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NPI 1275690737 · Charleston, WV · Land Ambulance
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Kanawha County Emergency Ambulance Authority is a land ambulance provider located in Charleston, West Virginia. This profile covers 7 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 | Kanawha County Emergency Ambulance Authority |
| Address | 601 Brooks St |
| City | Charleston |
| State | WV |
| ZIP | 25301 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | January 3, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $31.9M |
| Medicare | $2.3M |
KANAWHA COUNTY EMERGENCY AMBULANCE AUTHORITY’s billing profile is dominated by emergency ground-ambulance services: its top Medicare and Medicaid revenue drivers are A0427, A0429, and A0425, which are advanced/basic life-support emergency transports and ground mileage. The provider’s Land Ambulance taxonomy and the large shares attributable to these codes indicate an operational focus on emergency transport rather than non-transport or ancillary services.
Revenue concentration is high on both payers. For Medicare, the top 3 codes account for 80.5% of the provider’s Medicare revenue, and for Medicaid the top 3 codes account for 88.6% of Medicaid revenue, indicating that most receipts are tied to a very small set of transport and mileage codes.
Payer mix is heavily skewed toward Medicaid: total Medicaid revenue is $31.9M compared with total Medicare revenue of $2.3M, so Medicaid is the dominant payer by scale for this provider. This profile implies the business’s volume and cashflow are materially driven by state Medicaid contracts and utilization rather than Medicare.
On Medicare, the provider shows above-typical national participation on specific ambulance codes: A0429 ranks #176 of 7808 providers nationally (98th percentile) and A0425 ranks #207 of 8934 providers nationally (98th percentile), both labeled as notably above typical national volume for those codes. Other Medicare top codes such as A0427 and A0428 are described as typical or unremarkable in national standing despite contributing sizable shares of Medicare revenue, so the national footprint is mixed by code.
Within West Virginia Medicaid, the provider is a clear volume leader for core transport codes. A0427, A0429, and A0425 each rank #1 in-state and are labeled as extreme outliers, far above typical state volume; these three codes alone generate $10.5M, $9M, and $8.8M respectively and together drive the majority of the provider’s $31.9M Medicaid revenue. This statewide dominance suggests the provider is a primary ambulance operator for Medicaid beneficiaries in its market.
Operational detail: the mileage-driven revenue line is large on both payers and particularly concentrated in Medicaid (A0425: 118.5K claims, $8.8M Medicaid revenue; on Medicare A0425: 82.5K claims, $577.3K revenue). High claim counts for A0425 imply substantial travel distance or high trip volume, which has implications for resource deployment, vehicle utilization, and reimbursement exposure tied to per-mile payment.
Tenure and stability: the provider’s NPI was enumerated on 2007-01-03 (~19 years ago), indicating long-standing operation and established billing patterns across both Medicare and Medicaid. Combined longevity and concentrated code dominance in-state suggest entrenched service relationships with the local payer mix and referral sources.
Business risk and strategic implications: heavy reliance on a small set of emergency transport and mileage codes (top-3 shares of 80.5% Medicare and 88.6% Medicaid) creates concentration risk—changes in reimbursement policy, state Medicaid rates, or non-emergency transport utilization patterns could materially affect revenue. Conversely, the provider’s extreme in-state volume for core Medicaid ambulance codes positions it well for negotiating with the state or participating in regional planning for emergency medical services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 2,010 | $350 | $705.2K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 2,080 | $300 | $620.4K |
| A0425 | Ground mileage, per statute mile | 82,470 | $10 | $577.3K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 2,450 | $170 | $418.6K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 60 | $230 | $14.6K |
| A0433 | Advanced life support, level 2 (als 2) | 30 | $510 | $14.3K |
| A0434 | Specialty care transport (sct) | 20 | $610 | $12.9K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 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 |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 41,470 | $250 | $10.5M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 42,480 | $210 | $9M |
| A0425 | Ground mileage, per statute mile | 118,480 | $70 | $8.8M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 32,330 | $110 | $3.4M |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 1,110 | $180 | $198.1K |
| A0433 | Advanced life support, level 2 (als 2) | 60 | $340 | $21K |
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 | 1 | 140 | 2,710 | $100 | $955.9K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 4 | 70 | 3,360 | $110 | $830K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 1 | 100 | 840 | $260 | $730.3K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1 | 110 | 950 | $220 | $703.7K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 7 | 30 | 530 | $190 | $203K |
| A0433 | Advanced life support, level 2 (als 2) | 1 | 10 | 30 | $340 | $12.1K |
Other providers in the same ZIP code as Kanawha County Emergency Ambulance Authority, ranked by combined Medicare and Medicaid revenue.
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