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NPI 1265452510 · Elkins, WV · Land Ambulance
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Randolph County Court Emergency Squad is a land ambulance provider located in Elkins, West Virginia. This profile covers 6 Medicare and 6 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 | Randolph County Court Emergency Squad |
| Address | 2 11th St |
| City | Elkins |
| State | WV |
| ZIP | 26241 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | July 20, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $5.3M |
| Medicare | $1M |
RANDOLPH COUNTY COURT EMERGENCY SQUAD’s code mix is clearly a land-ambulance operation: the top billed codes are mileage and ambulance transport services (A0425, A0429, A0428, A0427, A0426), with occasional specialty care transport (A0434). This pattern indicates core operations are ground transport for both emergency and non-emergency BLS and ALS services rather than hospital- or clinic-based care lines.
Medicare revenue is highly concentrated: the top 3 Medicare codes account for 74.6% of the provider's Medicare revenue, led by A0425 (A0425 – Ground mileage) at $317.8K (31.4% of Medicare revenue), A0429 at $230.1K (22.8%), and A0428 at $206.9K (20.5%). A0425 alone shows very high claim volume on Medicare (39.7K claims) but a low avg paid/claim ($8), consistent with mileage-driven billing that aggregates many low-paid units.
Medicaid billing is even more concentrated: the top 3 Medicaid codes account for 82.3% of the provider's Medicaid revenue, dominated by A0425 at $2.2M (41.5%), A0429 at $1.2M (23.4%), and A0427 at $921.4K (17.5%). These three codes together drive the bulk of Medicaid revenue, with large claim counts reported (e.g., A0425: 20.6K claims; A0429: 7K claims; A0427: 4.4K claims), indicating Medicaid transports are the primary revenue engine.
The provider’s payer mix is Medicaid-weighted: lifetime Medicaid revenue is $5.3M versus total Medicare revenue of $1M, indicating Medicaid accounts for the majority of lifetime third-party billing on file. This makes the entity effectively Medicaid-dominant in scale, so reimbursement changes or network decisions by Medicaid programs are likely to have outsized financial impact.
Competitive standing varies by payer and code. On Medicare, A0425 ranks #533 of 8934 (94th percentile) and A0429 ranks #906 of 7808 (88th percentile), showing above-median national presence on mileage and emergency BLS transports but not a national dominant operator; these codes are described as "typical, unremarkable volume for this code." On Medicaid, A0425 ranks #17 of 137 (88th percentile) and A0429 ranks #13 of 113 (89th percentile), positioning the provider as a relatively significant in-state supplier of mileage and emergency BLS services.
Payment and unit-profile differences between payers are pronounced: for A0425 the avg paid/claim is $8 on Medicare versus $106 on Medicaid, and for A0429 it is $373 on Medicare versus $175 on Medicaid; A0428 is $234 on Medicare versus $89 on Medicaid. These per-claim payment differentials, combined with large claim volumes on Medicaid, suggest that Medicaid payment rates and utilization patterns materially shape revenue despite lower national ranking for some Medicare transport codes.
Tenure and operational continuity are evident: the NPI was enumerated 2006-07-20 (~20 years ago), indicating long-standing Medicare/Medicaid enrollment and likely operational stability in the local emergency transport market. This length of enrollment supports continuity in billing relationships and historical presence in the regional EMS ecosystem.
There are modest specialty and non-core volumes: A0434 (specialty care transport) represents just $16.5K and 1.6% of Medicare revenue with 22 claims and a rank of #433 of 591 (26th percentile), indicating SCT is a minor line. By contrast, certain ALS non-emergency items on Medicaid (A0426) show relatively strong in-state placement (rank #5 of 27, 85th percentile), suggesting the provider has a measurable role in higher-acuity non-emergency ALS work within the state even though overall SCT activity is limited.
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 |
|---|---|---|---|---|
| A0425 | Ground mileage, per statute mile | 39,720 | $10 | $317.8K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 620 | $370 | $230.1K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 880 | $230 | $206.9K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 440 | $450 | $196.7K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 150 | $280 | $43.3K |
| A0434 | Specialty care transport (sct) | 20 | $750 | $16.5K |
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.
6 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0425 | Ground mileage, per statute mile | 20,600 | $110 | $2.2M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 7,040 | $180 | $1.2M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 4,430 | $210 | $921.4K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 6,770 | $90 | $602.4K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 1,900 | $170 | $322.3K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 90 | $60 | $5.5K |
How this provider's Medicaid billing volume and revenue compare to other West Virginia providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. West Virginia median
6 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0425 | Ground mileage, per statute mile | 17 | 140 | 2,710 | $100 | $955.9K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 26 | 70 | 3,360 | $110 | $830K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 18 | 100 | 840 | $260 | $730.3K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 13 | 110 | 950 | $220 | $703.7K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 5 | 30 | 530 | $190 | $203K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 7 | 10 | 220 | $20 | $18.7K |
Other providers in the same ZIP code as Randolph County Court Emergency Squad, ranked by combined Medicare and Medicaid revenue.
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