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NPI 1134193717 · Tuscaloosa, AL · Land Ambulance
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Northstar Ems, Inc. is a land ambulance provider located in Tuscaloosa, Alabama. This profile covers 7 Medicare and 6 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 | Northstar Ems, Inc. |
| Address | 2106 17th Ave |
| City | Tuscaloosa |
| State | AL |
| ZIP | 35401 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | February 13, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $5.6M |
| Medicare | $2.1M |
This provider maintains an active NPI since 2006-02-13 (~20 years ago) and reports materially different scale of activity across payers: Total Medicare revenue is $2.1M while Total Medicaid revenue is $5.6M. The Medicaid book is larger in absolute dollar terms, indicating the provider’s operational footprint is more heavily aligned with state-covered patients.
Clinical/service profile is dominated by ground ambulance work: top revenue-driving codes across payers are ambulance transports and ground mileage (notably A0427, A0428, A0425 and A0429), which indicates the organization is principally a land ambulance operator providing both ALS and BLS emergency and non-emergency transports. The precomputed concentration measures show this mix is tightly concentrated — the top 3 Medicare codes account for 81.8% of Medicare revenue and the top 3 Medicaid codes account for 75.8% of Medicaid revenue — highlighting that a small set of transport services produces most revenue.
Medicare revenue is concentrated in a few high-ticket transport codes: A0427 accounts for $894.1K (42.9% of Medicare revenue), A0428 $461.6K (22.1%), and A0425 $349.4K (16.8%). On national comparisons these codes register in upper percentiles (A0427 ranks #273 of 6841, 96th percentile; A0428 ranks #274 of 2772, 90th percentile; A0425 ranks #394 of 8934, 96th percentile) even while the source data characterizes the volumes for these Medicare codes as "typical, unremarkable," suggesting the provider sits in the higher-volume range nationally but follows standard ambulance billing patterns.
Medicaid activity is heavily weighted toward mileage and both ALS and BLS transports: A0425 ($1.5M, 27.2%), A0427 ($1.5M, 26.1%), and A0428 ($1.3M, 22.5%) together make up the bulk of Medicaid revenue. In-state ranking underscores dominance on select lines — A0425 ranks #3 of 131 (98th percentile, extreme outlier), A0428 ranks #2 of 78 (99th percentile, extreme outlier), and A0427 ranks #7 of 102 (94th percentile, notably above typical state volume) — indicating this provider is a major Medicaid ambulance supplier in Alabama for mileage and both ALS/BLS transport.
The provider’s competitive stance is asymmetric: for Medicare they appear as a high-percentile but operationally "typical" national participant on core transport codes, while for Medicaid they are an in-state outlier and clear market leader on mileage and BLS non-emergency volume. Payers assessing network adequacy or negotiating Medicaid rates should treat NORTHSTAR EMS, INC. as a significant local provider for ground transport capacity.
Operational signals from single-code volumes are striking: Medicaid shows 61K claims for A0425 with $25 avg paid/claim and 30K claims for A0428 with $42 avg paid/claim, while Medicare shows 49.9K claims for A0425 with $7 avg paid/claim and 2.7K claims for A0428 with $172 avg paid/claim. These per-claim and claim-count contrasts suggest materially different utilization and reimbursement mixes across payers and that mileage billing (A0425) is a dominant throughput driver in the Medicaid population.
High revenue concentration in a few codes creates exposure to pricing or policy changes: because the top three codes account for 81.8% of Medicare revenue and 75.8% of Medicaid revenue, shifts in reimbursement, medical necessity rules, or contract terms for A0425/A0427/A0428 could disproportionately affect this provider’s financials. Analysts and contracting teams should prioritize monitoring and negotiating rates and utilization controls for these specific codes.
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) | 2,460 | $360 | $894.1K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 2,680 | $170 | $461.6K |
| A0425 | Ground mileage, per statute mile | 49,920 | $10 | $349.4K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1,120 | $310 | $342.1K |
| A0433 | Advanced life support, level 2 (als 2) | 30 | $520 | $14.6K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 50 | $230 | $11.7K |
| A0434 | Specialty care transport (sct) | 20 | $630 | $11.4K |
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.
6 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0425 | Ground mileage, per statute mile | 60,960 | $30 | $1.5M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 17,410 | $80 | $1.5M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 30,010 | $40 | $1.3M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 13,080 | $80 | $1.1M |
| A0382 | Bls routine disposable supplies | 14,100 | $20 | $296.1K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 200 | $10 | $2.6K |
How this provider's Medicaid billing volume and revenue compare to other Alabama providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Alabama median
6 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0425 | Ground mileage, per statute mile | 3 | 130 | 3,610 | $40 | $394K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 7 | 100 | 1,850 | $90 | $379.6K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 2 | 80 | 2,590 | $40 | $248.6K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 4 | 90 | 1,170 | $70 | $209.8K |
| A0382 | Bls routine disposable supplies | 3 | 40 | 1,930 | $20 | $77.6K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 17 | 20 | 410 | $10 | $12.1K |
Other providers in the same ZIP code as Northstar Ems, Inc., ranked by combined Medicare and Medicaid revenue.
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