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NPI 1174912695 · Huntsville, AL · Clinical Medical Laboratory
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Madison Core Laboratories, LLC is a clinical medical laboratory provider located in Huntsville, Alabama. This profile covers 84 Medicare and 85 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 | Madison Core Laboratories, LLC |
| Address | 2705 Artie St Sw |
| City | Huntsville |
| State | AL |
| ZIP | 35805 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | January 21, 2015 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $4M |
| Medicare | $1.5M |
Medicaid dominates this provider’s payer mix: reported lifetime Medicaid revenue is $4M versus total Medicare revenue of $1.5M, indicating that the practice’s scale is primarily Medicaid-driven rather than Medicare-driven. The NPI was enumerated 2015-01-21 (~11 years ago), so this footprint has been established for roughly a decade.
Revenue concentration is high on a few services for both payers: the top three Medicare codes account for 56.7% of Medicare revenue and the top three Medicaid codes account for 57.2% of Medicaid revenue. At the code level, P9603 alone supplies $454.1K (33.9% of Medicare revenue) on Medicare while 87798 supplies $1.3M (35.3% of Medicaid revenue), showing heavy reliance on a single dominant service in each payer stream.
The code mix points to a laboratory operation built around mobile/specimen collection and high-volume molecular infectious disease testing: P9603 (travel allowance for home-bound/SNF specimen collection) is the single largest Medicare line and U0004/U0005 and multiple multiplex respiratory codes appear prominently across both payers. This suggests field collection (home or nursing facility draws) plus high-throughput molecular testing capacity as core service lines rather than solely in-office phlebotomy.
Routine clinical testing volumes are also substantial on Medicare, with traditional panels and analytes showing very high national placement: 80053 $60.1K (rank #286 of 26416, 99th percentile), 85025 $42.6K (rank #314 of 32833, 99th percentile), and 80061 $35.5K (rank #312 of 21671, 99th percentile). These listings indicate the lab performs large volumes of common chemistry and hematology panels in addition to its molecular and collection business.
On Medicare this provider is a recognizable national participant for specific services but not a dominant national lab overall: P9603 ranks #31 of 267 nationally (89th percentile; characterized as typical), U0004 ranks #28 of 259 (90th percentile; typical), and G0471 ranks #36 of 117 (70th percentile; typical). In plain terms, the provider reports elevated but described-as-typical volumes for its highest Medicare lines rather than outlier activity.
Within Alabama Medicaid competitive standing is meaningful for molecular and specialized testing but not uniformly leading: 87798 is $1.3M and ranks #16 of 57 in-state (73rd percentile; typical), U0004 is $415.4K and ranks #7 of 15 (57th percentile; typical), and G0481 (definitive drug testing) is $194.5K and ranks #5 of 18 (76th percentile; typical). These placements indicate the lab is an active in-state player for infectious-agent and drug confirmation testing but not necessarily the statewide market leader across all services.
Drug-testing and toxicology work is a clear service line focus in Medicaid receipts and is present in Medicare as well: Medicaid G0481 $194.5K (5.4% of Medicaid revenue), G0483 $113.7K (3.1%), G0482 $72.8K (2.0%), and G0480 $52.1K (1.4%) together show multi-tier definitive testing volume, while Medicare records G0481 at $24.3K (1.8% of Medicare revenue). This pattern supports an operational capability in GC/MS- and LC/MS-type confirmatory testing in addition to immunoassay screening.
Concentration and cross-payer dependence on infectious-agent molecular testing and specimen-collection services create business risk if demand or reimbursement for those lines shifts: U0004 appears as a top code on both payers (Medicare $223.6K, 16.7% of Medicare revenue; Medicaid $415.4K, 11.4% of Medicaid revenue), and the provider’s top-three-code concentration (56.7% Medicare, 57.2% Medicaid) highlights how changes to a small set of services could materially affect total revenue.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
84 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| P9603 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled | 454,060 | $1 | $454.1K |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by… | 3,020 | $70 | $223.6K |
| G0471 | Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) | 8,140 | $10 | $81.4K |
| U0005 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc,… | 2,860 | $30 | $71.5K |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 6,010 | $10 | $60.1K |
| 85025 | A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a… | 5,330 | $10 | $42.6K |
| 84443 | The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the… | 2,280 | $20 | $36.5K |
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 2,730 | $10 | $35.5K |
| 82306 | The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced… | 1,120 | $30 | $32.4K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 3,630 | $10 | $29K |
Showing 1–10 of 84
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 84 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
84 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| U0004 | 2 | 10 | 460 | $70 | $117.5K |
| P9603 | 1 | 10 | 23,200 | $1 | $108.3K |
| G2024 | 2 | 10 | 3,660 | $20 | $91.2K |
| G0471 | 1 | 10 | 8,140 | $10 | $84.3K |
| G0480 | 19 | 30 | 90 | $110 | $52.5K |
| 83970 | 12 | 40 | 60 | $40 | $49.3K |
| G0481 | 17 | 40 | 110 | $150 | $35K |
| U0005 | 2 | 20 | 100 | $20 | $21.9K |
| 80069 | 4 | 10 | 50 | $10 | $20.1K |
| 80307 | 54 | 120 | 170 | $60 | $19.7K |
Showing 1–10 of 84
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
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Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
85 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 87798 | The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified… | 7,730 | $170 | $1.3M |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by… | 10,380 | $40 | $415.4K |
| 87900 | The lab analyst measures a patient’s susceptibility or resistance to drugs aimed at a virus. The test predicts the behavior of the phenotype based on comparing patient data to regularly updated… | 3,980 | $100 | $377.9K |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 5,000 | $50 | $234.9K |
| G0481 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 2,780 | $70 | $194.5K |
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 830 | $140 | $113.7K |
| 87631 | The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,… | 1,620 | $60 | $93.7K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 1,050 | $80 | $84.1K |
| 87633 | The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for… | 450 | $180 | $82.4K |
| 87641 | The lab analyst performs a test for methicillin–resistant Staphylococcus aureus (MRSA) using an amplified nucleic acid probe technique. | 3,900 | $20 | $74.1K |
Showing 1–10 of 85
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
85 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 87798 | The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified… | 16 | 60 | 1,260 | $60 | $1.2M |
| 87633 | The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for… | 50 | 100 | 470 | $130 | $1.2M |
| 80050 | The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the… | 11 | 20 | 160 | $20 | $1.1M |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by… | 7 | 20 | 10,040 | $40 | $825.9K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 23 | 40 | 450 | $20 | $591.3K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 23 | 40 | 460 | $20 | $584.1K |
| 87661 | The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique. | 25 | 40 | 1,540 | $10 | $397.4K |
| 87581 | The lab analyst performs a test for Mycoplasma pneumonia, a bacteria, using amplified nucleic acid probe technique. | 20 | 40 | 1,440 | $20 | $372.1K |
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 50 | 90 | 500 | $40 | $303.6K |
| 87486 | The lab analyst performs a test for Chlamydia pneumoniae using amplified nucleic acid probe technique. Chlamydia pneumoniae also known as TWAR, Taiwan Acute Respiratory agent, commonly causes mild… | 25 | 40 | 2,000 | $20 | $273.5K |
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Other providers in the same ZIP code as Madison Core Laboratories, LLC, ranked by combined Medicare and Medicaid revenue.
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