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NPI 1235866278 · Hyannis, MA · Land Ambulance
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Coastal Ambulance LLC is a land ambulance provider located in Hyannis, Massachusetts. This profile covers 6 Medicare and 9 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 | Coastal Ambulance LLC |
| Address | 372 Yarmouth Rd |
| City | Hyannis |
| State | MA |
| ZIP | 02601 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | August 1, 2022 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $8.2M |
| Medicare | $5.1M |
COASTAL AMBULANCE LLC is categorized under a Land Ambulance taxonomy and its claims mix is dominated by basic life support and mileage codes, indicating a core business of patient transport rather than in-hospital clinical services. Medicare top code A0428 (BLS non‑emergency) alone accounts for $3.1M and 59.2% of this provider's Medicare revenue, and Medicaid A0428 accounts for $4.4M and 53.9% of Medicaid revenue, showing the operation is primarily centered on routine ambulance transports.
Revenue is highly concentrated across a very small number of codes on both payers: the precomputed top three Medicare codes account for 91.3% of Medicare revenue and the precomputed top three Medicaid codes account for 88.3% of Medicaid revenue. For Medicare those top drivers are A0428, A0425, and A0429; for Medicaid they are A0428, A0425, and A0429, implying operational and reimbursement risk is concentrated in a narrow set of transport services.
The provider’s payer mix skews toward Medicaid in scale: lifetime Medicaid revenue is $8.2M versus $5.1M in Medicare, so Medicaid represents the larger single payer relationship by dollars. Both payers are material sources of revenue, but the absolute Medicaid dollar scale exceeds Medicare.
Nationally for Medicare COASTAL AMBULANCE shows exceptional concentration and ranking on a pair of transport codes: A0428 (14.1K claims, $3.1M) ranks #21 of 2772 providers (99th percentile; labeled an extreme outlier) and A0425 (145.3K claims, $1M) ranks #72 of 8934 providers (99th percentile; labeled an extreme outlier). These standings indicate the provider bills far above typical national volumes for those two codes and is a dominant outlier on Medicare for BLS non‑emergency and mileage billing.
Within Massachusetts Medicaid comparisons the provider is also a strong regional participant for core transport services: A0425 ranks #22 of 295 in‑state (93rd percentile) and A0428 ranks #10 of 56 in‑state (84th percentile), with A0429 at the 82nd percentile in‑state. Those percentiles indicate a substantial in‑state footprint for mileage and BLS transport billing relative to local peers.
Not all high-ranking codes are described the same way in the source labels: for Medicare A0429 appears with a high percentile (rank #229 of 7808, 97th percentile) but is described as a "typical, unremarkable volume" in the supplied metadata, while A0427 and A0426 are characterized as typical/unremarkable at lower percentiles. This mix suggests the provider’s extreme national outlier status is concentrated specifically in select codes (A0428 and A0425) rather than uniformly across all ambulance service codes.
Operational scale indicators are notable in the raw claim counts reported: Medicare shows 145.3K claims for A0425 and 14.1K claims for A0428, and Medicaid shows 44.6K claims for A0425 and 35.7K claims for A0428, which aligns with a high-volume transport operation focused on mileage-billed and BLS non‑emergency trips. Those claim volumes, together with the revenue concentration, suggest the business model is heavily based on frequent, mileage-associated transports.
The provider’s NPI was enumerated on 2022-08-01 (~4 years ago), so the profile of large, concentrated billing has developed within a relatively recent enrollment window; this tenure context is important when assessing whether current volume patterns reflect rapid growth, localized market capture, or stabilization at a new scale.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
6 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 14,060 | $220 | $3.1M |
| A0425 | Ground mileage, per statute mile | 145,290 | $10 | $1M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1,730 | $370 | $635.9K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 640 | $430 | $275.4K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 380 | $280 | $106.2K |
| A0434 | Specialty care transport (sct) | 90 | $750 | $64.2K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 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.
9 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 35,680 | $120 | $4.4M |
| A0425 | Ground mileage, per statute mile | 44,640 | $40 | $1.7M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 5,430 | $220 | $1.2M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 1,980 | $270 | $537.1K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 1,220 | $180 | $215.2K |
| A0434 | Specialty care transport (sct) | 280 | $560 | $157.6K |
| A0130 | Non-emergency transportation: wheelchair van | 680 | $40 | $23.9K |
| A0999 | Unlisted ambulance service | 190 | $110 | $20.6K |
| S0215 | Non-emergency transportation; mileage, per mile | 430 | $10 | $5.6K |
How this provider's Medicaid billing volume and revenue compare to other Massachusetts providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Massachusetts median
9 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 10 | 60 | 9,300 | $90 | $2.1M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 44 | 240 | 980 | $180 | $1.2M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 86 | 220 | 1,290 | $180 | $740.6K |
| A0130 | Non-emergency transportation: wheelchair van | 68 | 80 | 5,670 | $30 | $449K |
| A0434 | Specialty care transport (sct) | 15 | 30 | 210 | $390 | $404.6K |
| A0425 | Ground mileage, per statute mile | 22 | 300 | 2,300 | $20 | $267.6K |
| S0215 | Non-emergency transportation; mileage, per mile | 91 | 100 | 8,500 | $10 | $253.8K |
| A0999 | Unlisted ambulance service | 13 | 20 | 690 | $30 | $155.8K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 11 | 40 | 510 | $140 | $137K |
Other providers in the same ZIP code as Coastal Ambulance LLC, ranked by combined Medicare and Medicaid revenue.
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