County supervisors will decide next week whether to charge residents of unincorporated areas $185 each time they use paramedic services.
The Orange County Fire Authority, which represents the county and 19 cities, already has approved the new fee.
Last year, the paramedics provided advanced life-support services to 13,678 patients during transport to emergency rooms.
Total cost per call for transport and paramedic services was $184.41, according to authority figures.
The fee is needed to defray the costs of paramedic services, which have mounted over the years.
Medical-aid calls now account for the majority of fire service calls.
Other member cities that have approved the paramedic fee include Buena Park, Irvine, La Palma, Laguna Niguel, Los Alamitos, Placentia, San Juan Capistrano, Stanton, Seal Beach, Villa Park and Yorba Linda.