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NPI 1215982749 · Monroe, MI · Ambulance
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Monroe Community Ambulance is a ambulance provider located in Monroe, Michigan. This profile covers 7 Medicare and 7 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 | Monroe Community Ambulance |
| Address | 1598 W 7th St |
| City | Monroe |
| State | MI |
| ZIP | 48161 |
| Taxonomy | Ambulance |
| NPI Enumerated | May 23, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $5.9M |
| Medicare | $1.6M |
This provider's payer mix is heavily skewed toward Medicaid: lifetime Medicaid revenue is $5.9M compared with $1.6M in Medicare, making Medicaid the dominant source of billed revenue for MONROE COMMUNITY AMBULANCE. The scale difference suggests the provider's operational footprint and contracting priorities are likely oriented to Medicaid populations and state-level programs rather than Medicare-first growth strategies.
Medicare revenue is highly concentrated in a few transport services: the precomputed top 3 Medicare codes account for 84.1% of this provider's total Medicare revenue. The leading Medicare code is A0427 (ALS emergency) with $857.3K (52.3% of Medicare revenue), followed by A0429 and A0425, indicating emergency advanced and basic life-support transports plus mileage drive most Medicare dollars.
Medicaid revenue is similarly concentrated: the precomputed top 3 Medicaid codes account for 83.4% of this provider's total Medicaid revenue. A0427 (ALS emergency) is the top Medicaid code with $3.1M (51.8% of Medicaid revenue), supported by substantial ground mileage (A0425, $1.1M) and BLS emergency transports (A0429, $780.2K), showing the same core services dominate across payers.
Operational profile: the code mix—A0427, A0429, and A0425—signals a fleet focused on emergency transport capacity with significant mileage volumes. Medicare shows 2.3K claims for A0427 and 32K claims for A0425, while Medicaid shows 14.6K claims for A0427 and 25.9K for A0425, which together imply frequent emergency responses and many miles billed rather than a business concentrated on non-emergency interfacility moves alone.
Competitive standing nationally for Medicare is notable but characterized as typical in the peer dataset: A0427 ranks #301 of 6841 providers nationally (96th percentile) and is labeled "typical, unremarkable volume" in the comparison data. A0429 and A0425 also rank in the 90+ percentiles nationally (93th), which indicates high absolute placement among peers but the vendor dataset still classifies these volumes as typical for ambulance providers.
State-level competitive position on Medicaid shows strong placement for the same emergency services: A0427 ranks #17 of 163 in-state (90th percentile) and A0425 ranks #24 of 199 (88th percentile). Those ranks position this provider among the larger in-state billers for emergency ambulance and mileage, suggesting it is an important regional resource for Medicaid transports.
Presence of no-transport and specialty response activity on Medicaid: A0998 (ambulance response and treatment, no transport) generated $402.1K (6.8% of Medicaid revenue) with 2.6K claims, indicating the provider performs a meaningful volume of scene care without transport in addition to its transport work. Specialty care transport (A0434) appears on Medicare with $28.6K (1.7% of Medicare revenue), so higher-acuity interfacility capabilities exist but are a small share of overall revenue.
Tenure and taxonomy: MONROE COMMUNITY AMBULANCE is enumerated as of 2006-05-23 (~20 years ago) and is classified under the Ambulance taxonomy. This long enrollment period combined with concentrated ALS/BLS emergency billing patterns suggests an established emergency transport operator with sustained Medicaid-dependent revenue streams and a consistent role in regional emergency response.
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) | 2,280 | $380 | $857.3K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 940 | $320 | $297.7K |
| A0425 | Ground mileage, per statute mile | 31,990 | $10 | $223.9K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 980 | $200 | $194K |
| A0434 | Specialty care transport (sct) | 40 | $650 | $28.6K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 80 | $240 | $19.1K |
| A0433 | Advanced life support, level 2 (als 2) | 30 | $550 | $18.1K |
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.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 14,570 | $210 | $3.1M |
| A0425 | Ground mileage, per statute mile | 25,880 | $40 | $1.1M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 5,570 | $140 | $780.2K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 4,840 | $120 | $570.6K |
| A0998 | Ambulance response and treatment, no transport | 2,590 | $160 | $402.1K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 40 | $200 | $7.3K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 550 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Michigan providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Michigan median
7 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) | 17 | 160 | 1,880 | $230 | $1.3M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 19 | 70 | 1,790 | $130 | $1M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 33 | 150 | 1,570 | $150 | $951.3K |
| A0425 | Ground mileage, per statute mile | 24 | 200 | 2,950 | $50 | $648.5K |
| A0998 | Ambulance response and treatment, no transport | 19 | 50 | 1,100 | $180 | $553.8K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 42 | 50 | 540 | $220 | $285.3K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 12 | 30 | 290 | $1 | $1 |
Other providers in the same ZIP code as Monroe Community Ambulance, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Chs Group LLC | MI | Case Manager/Care Coordinator | $0 | $61.2M |
| Monroe County Community Mental Health Authority | MI | Community/Behavioral Health Agency | $0 | $55.3M |
| Passion Of Mind Healing Center | MI | Methadone Clinic | $163.1K | $6.1M |
| The Surgical Institute Of Monroe Ambulatory Surgery Center LLC | MI | Ambulatory Surgical Clinic/Center | $370.2K | $71.9K |
| Mahmood Moosa | MI | Endocrinology, Diabetes & Metabolism Physician | $215.1K | $4.2K |
| Abdul Kabir | MI | Internal Medicine Physician | $219.3K | $0 |
| Michael Tilson | MI | Family Medicine Physician | $137.9K | $0 |
| Kristi Simmons | MI | Physician Assistant | $8K | $0 |
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