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NPI 1316334972 · Charleston, WV · Land Ambulance
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Healthteam Critical Care Transport LLC is a land ambulance provider located in Charleston, 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 | Healthteam Critical Care Transport LLC |
| Address | 3211 Maccorkle Ave Se |
| City | Charleston |
| State | WV |
| ZIP | 25304 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | April 22, 2015 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $19.8M |
| Medicare | $2.5M |
This provider is predominantly a Medicaid-billed ambulance operator by revenue scale: lifetime Medicaid revenue is $19.8M versus total Medicare revenue of $2.5M, indicating Medicaid accounts for the bulk of billed dollars. The NPI was enumerated on 2015-04-22 (~11 years ago), so this performance reflects roughly a decade of claims activity under the same registration window.
Revenue is highly concentrated across a small set of codes for Medicare: the top three Medicare codes account for 93.8% of the provider's Medicare revenue, with A0428 (43.7% of Medicare revenue) and A0425 (42.9% of Medicare revenue) together making up the vast majority. Those two codes are high-volume nationally for this provider — A0428 ranks #104 of 2772 (96th percentile, notably above typical national volume) and A0425 ranks #67 of 8934 (99th percentile, extreme outlier) — which signals dependency on mileage and BLS non-emergency transports in Medicare.
Medicaid billing is even more concentrated: the top three Medicaid codes account for 95.4% of the provider's Medicaid revenue, dominated by A0425 at $11.8M (59.4% of Medicaid revenue) and A0428 at $5.5M (27.6% of Medicaid revenue). Both codes are high-volume in-state — A0425 ranks #5 of 137 (97th percentile, notably above typical state volume) and A0428 ranks #2 of 74 (99th percentile, extreme outlier) — indicating the provider is a major conduit for ground-mileage and BLS non-emergency Medicaid transports in West Virginia.
The code mix (A0425 ground mileage, A0428 BLS non-emergency, plus A0426 ALS non-emergency and A0434 specialty care transport) paints a clear operational profile: the organization appears oriented toward high-mileage interfacility and non-emergency patient moves with capability to provide advanced and specialty care transport when needed. High reported mileage counts (e.g., 152.3K Medicare claims for A0425 and 57.5K Medicaid claims for A0425) suggest routing patterns that generate significant per-transport mileage billing rather than being focused solely on short-scene emergency runs.
Competitive standing differs by payer and code: nationally for Medicare the provider ranks in the top percentiles for its largest codes (A0425 at the 99th percentile and A0428 at the 96th), making it an unusually large national participant for those services. In-state for Medicaid the provider is a dominant player for several high-value codes — A0426 and A0434 both rank #1 in-state for their respective codes and A0428 ranks #2 — indicating a leading market position in West Virginia for both routine and higher-acuity non-emergency transports.
There are clear statistical outlier signals to note separately by payer and code: A0425 is flagged as an "extreme outlier" nationally for Medicare volume, while several Medicaid codes are described as extreme or notably above typical state volume (A0426 at 100th percentile, A0434 and A0422 at 100th percentile for their code sets). These characterizations imply the provider bills these specific line items at volumes that substantially exceed typical peers, which is relevant when benchmarking utilization and negotiating rates or audits.
Because top codes drive virtually all revenue on both payers (top three Medicare codes = 93.8% of Medicare revenue; top three Medicaid codes = 95.4% of Medicaid revenue), the provider has high revenue concentration risk tied to mileage and basic/advanced non-emergency transport volumes. Any changes in coverage policy, mileage reimbursement, or utilization management focused on A0425/A0428/A0426 would disproportionately affect this provider's financial performance.
Operational and contracting implications flow from the mix: payers evaluating network value or medical necessity policies should prioritize review of ground mileage (A0425) and BLS non-emergency transport (A0428) utilization given their revenue dominance, while also recognizing the provider’s capacity to deliver ALS non-emergency (A0426) and specialty care transport (A0434). Given the provider's tenure since 2015-04-22 (~11 years ago) and its high in-state market ranks, contracting teams may find it a key regional transport partner but should factor the concentrated code exposure into any rate or utilization safeguards.
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 |
|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 5,750 | $190 | $1.1M |
| A0425 | Ground mileage, per statute mile | 152,340 | $10 | $1.1M |
| A0434 | Specialty care transport (sct) | 290 | $620 | $181K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 650 | $230 | $147.5K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 20 | $360 | $6.4K |
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 | 57,520 | $210 | $11.8M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 44,850 | $120 | $5.5M |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 9,010 | $190 | $1.7M |
| A0434 | Specialty care transport (sct) | 1,580 | $440 | $696.6K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 750 | $220 | $164.6K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 4,400 | $10 | $39.6K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 150 | $140 | $20.1K |
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 | 5 | 140 | 2,710 | $100 | $955.9K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 2 | 70 | 3,360 | $110 | $830K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 52 | 100 | 840 | $260 | $730.3K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 92 | 110 | 950 | $220 | $703.7K |
| A0434 | Specialty care transport (sct) | 1 | 10 | 210 | $450 | $212.3K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 1 | 30 | 530 | $190 | $203K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 1 | 10 | 220 | $20 | $18.7K |
Other providers in the same ZIP code as Healthteam Critical Care Transport LLC, ranked by combined Medicare and Medicaid revenue.
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