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NPI 1043243538 · New Haven, CT · Ambulance
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American Medical Response Of Connecticut Incorporated is a ambulance provider located in New Haven, Connecticut. This profile covers 7 Medicare and 12 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 | American Medical Response Of Connecticut Incorporated |
| Address | 58 Middletown Ave |
| City | New Haven |
| State | CT |
| ZIP | 06513 |
| Taxonomy | Ambulance |
| NPI Enumerated | July 8, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $129.5M |
| Medicare | $13.2M |
This provider’s billing profile is focused on traditional ground ambulance services: the top Medicare and Medicaid revenue drivers are A0429, A0427 and A0428, which correspond to BLS emergency, ALS1 emergency and BLS non‑emergency transports respectively. The presence of large volumes for both emergency and non‑emergency transport codes, plus material mileage billing (A0425), indicates an operation centered on high-volume patient transport rather than episodic specialty services.
Revenue concentration is high for both payers: the top 3 Medicare codes account for 86.1% of Medicare revenue and the top 3 Medicaid codes account for 94.7% of Medicaid revenue. This indicates that a very small set of ambulance transport services drive the overwhelming majority of the provider’s public‑payer revenue.
On payer mix, Medicaid dominates this entity’s public revenue picture: total Medicaid revenue is $129.5M versus total Medicare revenue of $13.2M. The file indicates the provider is effectively Medicaid‑heavy in scale, with Medicaid revenue making up the majority of reported public‑payer receipts.
Competitive standing differs by payer: for Medicare the provider is a national high‑volume performer on core codes — for example A0429 is ranked #9 of 7808 providers nationally (100th percentile; extreme outlier) and A0427 is ranked #48 of 6841 providers nationally (99th percentile; extreme outlier). For Medicaid the provider is the undisputed statewide leader on the same core codes: A0429, A0427, A0428 and A0425 all rank #1 in‑state (100th percentile; extreme outlier). These ranks portray the organization as a major market incumbent in Connecticut and a top national volume reporter on key ambulance codes.
The provider reports very large absolute volumes for Medicaid claims on its top codes (for example A0429: 296.4K claims, $204 avg paid/claim, $60.5M revenue; A0427: 224.4K claims, $218 avg paid/claim, $48.9M revenue; A0428: 176.8K claims, $74 avg paid/claim, $13.1M revenue). Such concentrated, high claim counts on emergency and non‑emergency transport lines suggest enterprise‑scale routing and dispatch operations and likely broad geographic coverage or multiple contracts with Medicaid plans.
Medicare volume is also concentrated but smaller in dollar scale: Medicare A0429 generated $4.7M (13K claims, $363 avg paid/claim), A0427 generated $4.1M (9.5K claims, $431 avg paid/claim), and A0428 generated $2.7M (12.3K claims, $216 avg paid/claim). Those three codes together make up 86.1% of Medicare revenue, indicating that even the Medicare book is primarily driven by the same core transport services.
Several individual codes are flagged as statistical outliers by the benchmarks provided: multiple core codes are described as “extreme outlier” or “far above typical” for volume both nationally (Medicare A0429, A0427, A0428, A0425) and in‑state (Medicaid A0429, A0427, A0428, A0425). Where the report labels a code as “notably above typical” or “typical, unremarkable,” those characterizations align with mid‑to‑low rank percentiles in the provided lists (for example Medicare A0426 and A0433 are in typical ranges).
The provider has an established tenure in federal enrollment, with an NPI enumerated on 2006-07-08 (~20 years ago), which supports interpretation of the patterns above as the output of a mature ambulance operation rather than a recent entrant. That longevity combined with top statewide rankings on Medicaid suggests long‑standing market presence and operational scale in Connecticut.
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 |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 12,960 | $360 | $4.7M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 9,460 | $430 | $4.1M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 12,270 | $220 | $2.7M |
| A0425 | Ground mileage, per statute mile | 240,190 | $10 | $1.7M |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 270 | $270 | $74.5K |
| A0433 | Advanced life support, level 2 (als 2) | 100 | $620 | $63K |
| A0434 | Specialty care transport (sct) | 40 | $740 | $31K |
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.
12 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 296,450 | $200 | $60.5M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 224,400 | $220 | $48.9M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 176,790 | $70 | $13.1M |
| A0425 | Ground mileage, per statute mile | 353,830 | $10 | $3.9M |
| S0215 | Non-emergency transportation; mileage, per mile | 42,650 | $50 | $2.1M |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 6,120 | $110 | $698.1K |
| A0432 | Paramedic intercept (pi), rural area, transport furnished by a volunteer ambulance company which is prohibited by state law from billing third party payers | 1,490 | $110 | $165.8K |
| A0998 | Ambulance response and treatment, no transport | 530 | $50 | $24.8K |
| A0434 | Specialty care transport (sct) | 1,550 | $10 | $20.1K |
| A0130 | Non-emergency transportation: wheelchair van | 760 | $20 | $13.6K |
Showing 1–10 of 12
How this provider's Medicaid billing volume and revenue compare to other Connecticut providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Connecticut median
12 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 1 | 20 | 17,430 | $80 | $2.7M |
| S0215 | Non-emergency transportation; mileage, per mile | 2 | 20 | 10,360 | $20 | $2.6M |
| A0130 | Non-emergency transportation: wheelchair van | 3 | 10 | 1,950 | $30 | $1.8M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1 | 120 | 1,930 | $180 | $1.3M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 1 | 80 | 900 | $190 | $1.3M |
| A0432 | Paramedic intercept (pi), rural area, transport furnished by a volunteer ambulance company which is prohibited by state law from billing third party payers | 9 | 20 | 1,490 | $110 | $321.7K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 1 | 10 | 360 | $120 | $206.1K |
| A0425 | Ground mileage, per statute mile | 1 | 130 | 2,510 | $10 | $141.8K |
| A0434 | Specialty care transport (sct) | 2 | 10 | 1,550 | $20 | $24K |
| A0998 | Ambulance response and treatment, no transport | 4 | 20 | 100 | $60 | $18.3K |
Showing 1–10 of 12
Other providers in the same ZIP code as American Medical Response Of Connecticut Incorporated, ranked by combined Medicare and Medicaid revenue.
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