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NPI 1275509259 · Irving, TX · Ambulance
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Careflite is a ambulance provider located in Irving, Texas. This profile covers 9 Medicare and 13 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 | Careflite |
| Address | 1630 Corporate Ct |
| City | Irving |
| State | TX |
| ZIP | 75038 |
| Taxonomy | Ambulance |
| NPI Enumerated | February 28, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $14.4M |
| Medicare | $11M |
CAREflITE operates as a mixed air-and-ground ambulance provider: its top revenue codes include A0431 (rotary wing air transport), A0425 (ground mileage), A0428 (BLS non-emergency), and A0427 (ALS 1 emergency), indicating a blended service line that bills both high-acuity air transports and high-volume ground transfers. The presence of A0431 as a top code on both payers and substantial ground mileage counts suggests operational capacity for long-distance and rotary-wing missions as well as routine BLS/ALS ground work.
Medicare revenue is concentrated in a small set of ambulance services: the precomputed top three Medicare codes account for 71.9% of the provider's Medicare revenue, with A0428 ($3.1M, 28.0%), A0431 ($2.9M, 26.2%), and A0425 ($1.9M, 17.8%) driving most receipts. This concentration underscores dependence on a few service lines—primarily BLS non-emergency, rotary wing air transport, and ground mileage—for the $11M in total Medicare revenue.
Medicaid revenue is likewise top-heavy: the precomputed top three Medicaid codes account for 65.6% of Medicaid revenue, led by A0431 ($4.1M, 28.4%), A0427 ($2.9M, 19.8%), and A0425 ($2.5M, 17.4%). Those three codes together form the backbone of the provider's $14.4M Medicaid portfolio, with rotary wing and ALS emergency services prominent in-state.
The provider has a Medicaid-heavy scale: total Medicaid revenue ($14.4M) exceeds total Medicare revenue ($11M), so CAREFLITE is not effectively single-payer and derives a larger absolute share of revenue from Medicaid-based activity. This mix suggests payer-specific operational emphasis and contract exposure to state Medicaid rates and utilization patterns.
CAREFLITE is a national outlier on specific Medicare codes: A0428 ranks #20 of 2772 nationally and is labeled an "extreme outlier," and A0425 ranks #17 of 8934 with an "extreme outlier" designation as well, signaling volumes far above typical national peers for those ground and BLS services. In contrast, A0431 on Medicare ranks #14 of 348 (96th percentile) and is described as "typical, unremarkable volume," indicating unusually high volumes for some ground-related codes but more conventional standing among rotary-wing Medicare peers.
State-level competitive standing on Medicaid shows major market positioning for several codes: A0431 ranks #3 of 18 in-state (88th percentile, typical), A0425 ranks #8 of 496 (99th percentile, notably above typical state volume), and A0428 ranks #3 of 193 (99th percentile, notably above typical state volume). These ranks indicate CAREFLITE is a leading in-state supplier for both rotary-wing transports and high-volume ground/BLS services.
The payer-level price profile varies markedly across codes: A0431 average paid per claim is $4006 on Medicare and $2048 on Medicaid, showing air transports are high-dollar services on both payers though Medicare averages are higher; ground-mileage and other mileage codes show much lower per-claim averages (A0425 Medicare avg $7, Medicaid avg $36), reflecting a revenue model that couples a small number of high-dollar air claims with very large volumes of low-dollar mileage claims. Analysts should note this mix because per-claim values and claim counts both materially shape revenue despite very different unit prices.
CAREFLITE has long-standing enrollment visibility, with its NPI enumerated on 2006-02-28 (~20 years ago). That tenure combined with the provider's concentrated code profile and high percentile ranks on several codes suggests an established regional presence and operational focus on ambulance transport specialties rather than a new or transient billing pattern.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
9 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 14,710 | $210 | $3.1M |
| A0431 | Ambulance service, conventional air services, transport, one way (rotary wing) | 710 | $4,010 | $2.9M |
| A0425 | Ground mileage, per statute mile | 278,050 | $10 | $1.9M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 4,050 | $380 | $1.6M |
| A0436 | Rotary wing air mileage, per statute mile | 28,400 | $30 | $823.7K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1,630 | $320 | $524.2K |
| A0433 | Advanced life support, level 2 (als 2) | 140 | $560 | $77.8K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 220 | $250 | $55.2K |
| A0434 | Specialty care transport (sct) | 50 | $680 | $33.8K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
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.
13 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0431 | Ambulance service, conventional air services, transport, one way (rotary wing) | 2,010 | $2,050 | $4.1M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 17,550 | $160 | $2.9M |
| A0425 | Ground mileage, per statute mile | 69,830 | $40 | $2.5M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 39,400 | $50 | $1.9M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 10,310 | $150 | $1.5M |
| A0436 | Rotary wing air mileage, per statute mile | 2,000 | $560 | $1.1M |
| A0398 | Als routine disposable supplies | 10,860 | $20 | $163K |
| A0382 | Bls routine disposable supplies | 6,390 | $20 | $95.8K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 3,040 | $10 | $33.5K |
| A0433 | Advanced life support, level 2 (als 2) | 140 | $230 | $32.2K |
Showing 1–10 of 13
How this provider's Medicaid billing volume and revenue compare to other Texas providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Texas median
13 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0431 | Ambulance service, conventional air services, transport, one way (rotary wing) | 3 | 20 | 90 | $2,520 | $2.2M |
| A0436 | Rotary wing air mileage, per statute mile | 3 | 20 | 90 | $1,160 | $1M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 19 | 320 | 920 | $180 | $720.3K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 16 | 310 | 500 | $160 | $474.9K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 3 | 190 | 2,590 | $60 | $427.4K |
| A0434 | Specialty care transport (sct) | 24 | 30 | 200 | $450 | $322.2K |
| A0425 | Ground mileage, per statute mile | 8 | 500 | 1,970 | $40 | $284.3K |
| A0433 | Advanced life support, level 2 (als 2) | 12 | 30 | 110 | $560 | $224.9K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 9 | 40 | 130 | $70 | $45.6K |
| A0382 | Bls routine disposable supplies | 19 | 220 | 460 | $10 | $31.6K |
Showing 1–10 of 13
Other providers in the same ZIP code as Careflite, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Green Apple LLC | TX | Home Health Agency | $0 | $59.8M |
| Therapy 2000 Inc | TX | Home Health Agency | $0 | $47.8M |
| Texas Molecular Diagnostics Laboratory | TX | Clinical Medical Laboratory | $43M | $11.6K |
| Northstar Anesthesia Of Michigan Iii PLLC | TX | Pain Medicine (Anesthesiology) Physician | $0 | $12.7M |
| Northstar Anesthesia Of Michigan PLLC | TX | Anesthesiology Physician | $0 | $12M |
| Houston Neurodiagnostics, LLC | TX | Physiological Laboratory | $1.7M | $8.5M |
| V-labs America Inc | TX | Clinical Medical Laboratory | $2.4M | $1K |
| Charles Powell | TX | Family Medicine Physician | $1.1M | $0 |
| Sumana Ketha | TX | Internal Medicine Physician | $605.1K | $500 |
| Padmavathy Uppalapati | TX | Cardiovascular Disease Physician | $283.4K | $0 |
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