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NPI 1194842781 · Hartford, CT · Land Ambulance
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Aetna Ambulance Service, Inc is a land ambulance provider located in Hartford, Connecticut. This profile covers 7 Medicare and 11 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 | Aetna Ambulance Service, Inc |
| Address | 140 Van Block Ave |
| City | Hartford |
| State | CT |
| ZIP | 06106 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | March 26, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $22.2M |
| Medicare | $2.9M |
This provider has a Medicaid-dominant revenue footprint: lifetime Medicaid revenue is $22.2M compared with $2.9M in Medicare, indicating that Medicaid accounts for the large majority of billing volume and dollars for the operation. Analysts should treat the entity as effectively a Medicaid-focused ambulance operator when evaluating network participation or state-level contracting opportunities.
Revenue is highly concentrated in a small set of ambulance codes on both payers: the top three Medicare codes account for 81.0% of Medicare revenue, and the top three Medicaid codes account for 90.3% of Medicaid revenue. This concentration signals material dependence on core transport services (both emergency and non‑emergency) for overall financial performance.
The code mix points to a broad ambulance transport business with both emergency and non‑emergency activity: Medicare top codes include A0428 (BLS non‑emergency), A0425 (ground mileage), and A0427 (ALS1 emergency), while Medicaid top codes are A0429 (BLS emergency), A0427 (ALS1 emergency), and A0428 (BLS non‑emergency). High volumes of mileage and BLS claims across payers suggest the operation dispatches many routine interfacility and patient transport trips in addition to emergency responses.
On Medicare the provider shows national-level strength for certain lines: A0428 is ranked #100 of 2772 (96th percentile) and A0425 is ranked #221 of 8934 (98th percentile), both described as notably above typical national volume for these codes; by contrast A0427 and A0429 are described as typical, unremarkable volume for their respective national peer groups. In sum, the organization is a major national-volume filer for mileage and BLS non‑emergency Medicare claims but not an exceptional national outlier for ALS emergency transports.
In‑state Medicaid positioning is strong for emergency and BLS transports: A0429 is ranked #4 of 122 (98th percentile), A0427 is #3 of 80 (97th percentile), and A0428 is #3 of 17 (88th percentile); these Medicaid rankings, while labeled typical, unremarkable volume for the codes, place the provider among the top filers statewide and indicate a leading market share role in Connecticut ambulance billing. The provider’s large claim counts on Medicaid (for example, 41.9K claims for A0429 and 29.9K claims for A0427) reinforce its significant state-level activity.
Operational workload indicators underline high transport throughput: Medicare shows 79.3K claims for A0425 (ground mileage) and 5.9K claims for A0428, while Medicaid shows 65.4K claims for A0428 and 57.1K claims for A0425. These large claim volumes and the presence of both per‑mile and per‑transport codes imply extensive geographic coverage and frequent trip dispatching rather than a niche or occasional-service provider.
Dependence on a narrow set of ambulance CPT/HCPCS creates revenue concentration risk: with the top three Medicare codes making up 81.0% of Medicare revenue and the top three Medicaid codes making up 90.3% of Medicaid revenue, changes in reimbursement policy, mileage rules, or coverage for a small number of codes could materially affect total revenue. Payors and analysts should monitor policy or rate changes for A0428, A0425, A0427, and A0429 as potential levers of financial impact.
The provider has an established billing history, with its NPI enumerated on 2007-03-26 (~19 years ago), indicating sustained participation in Medicare and Medicaid networks. That longevity, combined with high-volume mileage and transport billing, suggests an operationally mature ambulance service with entrenched billing patterns to both state Medicaid and federal Medicare programs.
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 |
|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 5,860 | $230 | $1.3M |
| A0425 | Ground mileage, per statute mile | 79,340 | $10 | $555.4K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 1,130 | $430 | $488.3K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1,280 | $360 | $462.3K |
| A0434 | Specialty care transport (sct) | 70 | $740 | $51.2K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 120 | $270 | $32.5K |
| A0433 | Advanced life support, level 2 (als 2) | 10 | $630 | $7.5K |
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.
11 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 41,880 | $200 | $8.2M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 29,940 | $210 | $6.3M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 65,390 | $90 | $5.6M |
| S0215 | Non-emergency transportation; mileage, per mile | 23,580 | $50 | $1.2M |
| A0425 | Ground mileage, per statute mile | 57,100 | $10 | $799.4K |
| A0432 | Paramedic intercept (pi), rural area, transport furnished by a volunteer ambulance company which is prohibited by state law from billing third party payers | 740 | $120 | $87.6K |
| A0998 | Ambulance response and treatment, no transport | 470 | $80 | $37.3K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 240 | $130 | $31.2K |
| 4701Y | N/A | 1,060 | $10 | $14.8K |
| A0420 | Ambulance waiting time (als or bls), one half (1/2) hour increments | 50 | $20 | $1K |
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How this provider's Medicaid billing volume and revenue compare to other Connecticut providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Connecticut median
11 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 3 | 20 | 17,430 | $80 | $2.7M |
| S0215 | Non-emergency transportation; mileage, per mile | 4 | 20 | 10,360 | $20 | $2.6M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 4 | 120 | 1,930 | $180 | $1.3M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 3 | 80 | 900 | $190 | $1.3M |
| A0432 | Paramedic intercept (pi), rural area, transport furnished by a volunteer ambulance company which is prohibited by state law from billing third party payers | 14 | 20 | 1,490 | $110 | $321.7K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 8 | 10 | 360 | $120 | $206.1K |
| A0425 | Ground mileage, per statute mile | 5 | 130 | 2,510 | $10 | $141.8K |
| A0998 | Ambulance response and treatment, no transport | 5 | 20 | 100 | $60 | $18.3K |
| 4701Y | N/A | 3 | 10 | 390 | $20 | $8.1K |
| A0888 | Noncovered ambulance mileage, per mile (e.g., for miles traveled beyond closest appropriate facility) | 5 | 10 | 190 | $1 | $910 |
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Other providers in the same ZIP code as Aetna Ambulance Service, Inc, ranked by combined Medicare and Medicaid revenue.
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