Loading...
NPI 1063693919 · Lakewood, NJ · Ambulance
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Gem Ambulance LLC is a ambulance provider located in Lakewood, New Jersey. This profile covers 3 Medicare and 7 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 | Gem Ambulance LLC |
| Address | 1750 Cedar Bridge Ave |
| City | Lakewood |
| State | NJ |
| ZIP | 08701 |
| Taxonomy | Ambulance |
| NPI Enumerated | November 20, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $4.2M |
| Medicaid | $1.7M |
GEM AMBULANCE LLC shows a clear payer concentration with Medicare revenue of $4.2M and Medicaid revenue of $1.7M, indicating Medicare is the larger single payer relationship for this operation; the provider is not effectively single-payer but leans substantially on Medicare-sourced reimbursements. The entity has been NPI enumerated since 2007-11-20 (~19 years ago), which supports interpretation of these patterns as the result of a long-established ambulance operation rather than a short-lived billing spike.
The provider’s service mix is dominated by ground ambulance basic life support transports and mileage: Medicare top codes are A0429, A0428, and A0425, and Medicaid top codes mirror that mix with A0429, A0425, and A0428. These code-level patterns (BLS emergency, BLS non-emergency, and ground mileage) point to a core operational focus on ground transport services rather than specialty ALS procedures or equipment-heavy interventions.
Medicare revenue is highly concentrated: the precomputed top-3 Medicare codes (A0429, A0428, A0425) account for 100.0% of the provider’s total Medicare revenue, with A0429 accounting for $1.9M (45.2%), A0428 $1.7M (40.3%), and A0425 $601.5K (14.5%). This extreme concentration means reimbursement risk is tightly linked to a small set of ambulance transport and mileage codes.
Medicaid revenue is also concentrated but slightly more diverse across the same service lines: the top-3 Medicaid codes (A0429, A0425, A0428) account for 98.6% of total Medicaid revenue, led by A0429 at $1.2M (71.9%), A0425 at $249.8K (15.2%), and A0428 at $190.1K (11.5%). The dominance of A0429 in Medicaid revenue emphasizes that emergency BLS transports constitute the bulk of the provider’s Medicaid business.
On Medicare competitive standing, GEM AMBULANCE ranks at the very high end for its top ambulance codes: A0429 ranks #52 of 7808 nationally (99th percentile; extreme outlier) with 5K claims and a $372 avg paid/claim, and A0428 ranks #66 of 2772 (98th percentile; notably above typical) with 8.2K claims and a $203 avg paid/claim. These national placements indicate GEM is a major, high-volume operator for core BLS ambulance services in the Medicare market, far above typical provider volumes.
Within the state-level Medicaid market the picture is different: A0429 ranks #12 of 264 in-state (96th percentile; typical, unremarkable) despite large absolute counts (26.4K claims, $45 avg paid/claim, $1.2M revenue), while A0425 and A0428 rank in the mid-to-upper state percentiles (A0425 #53 of 426, 88th percentile; A0428 #12 of 86, 87th percentile). These placements suggest GEM is a meaningful Medicaid provider in-state by volume but operates in a denser competitive field where high absolute counts do not translate into the same standout percentile shown nationally for Medicare.
Mileage reporting is a consistent secondary revenue stream across both payers: A0425 (ground mileage) generates $601.5K (14.5%) of Medicare revenue with 100.2K claims and $249.8K (15.2%) of Medicaid revenue with 41.6K claims. The code’s ranking on Medicare (#152 of 8934, 98th percentile; notably above typical) and its elevated in-state Medicaid rank (53 of 426, 88th percentile) reinforce that ground mileage billing is a substantial and high-volume component of GEM’s operations.
The overall pattern—long tenure since 2007-11-20 (~19 years ago), extreme national standing on several Medicare ambulance codes, and concentrated top-3 code shares (100.0% Medicare; 98.6% Medicaid)—points to a business highly specialized in BLS ground transports with revenue and operational stability closely tied to a narrow set of transport and mileage codes. That specialization implies sensitivity to any reimbursement policy changes or utilization shifts affecting A0429, A0428, and A0425.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 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.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 26,350 | $50 | $1.2M |
| A0425 | Ground mileage, per statute mile | 41,630 | $10 | $249.8K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 14,620 | $10 | $190.1K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 2,100 | $10 | $14.7K |
| A0380 | Bls mileage (per mile) | 540 | $10 | $7.6K |
| A0130 | Non-emergency transportation: wheelchair van | 100 | $1 | $200 |
| A0999 | Unlisted ambulance service | 40 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other New Jersey providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New Jersey median
7 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 12 | 260 | 1,770 | $110 | $683K |
| A0130 | Non-emergency transportation: wheelchair van | 12 | 10 | 2,430 | $30 | $479.1K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 12 | 90 | 2,490 | $20 | $164.4K |
| A0425 | Ground mileage, per statute mile | 53 | 430 | 3,700 | $10 | $106.9K |
| A0380 | Bls mileage (per mile) | 2 | 10 | 1,190 | $10 | $8.2K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 8 | 40 | 220 | $10 | $7K |
| A0999 | Unlisted ambulance service | 3 | 10 | 680 | $1 | $1.2K |
Other providers in the same ZIP code as Gem Ambulance LLC, ranked by combined Medicare and Medicaid revenue.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.