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NPI 1124342282 · Boston, MA · Ambulance
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Boston Public Health Commission is a ambulance provider located in Boston, Massachusetts. This profile covers 4 Medicare and 4 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 | Boston Public Health Commission |
| Address | 785 Albany St |
| City | Boston |
| State | MA |
| ZIP | 02118 |
| Taxonomy | Ambulance |
| NPI Enumerated | March 18, 2010 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $67.6M |
| Medicare | $5.9M |
BOSTON PUBLIC HEALTH COMMISSION is effectively Medicaid-dominant by scale: Total Medicare revenue is $5.9M compared with Total Medicaid revenue of $67.6M, so Medicaid drives the bulk of the organization’s billed volume and dollars. The precomputed top-3 shares underline this concentration: the top 3 Medicare codes by revenue account for 98.9% of Medicare revenue, while the top 3 Medicaid codes by revenue account for 99.4% of Medicaid revenue, indicating very tight code-level concentration on both payers.
The provider’s service mix is clearly ambulance-focused with heavy reliance on basic life support emergency transports and associated mileage. A0429 (BLS emergency) and A0427 (ALS 1 emergency) are the dominant codes across payers: Medicare shows A0429 with 12.5K claims and $4.8M revenue (82.0% of Medicare revenue) and A0427 with 1.6K claims and $743.5K revenue (12.6% of Medicare revenue); Medicaid shows A0429 with 315.1K claims and $60.8M revenue (89.7% of Medicaid revenue) and A0427 with 21.9K claims and $3.9M revenue (5.7% of Medicaid revenue). Ground mileage A0425 also appears at scale (Medicaid: 337.8K claims, $2.7M revenue; Medicare: 36.6K claims, $255.9K revenue), consistent with frequent transport operations.
Revenue concentration is extreme at the code level: the precomputed top-3 share for Medicare is 98.9% and for Medicaid is 99.4%, meaning a very small set of ambulance codes (A0429, A0427, A0425) account for nearly all billed revenue. For payers, A0429 alone represents 82.0% of the provider’s Medicare revenue and 89.7% of its Medicaid revenue, making that single code the primary financial driver on both programs.
Within Massachusetts Medicaid, the provider is a dominant in-state operator for core ambulance lines: A0429 (315.1K claims, $60.8M revenue; 89.7% of Medicaid revenue) ranks #1 of 242 providers in-state (100th percentile; extreme outlier, far above typical state volume), and A0425 (337.8K claims, $2.7M revenue; 4.0% of Medicaid revenue) ranks #3 of 295 providers in-state (99th percentile; extreme outlier). These ranks indicate the provider is a primary source of Medicaid ambulance services in-state and substantially above peers for mileage and BLS emergency transports.
Nationally for Medicare, the provider is a pronounced outlier on BLS emergency service: A0429 (12.5K claims, $4.8M revenue; 82.0% of Medicare revenue) ranks #10 of 7808 providers nationally (100th percentile; extreme outlier), demonstrating unusually high national volume for that code. Other Medicare codes are comparatively ordinary: A0427 ranks #430 of 6841 (94th percentile; typical, unremarkable volume) and A0425 ranks #574 of 8934 (94th percentile; typical, unremarkable volume), so national prominence is concentrated in A0429.
Operational footprint implied by claim counts is large, especially on Medicaid where A0429 has 315.1K claims and A0425 has 337.8K claims; such high-frequency mileage and transport counts are consistent with a high-volume EMS/ambulance operator that conducts many routine emergency transports. This pattern suggests that changes in transport demand, regional EMS agreements, or ambulance reimbursement policy could quickly affect overall revenue given the heavy reliance on transport and mileage codes.
The provider’s competitive profile differs by payer: it is a major statewide leader on Medicaid ambulance lines (multiple extreme outlier ranks and 100th-percentile placement for A0429) while its Medicare footprint is nationally notable only for A0429 (extreme outlier) and otherwise more typical for ALS and mileage codes. Analysts should treat the entity as a dominant Medicaid ambulance supplier in MA but a more specialized/narrowly prominent player nationally for Medicare BLS emergency services.
The provider has a long tenure in the NPI system, enumerated 2010-03-18 (~16 years ago), indicating an established billing history. Given the extremely concentrated revenue base in a few ambulance CPT/HCPCS codes, continuity of operations and reimbursement stability for those codes will be key determinants of future financial performance.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 12,530 | $390 | $4.8M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 1,630 | $460 | $743.5K |
| A0425 | Ground mileage, per statute mile | 36,560 | $10 | $255.9K |
| A0433 | Advanced life support, level 2 (als 2) | 90 | $660 | $62.2K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 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.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 315,150 | $190 | $60.8M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 21,930 | $180 | $3.9M |
| A0425 | Ground mileage, per statute mile | 337,780 | $10 | $2.7M |
| A0433 | Advanced life support, level 2 (als 2) | 1,460 | $290 | $416.1K |
How this provider's Medicaid billing volume and revenue compare to other Massachusetts providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Massachusetts median
4 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1 | 240 | 980 | $180 | $1.2M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 8 | 220 | 1,290 | $180 | $740.6K |
| A0425 | Ground mileage, per statute mile | 3 | 300 | 2,300 | $20 | $267.6K |
| A0433 | Advanced life support, level 2 (als 2) | 1 | 10 | 790 | $300 | $231.1K |
Other providers in the same ZIP code as Boston Public Health Commission, ranked by combined Medicare and Medicaid revenue.
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