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NPI 1033111554 · Erie, PA · Ambulance
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Emergycare, Inc is a ambulance provider located in Erie, Pennsylvania. This profile covers 7 Medicare and 9 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Emergycare, Inc |
| Address | 1926 Peach St |
| City | Erie |
| State | PA |
| ZIP | 16502 |
| Taxonomy | Ambulance |
| NPI Enumerated | August 15, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $14.3M |
| Medicare | $2.9M |
This provider’s payer mix is heavily weighted toward Medicaid: reported Medicaid revenue is $14.3M versus Medicare revenue of $2.9M, so Medicaid represents the dominant source of billed revenue for EMERGYCARE, INC. Analysts should treat Medicaid activity as the primary driver of scale and operational footprint when evaluating the business.
Revenue concentration is high on a few ambulance codes for both payers: the top 3 Medicare codes by revenue account for 77.7% of the provider’s total Medicare revenue, and the top 3 Medicaid codes by revenue account for 82.4% of the provider’s total Medicaid revenue. For Medicare the leading codes are A0427, A0425 and A0428; for Medicaid the leading codes are A0429, A0427 and A0425.
The service mix is a classic ambulance operation with substantial emergency and mileage-driven activity: Medicare shows A0427 (ALS 1 emergency) as the single largest Medicare code and A0425 (ground mileage) with 95.6K claims, while Medicaid revenue is concentrated in A0429 (BLS emergency) and A0427 (ALS 1 emergency). The presence of high-volume mileage claims (A0425) plus both ALS and BLS emergency codes indicates frequent transport over distance and a full-spectrum EMS capability.
On Medicare the provider shows above-typical national presence for a couple of codes but remains modest in total Medicare scale: A0425 ranks #168 of 8934 nationally (98th percentile; notably above typical national volume) and A0427 ranks #249 of 6841 (96th percentile; typical, unremarkable volume), yet total Medicare revenue is $2.9M. This pattern suggests EMERGYCARE participates competitively on mileage and ALS emergency services nationally but does not derive the majority of its revenue from Medicare.
Within Pennsylvania Medicaid markets EMERGYCARE is a major statewide participant on core emergency transport codes: A0429 (BLS emergency) ranks #4 of 385 in-state (99th percentile; typical, unremarkable volume) and A0427 (ALS 1 emergency) ranks #4 of 285 in-state (99th percentile; notably above typical state volume). The provider’s high in-state ranks for A0425 (rank #7 of 442, 99th percentile; notably above typical state volume) and the $14.3M Medicaid scale indicate a strong competitive standing across both emergency transport and mileage in-state.
There are notable statistical outliers in the Medicaid profile that warrant attention: A0998 (ambulance response and treatment, no transport) is ranked #1 of 59 in-state (100th percentile; extreme outlier) with 3.5K claims, and A0160 (non-emergency transportation per mile, case worker) is ranked #1 of 7 in-state (100th percentile; notably above typical state volume). These extreme/peak rankings point to unusually high use of specific non-transport and case-worker mileage services relative to peers and should be reviewed for operational or contracting implications.
Payer-specific service emphasis is apparent: Medicaid revenue is dominated by BLS emergency activity (A0429 accounts for $5.7M or 40.2% of Medicaid revenue) while Medicare revenue is more heavily influenced by ALS emergency and mileage (A0427 and A0425 are the top Medicare drivers). This divergence suggests EMERGYCARE allocates resources or receives different utilization patterns by payer, with Medicaid driving higher-volume BLS emergency transports and Medicare showing stronger mileage/ALS claim counts.
EMERGYCARE has longstanding presence in the market, with an NPI enumerated on 2005-08-15 (~21 years ago), which is consistent with the high in-state rankings and broad claim volumes reported. For payer/provider analysts this tenure supports viewing the entity as an established regional EMS operator whose historical scale underpins its dominant Medicaid positioning and notable Medicare mileage activity.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 2,720 | $380 | $1M |
| A0425 | Ground mileage, per statute mile | 95,630 | $10 | $765K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 2,380 | $200 | $476.8K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1,470 | $310 | $460.1K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 610 | $240 | $148.1K |
| A0434 | Specialty care transport (sct) | 40 | $660 | $28.5K |
| A0433 | Advanced life support, level 2 (als 2) | 20 | $540 | $13K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
9 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 22,340 | $260 | $5.7M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 17,030 | $260 | $4.5M |
| A0425 | Ground mileage, per statute mile | 17,970 | $90 | $1.6M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 8,050 | $150 | $1.2M |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 2,770 | $260 | $731.5K |
| A0998 | Ambulance response and treatment, no transport | 3,540 | $90 | $315K |
| A0432 | Paramedic intercept (pi), rural area, transport furnished by a volunteer ambulance company which is prohibited by state law from billing third party payers | 1,450 | $130 | $193.2K |
| A0130 | Non-emergency transportation: wheelchair van | 1,950 | $30 | $58.4K |
| A0160 | Non-emergency transportation: per mile - case worker or social worker | 1,940 | $10 | $27.1K |
How this provider's Medicaid billing volume and revenue compare to other Pennsylvania providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Pennsylvania median
9 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 4 | 290 | 710 | $300 | $631.5K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 4 | 390 | 510 | $250 | $557.8K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 5 | 160 | 460 | $150 | $316.4K |
| A0130 | Non-emergency transportation: wheelchair van | 4 | 20 | 790 | $60 | $215.8K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 3 | 60 | 120 | $270 | $160.6K |
| A0432 | Paramedic intercept (pi), rural area, transport furnished by a volunteer ambulance company which is prohibited by state law from billing third party payers | 6 | 40 | 100 | $150 | $76.2K |
| A0425 | Ground mileage, per statute mile | 7 | 440 | 400 | $30 | $76K |
| A0998 | Ambulance response and treatment, no transport | 1 | 60 | 140 | $100 | $56.6K |
| A0160 | Non-emergency transportation: per mile - case worker or social worker | 1 | 10 | 150 | $10 | $4.8K |
Other providers in the same ZIP code as Emergycare, Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Linda Larochel | PA | Family Medicine Physician | $1.2M | $112.6K |
| Robert Haverly | PA | Ophthalmology Physician | $1.1M | $0 |
| Heath Fallin | PA | Pain Medicine (Anesthesiology) Physician | $208.5K | $0 |
| Robert Lupo | PA | Orthopaedic Surgery Physician | $207.4K | $0 |
| Orestis Pappas | PA | Interventional Cardiology Physician | $160.2K | $470 |
| Shameen Salam | PA | Internal Medicine Physician | $150.4K | $0 |
| Muhammad Baig | PA | Nephrology Physician | $142.2K | $0 |
| Edward Clark | PA | Nephrology Physician | $135.7K | $0 |
| Jasmin Martinez Castellanos | PA | Cardiovascular Disease Physician | $100.5K | $26.4K |
| Matthew Becker | PA | Interventional Cardiology Physician | $99.8K | $3.4K |
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