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NPI 1306289996 · Mckinney, TX · Air Ambulance
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Phi Health, L.L.C. is a air ambulance provider located in Mckinney, Texas. This profile covers 2 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 | Phi Health, L.L.C. |
| Address | 1508 Industrial Blvd |
| City | Mckinney |
| State | TX |
| ZIP | 75069 |
| Taxonomy | Air Ambulance |
| NPI Enumerated | April 12, 2013 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $25.9M |
| Medicare | $6.1M |
PHI HEALTH, L.L.C. operates as a rotary-wing air ambulance provider: its Medicare and Medicaid billing is dominated by air-transport codes A0431 and A0436, which correspond to one-way rotary wing transports and rotary wing mileage. The presence of A0434 (Specialty care transport) at very low Medicaid share further supports that fixed-wing or ground specialty services are only a marginal part of its mix.
Medicare revenue is highly concentrated in transport and mileage: the top 3 Medicare codes account for 100.0% of this provider's total Medicare revenue, with A0431 representing 72.3% and A0436 representing 27.7% of Medicare receipts. For these Medicare codes the file shows 1K claims for A0431 at $4334 avg paid/claim and 58.3K claims for A0436 at $29 avg paid/claim, illustrating that nearly all Medicare dollars come from rotary-wing transport and associated mileage line items within a $6.1M Medicare footprint.
Medicaid revenue is even more dominated by the same rotary-wing services: the top 3 Medicaid codes account for 99.7% of total Medicaid revenue, with A0431 at 65.4% ($16.9M) and A0436 at 34.0% ($8.8M) and A0434 contributing a residual 0.2% ($62.4K). This concentration means nearly all of the $25.9M in Medicaid revenue is attributable to rotary-wing transports and mileage, leaving other ambulance and ground codes immaterial to overall Medicaid dollars.
The provider is effectively Medicaid-dominant in scale: reported Medicaid revenue of $25.9M substantially exceeds Medicare revenue of $6.1M, indicating that public-payor exposure is skewed toward state Medicaid programs rather than Medicare in absolute dollars. That payer mix implies strategic importance of state Medicaid contracting and reimbursement policies for this operation’s overall financial performance.
Competitive standing differs sharply by payer and code: for Medicare A0431 and A0436 the provider ranks #9 of 348 providers nationally (98th percentile) but the file characterizes those volumes as “typical, unremarkable volume for this code,” indicating it is a high-ranked national biller by volume measures yet not flagged as unusual within the national distribution. By contrast, for Medicaid the provider ranks #1 of 18 providers in-state (100th percentile) on both A0431 and A0436, explicitly labeled an “extreme outlier,” which marks it as the dominant in-state rotary-wing supplier by reported billing.
The NPI was enumerated on 2013-04-12 (~13 years ago), signaling sustained tenure in the market; combined with the concentrated code mix, this longevity is consistent with an established specialty air-ambulance operator rather than a recent entrant. Longevity plus extreme in-state Medicaid share suggests entrenched operational capacity for rotary-wing transports.
Payment and billing structure differ markedly between payers: Medicare shows A0431 at $4334 avg paid/claim and A0436 at $29 avg paid/claim with very high claim counts for A0436 (58.3K), whereas Medicaid shows A0431 at $2104 avg paid/claim and A0436 at $1100 avg paid/claim with roughly 8.1K and 8K claims respectively. These large differences in avg paid/claim and claim counts between Medicare and Medicaid imply divergent unitization or rate structures (transport fee versus mileage unitization) and should prompt analysts to examine how mileage versus transport line items are reported and reimbursed across the two payers.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 2 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 |
|---|---|---|---|---|
| A0431 | Ambulance service, conventional air services, transport, one way (rotary wing) | 8,050 | $2,100 | $16.9M |
| A0436 | Rotary wing air mileage, per statute mile | 8,020 | $1,100 | $8.8M |
| A0434 | Specialty care transport (sct) | 220 | $290 | $62.4K |
| A0425 | Ground mileage, per statute mile | 550 | $110 | $59.5K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 140 | $180 | $24.8K |
| A0433 | Advanced life support, level 2 (als 2) | 10 | $370 | $5.2K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 50 | $10 | $420 |
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
7 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) | 1 | 20 | 90 | $2,520 | $2.2M |
| A0436 | Rotary wing air mileage, per statute mile | 1 | 20 | 90 | $1,160 | $1M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 211 | 310 | 500 | $160 | $474.9K |
| A0434 | Specialty care transport (sct) | 12 | 30 | 200 | $450 | $322.2K |
| A0425 | Ground mileage, per statute mile | 362 | 500 | 1,970 | $40 | $284.3K |
| A0433 | Advanced life support, level 2 (als 2) | 23 | 30 | 110 | $560 | $224.9K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 62 | 90 | 270 | $20 | $15.6K |
Other providers in the same ZIP code as Phi Health, L.L.C., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| North Central Texas Community Health Care Center Inc | TX | Federally Qualified Health Center (FQHC) | $0 | $14M |
| Monte Jones | TX | Hematology & Oncology Physician | $957.1K | $0 |
| Farhan Mohammad | TX | Hematology & Oncology Physician | $872.8K | $0 |
| Nithya Palanisamy | TX | Hematology & Oncology Physician | $850K | $0 |
| Sultan Chowdhary | TX | Hematology & Oncology Physician | $339.1K | $0 |
| Ann Snyder | TX | Family Medicine Physician | $283.8K | $0 |
| Nishant Bhatt | TX | Plastic and Reconstructive Surgery Physician | $266.2K | $0 |
| Muhammad Khan | TX | Cardiovascular Disease Physician | $240.3K | $0 |
| Salman Butt | TX | Nephrology Physician | $225.4K | $0 |
| Ankit Maheshwari | TX | Interventional Pain Medicine Physician | $220.4K | $0 |
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