • Orsay
  • Palaiseau
  • Saclay
  • Saint-Aubin
  • Villebon-sur-Yvette
  • Verrières-le-Buisson
  • Villejust
  • Villiers-le-Bâcle
  • Vauhallan
  • Athis-Mons
  • Ballainvilliers
  • Champlane
  • Chilly-Mazarin
  • Épinay-sur-Orge
  • Juvisy-sur-Orge
  • Longjumeau
  • Massy
  • Morangis
  • Paray-Vieille-Poste
  • Savigny-sur-Orge
  • Saulx-les-Chartreux
  • Wissous
  • Boussy-Saint-Antoine
  • Brunoy
  • Crosne
  • Draveil
  • Épinay-sous-Sénart
  • Quincy-sous-Sénart
  • Montgeron
  • Vigneux-sur-Seine
  • Varennes-Jarcy
  • Yerres

Val d'Oise (95)

Companies in certain communes of this department and for transport in these communes may be charged for the cost.

The municipalities concerned are:

  • Argenteuil
  • Beauchamp
  • Bezons
  • Cormeilles
  • Franconville
  • The Cargo
  • Herblay
  • Montigny
  • Sannois
  • Andilly
  • Puffemont
  • Mourning
  • Domont
  • Water
  • Enghien
  • Ermont
  • Groslay
  • Margency
  • Montlignon
  • Montmagny
  • Montmorency
  • Piscop
  • Le Plessis-Bouchard
  • Saint-Brice
  • Saint-Gratien
  • Saint-Leu
  • Saint-Prix
  • Be-sous-Montmorency
  • Taverny
  • Arnoville-lès-Gonesse
  • Bonneuil-en-France
  • Bouqueval
  • Look
  • Ezanville
  • Garges-lès-Gonesse
  • Kindness
  • Goussainville
  • Le Thillay
  • Teals
  • Villiers-le-Bel

Yvelines (78)

Companies in certain communes of this department and for transport in these communes may be charged for the cost.

The municipalities concerned are:

  • Bois-d'Arcy
  • Bougival
  • Buc
  • La Elle-Saint-Cloud
  • Chesnay
  • Fontenay le Fleury
  • Guyancourt
  • Jouy-en-Josas
  • Les Loges-en-Josas
  • Louveciennes
  • Montigny-le-Bretonneux
  • Rocquencourt
  • Saint-Cyr-l'Ecole
  • Vélizy-Villacoublay
  • Versailles
  • Viroflay
  • Careers-sur-Seine
  • Chatou
  • Croissy-sur-Seine
  • L'Étang-la-Ville
  • Coal
  • Maisons-Lafitte
  • Mareil-Marly
  • Marly the King
  • Mesnil-le-Roi
  • Montesson
  • The Pecq
  • Port-Marly
  • Saint Germain en Laye
  • SarTrouville
  • Le Vésinet
  • Achères
  • Andréy
  • Careers-sous-Poissy
  • Chambourcy
  • Chanteloup-les-Vignes
  • Conflans-Sainte-Honorine
  • Twisted
  • Malpractice
  • Horse
  • Poissy

FYI  

the kilometers covered by the charge are charged from 1er km under load.

Surcharge

Surcharges are available at night, on Sundays and on public holidays.

Répondez aux questions successives et les réponses s’afficheront automatiquement

Night surcharge

Between 8pm and 8am, the rates are increased to 50%.

More than half of the trip must have been made within that time in order for the surcharge to apply.

Sunday and holiday surcharge

Between 8am and 8pm, the rates are increased to 25%.

Between 8pm and 8am, the opening hours shall be increased to 50%.

Supplement

A supplement may be requested for patients who are transported to the following locations:

  • Airport
  • Port
  • Station for boarding an aircraft, boat or train

It may also be asked whether the patient is taken care of when he or she descends from an airplane, boat or train.

FYI  

the night, sunday and holiday surcharges do not apply to this supplement.

Toll charges

These fees are charged in addition for the laden journey. However, they have to be justified.

FYI  

Approved HTAs must participate in the departmental guard, the period during which they are required to provide the transport requested by the Samu (Saturday, Sunday, public holidays, night from 8 pm to 8 am). There is a child care allowance and a specific fee.

Light Sanitary Vehicle (LSV)

These are vehicles used for ground sanitary transport other than specially adapted vehicles.

The VSL is reserved for sanitary transport of up to 3 patients in a seated position.

It can be used for transporting labile blood products (products derived from donor blood, intended to be transfused to a patient). It can also transport a patient and the labile blood products intended for him at the same time.

The choice of mode of transport should be prescribed by the physician according to the condition of the patient: sitting or lying down, monitoring or administration of oxygen for example.

Approved vehicles shall contain the following elements:

  • Warnings and special lights
  • Regular cross with 6 branches blue
  • Trade name of sanitary transport activity
  • Name of the natural or legal person holding the authorization

Warning  

a roadworthiness test must be carried out 1 year after the first entry into service (or at the time of the change of use of the vehicle). It has to be renewed every year.

The crew on board a VSL must meet certain conditions of qualification and professional competence.

A VSL shall carry at least one person on board who shall hold one of the following diplomas or qualifications:

  • State Diploma of Paramedic (DEA) or Certificate of Paramedic Capability (CCA)
  • Holder of Level 1 Civic Prevention and Relief Teaching Unit or Health Aid Card
  • Diploma in a medical profession, as a medical assistant, as a carer, as a childcare assistant or as a dental assistant

At least the crew members must also hold a B driving license with a certificate issued by the prefect following a medical examination of physical fitness. His license must be more than 3 years old (2 years for those who have taken an early learning of driving).

It should be vaccinated against the following diseases:

  • Hepatitis B
  • Diphtheria
  • Tetanus
  • Poliomyelitis

They must also wear clothing and have activity-specific changes consisting of white and/or blue trousers, blouses and jackets. The wearing of the outfit is forbidden outside the activity.

FYI  

an ambulance driver cannot drive a VSL.

The crew must follow safety instructions. For example:

  • Ease of passage: use special warning devices (lights and sirens) in emergency situations
  • Priority: Specific Warnings
  • Number of persons carried: not to exceed the number of seating positions

The sanitary transport company must send the list of their personnel who are part of the crew of their sanitary transport vehicles to the Regional Health Agency (ARS) each year. When the company hires a new employee or changes cars, it must immediately inform the LRA.

In order to carry out its health transport activity, the company must:

  • It must seek approval from the LRA territorial delegation (DTARS: titleContent). This must be done at least 2 months before the plan to create or take over a sanitary transport company.
  • They have to register with theUrssaf: titleContent.
  • Once the authorization has been granted, it must register in the commercial and business register and transmit the extract Kbis to the DTARS: titleContent.

The application shall include details of medical facilities, personnel, physical facilities and the company applying for approval.

Company Information

The company must include in its application:

  • The person's name, address, trade name used, and a criminal record extract of the person responsible
  • If it is an association or a business, its statutes
  • Address and telephone number of each location of the land health transport activity
Vehicle information to be attached

The company must include the following information with its application for registration:

  • Double-sided photocopy of the certificate of registration and the certificate of compliance with the minimum standards drawn up by the manufacturer or the body builder
  • For vehicles hired, photocopy of the lease
  • List of on-board equipment conforming to the minimum standards and their approval number if available

FYI  

approval shall be granted only to vehicles which have an authorization for placing in service granted on the basis of priorities (in particular the needs of the population and local competition).

Crew information to be attached

The company must include the following information with its application for registration:

  • List of the names of persons crewing medical vehicles and their qualifications
  • Double-sided copy of driving licenses and required diplomas
Physical Facilities Information to Attach

The company must include the following information with its application for registration:

  • Address of the premises used for the health transport activity and its use
  • Declaration on honor attesting that these installations are in conformity with the required standards

FYI  

lack of response fromARS: titleContent if an application for approval is made for a period of four months, the application shall be rejected.

A company carrying out medical transport may sign an agreement with the primary sickness insurance fund. This agreement lays down the rates and the conditions for taking over. Without this prior agreement, no reimbursement to the insured person or waiver of advance payment of costs may be made.

The caisse sends its agreement to the health carriers that depend on it geographically. The health carrier has one month to send its reply in writing to the cash register. If he decides to sign the agreement, he must send an additional Urssaf certificate which indicates that it is up to date with the payment of its employee and employer contributions.

Failure to reply within 1 month shall be deemed to constitute a refusal to accede to the Convention.

In order to keep the agreement, the company must send the Urssaf's certificate each year during the second quarter.

It is also possible to stop accession. In the event of a change of situation, a period of 1 month is necessary to amend the accession to the Convention.

The trader can see all the information about his activity on his Ameli account.

Enhanced account for healthcare professionals

Rates

Pricing for health transport comes in several forms: fixed price (variable according to the area), short-trip pricing, price per kilometer.

Tableau - Composition of zones A, B, C, D

Zones

Departments

A

  • Paris
  • Yvelines
  • Essonne
  • Hauts-de-Seine
  • Seine-Saint-Denis
  • Val-de-Marne
  • Val d'Oise

B

  • Alpes de Haute-Provence
  • Alpes-Maritimes
  • Ariege
  • Lower Rhine
  • Bouches-du-Rhône
  • South Corsica
  • Gironde
  • Upper Corsica
  • Haute-Garonne
  • Haute-Savoie
  • Hautes-Alpes
  • Hautes-Pyrénées
  • Isère
  • Loire
  • Loire-Atlantique
  • Nord, Pas-de-Calais
  • Pyrenees-Orientales
  • Rhone
  • Savoy
  • Seine-Maritime
  • Seine-et-Marne
  • Var
  • Martinique
  • Guiana
  • Meeting
  • Guadeloupe

C

  • Ain
  • Ardèche
  • Blade
  • Aveyron
  • Calvados
  • Cantal
  • Charente
  • Charente-Maritime
  • Corrèze
  • Côte d'Or
  • Hollow
  • Doubs
  • Drôme
  • Finistère
  • Guarded
  • Haut-Rhin
  • Haute-Loire
  • Haute-Vienne
  • Herault
  • Ile-et-Vilaine
  • Indre-et-Loire
  • Jura
  • Loiret
  • Lozère
  • Maine and Loire
  • Marne
  • Meurthe-et-Moselle
  • Morbihan
  • Moselle
  • Puy-de-Dôme
  • Pyrenees-Atlantiques
  • Sarthe
  • Sum
  • Vaucluse

D

  • Aisne
  • Ally
  • Ardennes
  • Aude
  • Expensive
  • Côtes-d'Armor
  • Deux-Sèvres
  • Dordogne
  • Eure
  • Eure-et-Loir
  • Gers
  • Haute-Marne
  • Haute-Saône
  • Indre
  • Moors
  • Loir-et-Cher
  • Batch
  • Lot and Garonne
  • Handle
  • Mayenne
  • Meuse
  • Nièvre
  • Oise
  • Ornate
  • Saône-et-Loire
  • Tarn
  • Tarn and Garonne
  • Belfort Territory
  • Vendée
  • Vienna
  • Vosges
  • Yonne
Tableau - Conventional sanitary transport fares (in effect in 2021)

VSL

Departmental Package

Zone A: €13.85

Zone B: €13.45

Area C: €12.60

Area D: €11.97

Support

€15.58

Mileage rate

€0.89

Short trip valuation

≤ 7 km driven

€6.26

Short trip valuation

> 7 and ≤ 8 km traveled

€6.05

Short trip valuation

> 8 and ≤ 9 km traveled

€5.53

Short trip valuation

> 9 and ≤ 10 km traveled

€5

Short trip valuation

> 10 km and ≤ 11 km traveled

€4.48

Short trip valuation

> 11 km and ≤ 12 km traveled

€3.96

Short trip valuation

> 12 km and ≤ 13 km traveled

€3.44

Short trip valuation

> 13 km and ≤ 14 km traveled

€2.92

Short trip valuation

> 14 km and ≤ 15 km traveled

€2.40

Short trip valuation

> 15 km and ≤ 16 km traveled

€1.88

Short trip valuation

> 16 km and ≤ 17 km traveled

€1.36

Short trip valuation

> 17 km and ≤ 18 km traveled

€0.83

The kilometric rate is based on the distance between the departure and the place of arrival, less the first 3 km included in the departmental package (or from 1er km traveled in case of billing of the support).

In the departmental package, the fare applicable to each sanitary transport company (ETS) is that of the department where the company is located (classification of departments into zones A, B, C and D), including when traveling to another department.

The billing can be made as a direct payment by the patient or as a paying third party. The reimbursement of costs by the Health Insurance may be carried out in part or 100%.

FYI  

Approved HTAs must participate in the departmental guard, the period during which they are required to provide the transport requested by the Samu (Saturday, Sunday, public holidays, night from 8 pm to 8 am). There is a child care allowance and a specific fee.

Support

Support cannot be charged by companies only in certain municipalities in the Paris region.

Répondez aux questions successives et les réponses s’afficheront automatiquement

Paris (75), Val-de-Marne (94), Seine-St-Denis (93), Hauts-de-Seine (92).

Companies in all these departments and for transport in these areas are billable for the cost.

Essonne (91)

Companies in certain communes of this department and for transport in these communes may be charged for the cost.

The municipalities concerned are:

  • Beers
  • Bures-sur-Yvette
  • Igny
  • Gif-sur-Yvette
  • Marcoussis
  • Nozay
  • Orsay
  • Palaiseau
  • Saclay
  • Saint-Aubin
  • Villebon-sur-Yvette
  • Verrières-le-Buisson
  • Villejust
  • Villiers-le-Bâcle
  • Vauhallan
  • Athis-Mons
  • Ballainvilliers
  • Champlane
  • Chilly-Mazarin
  • Épinay-sur-Orge
  • Juvisy-sur-Orge
  • Longjumeau
  • Massy
  • Morangis
  • Paray-Vieille-Poste
  • Savigny-sur-Orge
  • Saulx-les-Chartreux
  • Wissous
  • Boussy-Saint-Antoine
  • Brunoy
  • Crosne
  • Draveil
  • Épinay-sous-Sénart
  • Quincy-sous-Sénart
  • Montgeron
  • Vigneux-sur-Seine
  • Varennes-Jarcy
  • Yerres

Val d'Oise (95)

Companies in certain communes of this department and for transport in these communes may be charged for the cost.

The municipalities concerned are:

  • Argenteuil
  • Beauchamp
  • Bezons
  • Cormeilles
  • Franconville
  • The Cargo
  • Herblay
  • Montigny
  • Sannois
  • Andilly
  • Puffemont
  • Mourning
  • Domont
  • Water
  • Enghien
  • Ermont
  • Groslay
  • Margency
  • Montlignon
  • Montmagny
  • Montmorency
  • Piscop
  • Le Plessis-Bouchard
  • Saint-Brice
  • Saint-Gratien
  • Saint-Leu
  • Saint-Prix
  • Be-sous-Montmorency
  • Taverny
  • Arnoville-lès-Gonesse
  • Bonneuil-en-France
  • Bouqueval
  • Look
  • Ezanville
  • Garges-lès-Gonesse
  • Kindness
  • Goussainville
  • Le Thillay
  • Teals
  • Villiers-le-Bel

Yvelines (78)

Companies in certain communes of this department and for transport in these communes may be charged for the cost.

The municipalities concerned are:

  • Bois-d'Arcy
  • Bougival
  • Buc
  • La Elle-Saint-Cloud
  • Chesnay
  • Fontenay le Fleury
  • Guyancourt
  • Jouy-en-Josas
  • Les Loges-en-Josas
  • Louveciennes
  • Montigny-le-Bretonneux
  • Rocquencourt
  • Saint-Cyr-l'Ecole
  • Vélizy-Villacoublay
  • Versailles
  • Viroflay
  • Careers-sur-Seine
  • Chatou
  • Croissy-sur-Seine
  • L'Étang-la-Ville
  • Coal
  • Maisons-Lafitte
  • Mareil-Marly
  • Marly the King
  • Mesnil-le-Roi
  • Montesson
  • The Pecq
  • Port-Marly
  • Saint Germain en Laye
  • SarTrouville
  • Le Vésinet
  • Achères
  • Andréy
  • Careers-sous-Poissy
  • Chambourcy
  • Chanteloup-les-Vignes
  • Conflans-Sainte-Honorine
  • Twisted
  • Malpractice
  • Horse
  • Poissy

FYI  

the km driven under load are charged from 1er km under load.

Surcharge

Surcharges are available at night, on Sundays and on public holidays.

Répondez aux questions successives et les réponses s’afficheront automatiquement

Night surcharge

Between 8pm and 8am, the rates are increased to 50%.

More than half of the trip must have been made within that time in order for the surcharge to apply.

Sunday and holiday surcharge

Between 8am and 8pm, the rates are increased to 25%.

Between 8pm and 8am, the opening hours shall be increased to 50%.

Supplement

A supplement may be requested for patients who are transported to the following locations:

  • Airport
  • Port
  • Station for boarding an aircraft, boat or train

It may also be asked whether the patient is taken care of when he or she descends from an airplane, boat or train.

FYI  

night, sunday and public holiday surcharges do not apply to this supplement.

Toll charges

They are charged extra for the laden journey. However, they have to be justified.