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NPI 1124056296 · Clinton Township, MI · Ambulance
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Medstar, Inc. is a ambulance provider located in Clinton Township, Michigan. This profile covers 7 Medicare and 13 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 | Medstar, Inc. |
| Address | 380 N Gratiot Ave |
| City | Clinton Township |
| State | MI |
| ZIP | 48036 |
| Taxonomy | Ambulance |
| NPI Enumerated | June 29, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $50.5M |
| Medicare | $11.5M |
MEDSTAR, INC. is categorized under the Ambulance taxonomy and its top billed services are transport- and mileage-related codes such as A0427, A0428, and A0425; this mix indicates a core business of ground ambulance operations handling both advanced life support (ALS) emergency transports and basic life support (BLS) non-emergency transports. The presence of A0434 and A0433 at much smaller revenue shares on Medicare further suggests some specialty care transport and occasional higher-acuity ALS2 activity, but these are minor compared with standard transports and mileage.
Revenue for this provider is highly concentrated in a small set of transport codes: the top three Medicare codes account for 83.6% of total Medicare revenue and the top three Medicaid codes account for 82.0% of total Medicaid revenue. That concentration means a handful of ambulance and mileage services drive the vast majority of reported payer receipts rather than a broad mix of unrelated service lines.
The provider’s payer mix is skewed toward Medicaid in scale — lifetime Medicaid revenue is $50.5M versus $11.5M in Medicare — indicating that Medicaid reimbursements and state-level relationships are likely the primary drivers of the business’s financial performance. In practice this makes MEDSTAR effectively a Medicaid-dominant operator by revenue scale.
On Medicare, MEDSTAR is a national volume outlier for its principal ambulance codes: A0427 ranks #42 of 6841 providers (99th percentile, extreme outlier), A0428 ranks #16 of 2772 providers (99th percentile, extreme outlier), and A0425 ranks #12 of 8934 providers (100th percentile, extreme outlier). Those standings indicate the provider bills at volumes far above typical national peers for both ALS and BLS transports and for ground mileage.
Within Michigan Medicaid, MEDSTAR is likewise a top in-state operator: A0427 ranks #2 of 163 (99th percentile, extreme outlier), A0428 ranks #2 of 66 (98th percentile, extreme outlier), and A0425 ranks #3 of 199 (99th percentile, extreme outlier). These in-state ranks position MEDSTAR among the largest Medicaid ambulance providers in the state for the same core transport and mileage services.
Claim counts are substantial and point to heavy operational throughput: Medicare shows 337.6K claims for A0425 and 16.7K claims for A0428 (also 9.8K claims for A0427), while Medicaid shows 219.5K claims for A0425, 90.9K claims for A0428, and 75.5K claims for A0427. The combination of very high mileage claim volumes and large ALS/BLS claim counts suggests a sizable fleet, frequent trips, and significant cumulative travel distances billed to payers.
Payment levels vary materially by payer and code: Medicare average paid per claim is $388 for A0427, $206 for A0428, and $7 for A0425, while Medicaid averages are $222 for A0427, $140 for A0428, and $54 for A0425. These per-claim differences — particularly the much lower Medicare mileage per-claim payment versus Medicaid — imply that differing reimbursement structures for mileage and transport types meaningfully affect revenue composition despite similar service volumes.
MEDSTAR documents limited non-transport and infusion activity under Medicaid: small revenues are present for monoclonal antibody infusion codes (M0245 $54.6K, M0244 $52.6K, M0243 $21.4K, M0247 $13.7K) and for response-without-transport A0998 ($44.2K). These lines are ancillary relative to core transport revenue and indicate occasional on-scene treatment or home-based infusion work but are not major revenue drivers.
The provider has a long tenure on file — NPI enumerated 2006-06-29 (~20 years ago) — which, combined with the high and sustained billing volumes across both Medicare and Medicaid, suggests an established operational footprint rather than a newly formed entrant. Longevity plus the outsized ranking on core transport codes supports the view of MEDSTAR as a mature, high-volume ambulance operator.
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) | 9,820 | $390 | $3.8M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 16,730 | $210 | $3.4M |
| A0425 | Ground mileage, per statute mile | 337,570 | $10 | $2.4M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 4,020 | $320 | $1.3M |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 1,160 | $250 | $283.7K |
| A0434 | Specialty care transport (sct) | 400 | $670 | $267.6K |
| A0433 | Advanced life support, level 2 (als 2) | 60 | $570 | $35.7K |
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.
13 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 75,460 | $220 | $16.8M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 90,920 | $140 | $12.7M |
| A0425 | Ground mileage, per statute mile | 219,450 | $50 | $11.9M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 42,520 | $160 | $6.6M |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 9,220 | $230 | $2.1M |
| A0434 | Specialty care transport (sct) | 1,110 | $150 | $164.9K |
| M0245 | Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring | 180 | $310 | $54.6K |
| M0244 | Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring in the home or residence; this includes a beneficiary's… | 100 | $540 | $52.6K |
| A0998 | Ambulance response and treatment, no transport | 230 | $190 | $44.2K |
| A0433 | Advanced life support, level 2 (als 2) | 120 | $310 | $37.8K |
Showing 1–10 of 13
How this provider's Medicaid billing volume and revenue compare to other Michigan providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Michigan median
13 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) | 2 | 160 | 1,880 | $230 | $1.3M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 2 | 70 | 1,790 | $130 | $1M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 3 | 150 | 1,570 | $150 | $951.3K |
| A0425 | Ground mileage, per statute mile | 3 | 200 | 2,950 | $50 | $648.5K |
| A0998 | Ambulance response and treatment, no transport | 32 | 50 | 1,100 | $180 | $553.8K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 2 | 50 | 540 | $220 | $285.3K |
| A0433 | Advanced life support, level 2 (als 2) | 6 | 10 | 140 | $270 | $108.9K |
| A0434 | Specialty care transport (sct) | 2 | 10 | 200 | $140 | $89.8K |
| M0244 | Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring in the home or residence; this includes a beneficiary's… | 1 | 10 | 20 | $540 | $23.3K |
| M0243 | Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring | 16 | 50 | 50 | $270 | $20.2K |
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Other providers in the same ZIP code as Medstar, Inc., ranked by combined Medicare and Medicaid revenue.
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