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NPI 1245569144 · Lafayette, IN · Land Ambulance
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Franciscan Health Lafayette is a land ambulance provider located in Lafayette, Indiana. This profile covers 4 Medicare and 5 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 | Franciscan Health Lafayette |
| Address | 1501 Hartford St |
| City | Lafayette |
| State | IN |
| ZIP | 47904 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | December 24, 2009 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $8.8M |
| Medicare | $1.4M |
Franciscan Health Lafayette operates as a ground ambulance provider focused on emergency transport: its top Medicare and Medicaid revenue codes are A0429 (BLS emergency), A0427 (ALS 1 emergency), and A0425 (ground mileage), indicating primary operations are emergency ambulance transports with both basic and advanced life support responses. The presence of A0433 (ALS 2) and A0998 (response without transport) at much smaller shares further supports a service mix centered on transport rather than non-transport or highly specialized ALS 2 interventions.
Revenue concentration is high for both payers: the top three Medicare codes account for 97.6% of Medicare revenue and the top three Medicaid codes account for 99.7% of Medicaid revenue, showing that nearly all billed revenue is driven by emergency transport and mileage billing lines. This concentration implies limited revenue diversification beyond core ambulance transport services for both Medicare and Medicaid.
Scale and payer mix are skewed toward Medicaid in lifetime totals: the provider reports $1.4M in total Medicare revenue versus $8.8M in total Medicaid revenue, marking Medicaid as the substantially larger payer relationship by reported lifetime revenue. While both payers are active, the provider is effectively more dependent on Medicaid volume and reimbursement in absolute dollars.
Competitive standing differs by payer and code: for Medicare A0429 the provider ranks #172 of 7808 (98th percentile) and is described as “notably above typical national volume,” indicating a strong national presence for BLS emergency transports. By contrast A0427 (ALS 1) ranks #535 of 6841 (92nd percentile) and A0425 (mileage) ranks #996 of 8934 (89th percentile), which are high but characterized as typical/unremarkable volumes nationally, suggesting leadership specifically in BLS emergency transports with solid but less exceptional presence on ALS 1 and mileage at the national level.
In-state competitive position for Medicaid is pronounced: A0429 and A0427 both rank #6 in-state (97th percentile), which positions the provider as a top-tier ambulance operator in Indiana for both BLS and ALS emergency transport volumes. A0425 (mileage) ranks #11 in-state (97th percentile), indicating similarly strong geographic coverage or trip distances relative to peers statewide, while lower-ranked codes such as A0998 and A0433 show minimal contribution to Medicaid revenue and limited in-state competitive impact.
Coding mix and per-claim payment patterns suggest operational focus and case mix: Medicare average paid/claim for A0429 is $315 and for A0427 is $372, while Medicaid averages are lower at $178 and $196 respectively, which reflects payer-level payment differentials rather than differences in service types. The much higher claim counts for A0429 and A0427 on Medicaid (27.1K and 15.5K claims) versus Medicare (2.1K and 1.4K claims) indicate that Medicaid drives the bulk of trip volume even when per-claim payments are lower.
Provider tenure is well-established: the NPI was enumerated on 2009-12-24 (~17 years ago), indicating long-term operation and likely sustained relationships with regional payers and referral sources. This duration, coupled with the high percentile rankings in-state, supports the conclusion that the provider is an entrenched ambulance service in its market.
Statistical standing across specific codes should be noted: A0429 on Medicare is explicitly labeled as “notably above typical national volume,” signaling an outlier-level presence for BLS emergency transports nationally, while other top codes are described as typical/unremarkable or mid-percentile. For Medicaid, A0429 and A0427 are top in-state performers (97th percentile), but codes like A0433 and A0998 have minimal revenue shares and lower percentile placement, indicating limited activity in higher-level ALS 2 responses and non-transport encounters.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 2,130 | $320 | $669.7K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 1,390 | $370 | $516K |
| A0425 | Ground mileage, per statute mile | 21,240 | $10 | $148.7K |
| A0433 | Advanced life support, level 2 (als 2) | 60 | $540 | $33.1K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 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.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 27,120 | $180 | $4.8M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 15,530 | $200 | $3M |
| A0425 | Ground mileage, per statute mile | 41,900 | $20 | $921.7K |
| A0433 | Advanced life support, level 2 (als 2) | 70 | $380 | $24.4K |
| A0998 | Ambulance response and treatment, no transport | 50 | $60 | $3.3K |
How this provider's Medicaid billing volume and revenue compare to other Indiana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Indiana median
5 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 | 180 | 1,730 | $180 | $744.6K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 6 | 200 | 1,130 | $160 | $730.5K |
| A0425 | Ground mileage, per statute mile | 11 | 330 | 2,010 | $30 | $266.8K |
| A0433 | Advanced life support, level 2 (als 2) | 8 | 20 | 70 | $390 | $141K |
| A0998 | Ambulance response and treatment, no transport | 19 | 30 | 160 | $50 | $27.5K |
Other providers in the same ZIP code as Franciscan Health Lafayette, ranked by combined Medicare and Medicaid revenue.
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