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NPI 1134131915 · Antioch, TN · Ambulance
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Metropolitan Government Of Nashville & Davidson County is a ambulance provider located in Antioch, Tennessee. 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 | Metropolitan Government Of Nashville & Davidson County |
| Address | 5244 Hickory Hollow Parkway |
| City | Antioch |
| State | TN |
| ZIP | 37013 |
| Taxonomy | Ambulance |
| NPI Enumerated | August 12, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $32M |
| Medicare | $3.4M |
METROPOLITAN GOVERNMENT OF NASHVILLE & DAVIDSON COUNTY appears to operate as an ambulance services provider focused on emergency transports: its Medicare and Medicaid top codes are dominated by A0427 (ALS 1), A0429 (BLS emergency) and A0425 (ground mileage), indicating primary revenue from advanced and basic life‑support emergency ground transports rather than nonemergency or paratransit services. The prominence of both ALS and BLS emergency codes suggests the operation maintains crews and assets for high-acuity emergency response in its service area.
Revenue concentration is highly focused by payer: for Medicare the precomputed top 3 codes account for 98.8% of total Medicare revenue, and for Medicaid the top 3 codes account for 99.3% of total Medicaid revenue, showing that nearly all reported payer income is driven by a very small set of ambulance transport and mileage codes. This level of concentration indicates limited diversification across other ambulance or ancillary service codes.
On payer mix scale the provider is heavily Medicaid‑weighted in dollar terms: total Medicare revenue is $3.4M while total Medicaid revenue is $32M, indicating Medicaid receipts are an order of magnitude larger than Medicare for this entity. Operational and reimbursement analyses should treat this organization as effectively Medicaid-centric when assessing cash flow and rate sensitivity.
Competitive standing for key Medicare codes is strong relative to national peers: A0427 ranks #113 of 6841 providers (98th percentile, labeled an extreme outlier) and A0429 ranks #104 of 7808 providers (99th percentile, labeled an extreme outlier), indicating this provider bills substantially more ALS 1 and BLS emergency Medicare volume than nearly all national peers. By contrast A0425 (ground mileage) for Medicare ranks #376 of 8934 (96th percentile) and is characterized as typical/unremarkable relative to the national distribution.
In the state Medicaid market the provider is a dominant outlier on core transport codes: A0429 is #1 of 108 providers in‑state (100th percentile, extreme outlier) and A0427 is #3 of 120 providers in‑state (98th percentile, extreme outlier), demonstrating that this entity is a major provider of both BLS and ALS emergency Medicaid transports in Tennessee. A0425 (ground mileage) also ranks highly in‑state (#5 of 338, 99th percentile), reinforcing its high-volume role for Medicaid billing.
Unit economics differ sharply between payers and codes: Medicaid volumes are extremely large (e.g., A0429 shows 120K claims at $123 avg paid/claim and A0427 shows 105.8K claims at $133 avg paid/claim) and together these two codes represent 46.2% and 44.1% of Medicaid revenue respectively, while Medicare volumes for the same codes are much smaller in claim count but still concentrate revenue (A0427 and A0429 together account for the precomputed 98.8% of Medicare revenue). Analysts should factor both high Medicaid claim counts and comparatively lower Medicare totals when modeling revenue drivers.
The provider’s NPI has been enumerated since 2006-08-12 (~20 years), indicating long tenure in the market; combined with its outsized in‑state Medicaid rankings and elevated national Medicare ranks for ALS/BLS codes, this longevity is consistent with an established municipal ambulance operation that commands substantial dosing of emergency transports in its service area.
Code-level percentile descriptors point to consistent statistical outlier behavior across payers: Medicare labels for A0427 and A0429 are “extreme outlier” or “notably above typical,” and Medicaid labels for the same codes are “extreme outlier,” signaling that both payers show unusually high utilization of emergency ALS/BLS transport codes compared with peers. This pattern suggests persistent operational emphasis on emergency response rather than episodic spikes, meriting scrutiny of capacity, routing, and payer-rate exposure in network planning.
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 |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 5,440 | $370 | $2M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 3,180 | $310 | $989.6K |
| A0425 | Ground mileage, per statute mile | 51,350 | $10 | $359.5K |
| A0433 | Advanced life support, level 2 (als 2) | 90 | $500 | $42.5K |
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) | 119,980 | $120 | $14.8M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 105,800 | $130 | $14.1M |
| A0425 | Ground mileage, per statute mile | 223,030 | $10 | $2.9M |
| A0433 | Advanced life support, level 2 (als 2) | 1,140 | $180 | $209.2K |
How this provider's Medicaid billing volume and revenue compare to other Tennessee providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Tennessee median
4 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) | 3 | 120 | 5,200 | $120 | $1.4M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1 | 110 | 2,170 | $110 | $650.5K |
| A0425 | Ground mileage, per statute mile | 5 | 340 | 6,120 | $10 | $280.5K |
| A0433 | Advanced life support, level 2 (als 2) | 4 | 20 | 220 | $170 | $104.7K |
Other providers in the same ZIP code as Metropolitan Government Of Nashville & Davidson County, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Urgent Care Enterprise LLC | TN | Urgent Care Clinic/Center | $0 | $11.6M |
| Mighty Hearts Home Care Inc | TN | In Home Supportive Care Agency | $0 | $7.6M |
| Tennessee Pain Surgery Center, LLC | TN | Ambulatory Surgical Clinic/Center | $669.9K | $4.5M |
| Pain Management Group, P.C. | TN | Interventional Pain Medicine Physician | $0 | $4.2M |
| Eyecare Plus Hh, PLLC | TN | Optometrist | $0 | $3.5M |
| Prudent Health Services Inc. | TN | Home Health Agency | $0 | $3.2M |
| Savina Kimbrough | TN | Family Nurse Practitioner | $94.6K | $0 |
| John Welker | TN | Interventional Pain Medicine Physician | $77.3K | $0 |
| John Culclasure | TN | Pain Medicine (Anesthesiology) Physician | $24.2K | $0 |
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