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NPI 1104286087 · Tyler, TX · Land Ambulance
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Etmc Ems is a land ambulance provider located in Tyler, Texas. 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 | Etmc Ems |
| Address | 352 S Glenwood |
| City | Tyler |
| State | TX |
| ZIP | 75702 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | March 4, 2016 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $11M |
| Medicare | $7.4M |
ETMC EMS is a Land Ambulance operator based in TYLER, TX with an NPI enumerated (registered) on 2016-03-04 (~10 years ago). Its recorded lifetime Medicare revenue is $7.4M and lifetime Medicaid revenue is $11M, so it bills meaningfully to both payers rather than operating as a single-payer provider.
The provider’s service mix is strongly ambulance-focused: the top revenue codes across both payers are advanced life support emergency transport (A0427) and ground mileage (A0425), with additional volume in basic life support transports (A0428/A0429). This combination indicates a business model centered on high-volume emergency ALS transports plus heavy mileage billing rather than, for example, non-transport clinical services.
Revenue is highly concentrated: the precomputed top-3 Medicare codes account for 86.8% of the provider’s Medicare revenue and the top-3 Medicaid codes account for 91.2% of its Medicaid revenue. For Medicare the principal drivers are A0427, A0425 and A0428, while for Medicaid the top drivers are A0427, A0425 and A0429, meaning a small set of transport/mileage codes dominates financial performance.
On Medicare measures ETMC EMS is a national outlier on key ALS and mileage codes: A0427 ranks #32 of 6841 providers (100th percentile; extreme outlier) and A0425 ranks #37 of 8934 providers (100th percentile; extreme outlier), with additional extreme outlier placement for A0426 and A0433 (99th percentiles). Those ranks indicate the provider is operating at volumes far above typical national peers for emergency ALS and related high-acuity ambulance services.
Within Texas Medicaid reporting ETMC EMS also registers as a major statewide player on its top lines: A0427 ranks #9 of 317 (97th percentile; extreme outlier) and A0425 ranks #10 of 496 (98th percentile; notably above typical state volume), while A0426 ranks #2 of 37 (97th percentile; extreme outlier). These state-level standings reinforce that the provider holds dominant billing share for ALS emergency and mileage services in its market.
Operational economics show a mix of very high-volume, low-unit-value mileage claims and higher-unit-value ALS transports: Medicare A0425 has 223.8K claims at $8 avg paid/claim generating $1.8M, while Medicare A0427 averages $381 paid/claim across 10.6K claims yielding $4M. On Medicaid the pattern is similar in scale: A0425 has 65.6K claims at $38 avg paid/claim for $2.5M, and A0427 shows 38.8K claims at $164 avg paid/claim for $6.4M, underscoring that both frequent mileage billing and high-dollar ALS transports drive revenue.
Compared to payer mix expectations, Medicaid ($11M) exceeds Medicare ($7.4M) in lifetime revenue for ETMC EMS, so Medicaid is the larger single payer in absolute dollars. Analysts should treat this as a dual-payer operation with material exposure to state Medicaid program reimbursement dynamics as well as federal Medicare rules.
Given the heavy concentration in a few transport and mileage codes and the provider’s extreme percentile ranks on those codes, analysts should prioritize verification of trip volumes, mileage reporting practices, and any regional contracts or system roles that explain unusually high ALS and mileage billing. Those operational and contract-level explanations (e.g., primary EMS vendor for a county or regional ambulance routing) are plausible, and confirmatory review of claims-level detail and local EMS arrangements will clarify whether volumes reflect network position or other factors.
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) | 10,620 | $380 | $4M |
| A0425 | Ground mileage, per statute mile | 223,790 | $10 | $1.8M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 2,760 | $200 | $559.9K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1,250 | $320 | $397.2K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 1,560 | $240 | $380.4K |
| A0433 | Advanced life support, level 2 (als 2) | 320 | $560 | $176.8K |
| A0434 | Specialty care transport (sct) | 30 | $670 | $17.3K |
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 |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 38,770 | $160 | $6.4M |
| A0425 | Ground mileage, per statute mile | 65,620 | $40 | $2.5M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 8,770 | $140 | $1.2M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 12,050 | $40 | $518.2K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 4,060 | $40 | $150.2K |
| A0433 | Advanced life support, level 2 (als 2) | 470 | $300 | $140.4K |
| A0398 | Als routine disposable supplies | 8,990 | $10 | $125.8K |
| A0382 | Bls routine disposable supplies | 3,400 | $10 | $30.6K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 750 | $10 | $7.5K |
How this provider's Medicaid billing volume and revenue compare to other Texas providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Texas 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) | 9 | 320 | 920 | $180 | $720.3K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 18 | 310 | 500 | $160 | $474.9K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 30 | 190 | 2,590 | $60 | $427.4K |
| A0425 | Ground mileage, per statute mile | 10 | 500 | 1,970 | $40 | $284.3K |
| A0433 | Advanced life support, level 2 (als 2) | 7 | 30 | 110 | $560 | $224.9K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 2 | 40 | 130 | $70 | $45.6K |
| A0382 | Bls routine disposable supplies | 30 | 220 | 460 | $10 | $31.6K |
| A0398 | Als routine disposable supplies | 11 | 180 | 420 | $10 | $29.3K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 23 | 90 | 270 | $20 | $15.6K |
Other providers in the same ZIP code as Etmc Ems, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| First Choice Children's Homecare, LP | TX | Home Health Agency | $0 | $30.2M |
| Christus Trinity Clinic Texas | TX | Family Medicine Physician | $0 | $22.2M |
| Thomas Gregory | TX | Medical Oncology Physician | $2.4M | $0 |
| Donald Richards | TX | Medical Oncology Physician | $1.8M | $0 |
| Mark Saunders | TX | Radiation Oncology Physician | $1.8M | $0 |
| Jingdong Su | TX | Hematology & Oncology Physician | $1.7M | $0 |
| Habte Yimer | TX | Hematology & Oncology Physician | $1.7M | $0 |
| Sasha Davis | TX | Medical Oncology Physician | $1.2M | $0 |
| Carolyn Jenks | TX | Hematology & Oncology Physician | $1.2M | $0 |
| Nanna Sulai | TX | Hematology & Oncology Physician | $1.1M | $0 |
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