The ambulance that billed me in San Francisco after my accident was run by San Francisco Fire Department.

SF EMS is funded partially through the general fund and other bond measures, with additional billing to cover the rest. I believe it’s like $2K for a ride.

Many fire departments in the US send bills, whether responding to medical emergencies or fires.

Many makes it seem like this is common. But it extremely uncommon in the US to get a bill after a fire. There are some rural volunteer fire departments that are funded through memberships and they will bill you if you aren’t a member. But these are not common.