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NPI 1265719256 · Pineville, WV · Land Ambulance
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Stat Ems, LLC. is a land ambulance provider located in Pineville, West Virginia. This profile covers 5 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 | Stat Ems, LLC. |
| Address | 84-b Main Ave |
| City | Pineville |
| State | WV |
| ZIP | 24874 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | November 4, 2011 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $25.3M |
| Medicare | $2M |
STAT EMS, LLC. is a long-tenured land ambulance provider (taxonomy: Land Ambulance) with an NPI enumerated 2011-11-04 (~15 years ago). Its lifetime Medicare revenue on file is $2M while lifetime Medicaid revenue is $25.3M, indicating a Medicaid-heavy revenue base in scale and dependence. This tenure and payer mix position the organization as a mature, Medicaid-focused ambulance operator in its state.
Revenue concentration is very high on both payers: precomputed totals show the top 3 Medicare codes by revenue account for 91.6% of this provider's total Medicare revenue, and the top 3 Medicaid codes account for 91.0% of its total Medicaid revenue. That concentration means a small set of transport and mileage codes drive nearly all billed revenue for each payer, so changes to reimbursement or utilization for those codes would disproportionately affect overall revenue.
The provider’s code mix — dominated by A0425, A0428, and A0429 on both payers — is consistent with an operation focused on ground ambulance mileage and basic life support transports. A0425 (ground mileage) and A0428/A0429 (BLS non-emergency and BLS emergency) together dominating revenues suggests routine patient transports and mileage-billed activity are the core service lines rather than a heavier emphasis on advanced life support. This aligns with the Land Ambulance taxonomy listed for the NPI.
On Medicare the provider is an extreme outlier for mileage: A0425 accounts for $893.2K and 44.5% of this provider's total Medicare revenue and ranks #116 of 8934 providers nationally (99th percentile; extreme outlier). By contrast, A0428 ($612.2K, 30.5%) and A0429 ($332.9K, 16.6%) rank in the 94th percentile nationally and are described as exhibiting typical, unremarkable volume for those codes; collectively these three Medicare codes make up 91.6% of Medicare revenue, meaning the provider is nationally notable primarily for mileage billing.
In Medicaid billing the provider is dominant in-state for core codes: A0428 ($8.1M, 31.8%) ranks #1 of 74 providers in-state (100th percentile; extreme outlier) and A0425 ($11.4M, 45.2%) ranks #2 of 137 providers in-state (99th percentile; extreme outlier). A0429 ($3.6M, 14.0%) ranks #4 of 113 providers in-state (97th percentile; notably above typical). Those in-state rankings indicate the organization is a market-leading Medicaid ambulance biller in West Virginia for both mileage and BLS transports.
There is a notable divergence in per-claim payment patterns between payers for the same code: for A0425 the Medicare line shows 111.6K claims at $8 avg paid/claim while Medicaid shows 106K claims at $108 avg paid/claim, and for A0428 Medicaid reports $109 avg paid/claim versus Medicare $162 avg paid/claim for A0428. These payer-level per-claim differences, presented as reported, suggest materially different payment rates and revenue outcomes by payer for the same service codes and underline the importance of payer mix for unit economics.
Advanced life support codes appear but represent secondary revenue streams: Medicare A0427 generates $163.9K (8.2% of Medicare revenue) and A0426 is only $5K (0.3%), while on Medicaid A0427 is $2.1M (8.3%) and A0426 is $110.2K (0.4%). These figures indicate the provider performs some ALS emergency and non-emergency transports but that ALS services are a much smaller share of total billed revenue compared with mileage and BLS services.
Because such a large share of revenue is concentrated in a small number of codes (top three codes = 91.6% Medicare; 91.0% Medicaid), the provider’s financial performance is sensitive to utilization, audit focus, or reimbursement policy changes tied to A0425, A0428, and A0429. For payer/provider analysts, monitoring changes to mileage and BLS policy, state Medicaid fee schedules, and in-state competitive moves will be particularly important for forecasting revenue risk and operational planning.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0425 | Ground mileage, per statute mile | 111,640 | $10 | $893.2K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 3,780 | $160 | $612.2K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1,120 | $300 | $332.9K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 460 | $350 | $163.9K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 20 | $230 | $5K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 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 |
|---|---|---|---|---|
| A0425 | Ground mileage, per statute mile | 105,980 | $110 | $11.4M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 73,890 | $110 | $8.1M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 19,000 | $190 | $3.6M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 9,370 | $230 | $2.1M |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 840 | $130 | $110.2K |
| A0998 | Ambulance response and treatment, no transport | 670 | $50 | $32.1K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 840 | $40 | $30.1K |
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
7 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0425 | Ground mileage, per statute mile | 2 | 140 | 2,710 | $100 | $955.9K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 1 | 70 | 3,360 | $110 | $830K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 9 | 100 | 840 | $260 | $730.3K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 4 | 110 | 950 | $220 | $703.7K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 11 | 30 | 530 | $190 | $203K |
| A0998 | Ambulance response and treatment, no transport | 4 | 20 | 230 | $50 | $35.1K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 4 | 10 | 220 | $20 | $18.7K |
Other providers in the same ZIP code as Stat Ems, LLC., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Family Healthcare Associates Inc | WV | Rural Health Clinic/Center | $0 | $8.5M |
| Central Labs Inc | WV | Clinical Medical Laboratory | $209K | $1.9M |
| Kissel Family Optometry, Inc. | WV | Optometrist | $0 | $950.6K |
| Samuel Muscari | WV | Family Medicine Physician | $10.1K | $0 |
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