New York City's congestion pricing toll took effect on January 5, 2025. A National Bureau of Economic Research working paper found that total emergency medical service (EMS) travel time inside the congestion relief zone decreased by 63 to 70 seconds after the toll was implemented.

The study analyzed approximately 1.6 million EMS incidents across the city. Researchers compared ambulance runs on either side of 60th Street to measure the impact. The decrease represented a reduction of approximately 5% to 6% of overall EMS travel time. Travel time to the incident location decreased by 7 to 9 seconds, while transport time from the scene to the hospital decreased by 54 to 59 seconds.

Brad Humphreys, a professor of economics at West Virginia University and one of six economists who authored the study, described the methodology. "Our research design is sort of spatial. We match EMT trips on either side of 60th, above and below, in and out of the congestion zone, because they should be really similar in terms of other characteristics of whatever's going on with those emergency calls," Humphreys said.

The study found no displacement effect on EMT calls north of 60th Street. "We don't find any displacement effect. We don't find that those EMT calls slowed down north of 60th, or anywhere. Basically people just stop driving. They just stop driving in general," Humphreys said. Data from NYC street cameras analyzed by machine learning showed a 21% drop in passenger vehicles and an 18% drop in trucks near the boundary. Pedestrian counts increased by approximately 14% and bicycle counts increased by nearly 20% near the boundary.

In March 2025, the FDNY began requiring ambulances to transport patients to the nearest hospital rather than a preferred one. Humphreys noted that the authors identified that policy as an important confounder. "A couple of our co-authors live in New York City and we did some Google News searching and identified that policy as an important confounder," he said. "Somebody would undoubtedly say, 'You're getting these declines because of that policy change, not the congestion price.' We felt it was important to address that."

Sam Schwartz, a traffic analyst, reported in a firm study three months before congestion pricing launched that ambulance response times had increased nearly three minutes between 2014 and 2024. "In cardiac arrest, every minute reduces the chance of survival by 7 to 10%," Schwartz said. Michael Greco, president of Local 2507, the union representing the FDNY's EMTs and paramedics, offered a different perspective. "On the ground, we are not seeing a 60- to 90-second reduction, especially when, for the past, you know, two years, our response time is creeping up every day," Greco said. Greco requested more peer-reviewed research that accounts for the variety of traffic patterns in Manhattan.