Washington, D.C. — In a major win for patient access and America’s Blood Centers (ABC) advocacy, the Department of Defense (DoD) recently announced a new TRICARE demonstration project that will separately reimburse ambulance providers for blood products administered during emergency transport.
Prehospital blood transfusions (PHBT) save lives, yet only 1–2% of EMS agencies nationwide carry blood, largely because current payment policy does not cover the cost. Earlier this year, CMS finalized a rule folding PHBT into the existing Advanced Life Support, Level 2 (ALS2) ambulance rate rather than reimbursing it separately. ABC and partners argued this bundled approach does not come close to covering actual blood product costs, which can run $500–$925 or more per unit. This advocacy is cited directly in DoD’s rationale for this demonstration.
The demonstration launches January 1, 2027, and runs for five years, through December 31, 2031, under DoD’s authority to test alternative payment approaches (10 U.S.C. § 1092). Ambulance providers will be able to bill separately for blood products administered during medically necessary ALS2, Specialty Care Transport, or air ambulance transports. Coverage extends to TRICARE Prime, TRICARE Select, and TRICARE for Life beneficiaries, including those enrolled in a Medicare Advantage plan. It does not extend to USFHP enrollees, claims originating overseas, or beneficiaries whose other health insurance is primary.
The demonstration arrives at a moment of rapid growth for prehospital blood programs. As documented in ABC’s report, A Vital Resource: Community Blood Centers & The Growth of Prehospital Blood Programs, the number of community blood centers supplying blood for prehospital use nearly doubled between 2022 and 2025, with more than 30,000 blood products distributed for prehospital use in 2025 alone. The report identifies sustainable funding as the single greatest barrier to expanding these programs, precisely the question this demonstration is designed to answer.
ABC thanks the DoD for its leadership and looks forward to the data this demonstration will generate on utilization, costs, and patient outcomes. Learn more about ABC’s work expanding the use of blood in ambulances.
About America’s Blood Centers Founded in 1962, America’s Blood Centers (ABC) is the national organization bringing together community-based, independent blood centers across North America. These organizations operate in more than 1,100 communities and provide close to 60 percent of the U.S. and a quarter of the Canadian blood supply. ABC member organizations serve more than 150 million people and provide blood products and services to more than 3,500 hospitals and healthcare facilities. All ABC U.S. members are 501(c)(3) organizations licensed and regulated by the U.S. Food and Drug Administration or Health Canada. For more information, visit: www.AmericasBlood.org