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NPI 1164786257 · Jackson, TN · Land Ambulance
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Jackson-madison County General Hospital is a land ambulance provider located in Jackson, Tennessee. This profile covers 7 Medicare and 12 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 | Jackson-madison County General Hospital |
| Address | 620 Skyline Dr |
| City | Jackson |
| State | TN |
| ZIP | 38301 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | July 3, 2012 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $13M |
| Medicare | $5.1M |
Business/service-line profile: JACKSON-MADISON COUNTY GENERAL HOSPITAL is registered under the Land Ambulance taxonomy and its dominant billed services are ambulance transports and mileage, with the single largest Medicare line A0427 (ambulance service, advanced life support, emergency transport) and major Medicaid lines A0427, A0429 and A0425. The presence of both advanced life support (A0427, A0433) and basic life support codes (A0428, A0429), plus large ground-mileage reporting (A0425), indicates an operation primarily focused on emergency and interfacility ground transport rather than non-transport care bundles or alternative NEMT services.
Revenue concentration by code (Medicare): This provider’s top three Medicare codes account for 86.5% of its Total Medicare revenue, and those top contributors include A0427 ($2.1M, 40.4% of Medicare revenue), A0425 ($1.5M, 29.1%) and A0428 ($868.8K, 17.0%). That degree of concentration means Medicare revenue is heavily dependent on emergency ALS transports and mileage; any payer policy or utilization shifts affecting those specific codes would disproportionately affect the provider’s Medicare revenue stream of $5.1M.
Revenue concentration by code (Medicaid): The top three Medicaid codes account for 94.2% of Total Medicaid revenue, led by A0427 ($7.3M, 56.0% of Medicaid revenue), A0429 ($2.6M, 19.9%) and A0425 ($2.4M, 18.3%). Medicaid revenue is therefore extremely concentrated in emergency ALS and BLS transports plus mileage, making the provider’s $13M in Medicaid receipts highly dependent on those three codes.
Payer mix and scale: This provider reports $13M in Total Medicaid revenue versus $5.1M in Total Medicare revenue, indicating Medicaid is the substantially larger payer relationship on file. Because both payers are active, the enterprise is not single-payer, but the business appears more Medicaid-facing in scale and sensitivity to state-level reimbursement and program rules.
Competitive standing—national Medicare: JACKSON-MADISON ranks as an unusually high-volume national filer for core ambulance services: A0425 ranks #48 of 8934 providers (99th percentile; extreme outlier) and A0427 ranks #110 of 6841 (98th percentile; extreme outlier). Those percentile placements mean this provider is a major national outlier on ground-mileage and ALS-emergency Medicare billing volumes, far above typical national peers for those codes.
Competitive standing—state Medicaid: Within Tennessee, the provider is also a leading filer for key Medicaid ambulance codes: A0427 ranks #6 of 120 providers in-state (96th percentile; notably above typical state volume) and A0429 ranks #5 of 108 (96th percentile; notably above typical state volume). These rankings position the provider as a dominant regional operator for emergency transport services under Medicaid.
Payment mix and unit economics signal: Average paid amounts vary materially between codes and payers—examples include Medicare A0427 averaging $374 per claim versus Medicaid A0427 averaging $105 per claim, and Medicare A0425 averaging $8 per claim versus Medicaid A0425 averaging $17 per claim. These divergences suggest differing reimbursement rates and claim compositions across payers (higher per-claim Medicare ALS payments but far larger Medicaid volume dollars), which is relevant for contract and rate negotiations.
Tenure and operational longevity: The provider’s NPI was enumerated 2012-07-03 (~14 years ago), indicating more than a decade of operations under this NPI. That tenure, combined with consistently high ranking on core ambulance codes, supports that the organization is an established local/regional ambulance services operator rather than a newly formed entrant.
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) | 5,530 | $370 | $2.1M |
| A0425 | Ground mileage, per statute mile | 186,480 | $10 | $1.5M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 4,650 | $190 | $868.8K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1,550 | $310 | $482.4K |
| A0433 | Advanced life support, level 2 (als 2) | 230 | $540 | $121.7K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 320 | $240 | $75.8K |
| A0434 | Specialty care transport (sct) | 20 | $640 | $13.5K |
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.
12 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 69,160 | $110 | $7.3M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 27,410 | $90 | $2.6M |
| A0425 | Ground mileage, per statute mile | 139,660 | $20 | $2.4M |
| A0433 | Advanced life support, level 2 (als 2) | 2,570 | $140 | $364.5K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 39,810 | $10 | $318.4K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 1,820 | $20 | $29.1K |
| A0398 | Als routine disposable supplies | 2,940 | $10 | $14.7K |
| A0382 | Bls routine disposable supplies | 1,380 | $10 | $6.9K |
| T2005 | Non-emergency transportation; stretcher van | 250 | $30 | $6.9K |
| A0998 | Ambulance response and treatment, no transport | 650 | $10 | $3.2K |
Showing 1–10 of 12
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
12 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) | 6 | 120 | 5,200 | $120 | $1.4M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 5 | 110 | 2,170 | $110 | $650.5K |
| A0425 | Ground mileage, per statute mile | 12 | 340 | 6,120 | $10 | $280.5K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 5 | 120 | 3,840 | $20 | $207.3K |
| A0433 | Advanced life support, level 2 (als 2) | 2 | 20 | 220 | $170 | $104.7K |
| T2005 | Non-emergency transportation; stretcher van | 6 | 10 | 250 | $40 | $29.7K |
| A0998 | Ambulance response and treatment, no transport | 5 | 20 | 390 | $20 | $26.7K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 4 | 70 | 160 | $20 | $14K |
| A0380 | Bls mileage (per mile) | 30 | 50 | 250 | $10 | $7.1K |
| T2049 | Non-emergency transportation; stretcher van, mileage; per mile | 5 | 10 | 260 | $10 | $7K |
Showing 1–10 of 12
Other providers in the same ZIP code as Jackson-madison County General Hospital, ranked by combined Medicare and Medicaid revenue.
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