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NPI 1336130434 · Spearfish, SD · Land Ambulance
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Spearfish Emergency Ambulance Service is a land ambulance provider located in Spearfish, South Dakota. This profile covers 5 Medicare and 3 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 | Spearfish Emergency Ambulance Service |
| Address | 715 E Colorado Blvd |
| City | Spearfish |
| State | SD |
| ZIP | 57783 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | October 30, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $540.7K |
| Medicaid | $302.3K |
SPEARFISH EMERGENCY AMBULANCE SERVICE operates as a land ambulance provider with a code mix dominated by emergency advanced life support and basic life support transports plus extensive ground mileage billing; its top Medicare and Medicaid codes (A0427, A0425, A0429) are all ambulance service or mileage codes, indicating core operations are emergency patient transport rather than ancillary clinical services. This service-line concentration aligns with the provider taxonomy of Land Ambulance and the large claim counts reported for mileage and ALS/BLS transports.
Medicare revenue is concentrated: the precomputed top 3 Medicare codes account for 93.3% of the provider's Medicare revenue, led by A0427 at $286.8K (53.5% of Medicare revenue), A0425 at $115.1K (21.5%), and A0429 at $98.5K (18.4%). This concentration shows the Medicare business is heavily dependent on emergency ALS transports and mileage.
Medicaid billing is even more concentrated: the top 3 Medicaid codes account for 100.0% of Medicaid revenue, with A0427 contributing $195.1K (64.4%), A0425 $86.2K (28.5%), and A0429 $21.6K (7.1%). The Medicaid portfolio is therefore essentially limited to the same narrow set of ambulance and mileage services that drive Medicare revenue.
On payer mix, Medicare revenue ($540.7K) exceeds Medicaid revenue ($302.3K), so while the provider serves both programs it generates larger absolute revenue from Medicare. Both payers matter to operations, but Medicare represents the larger single-payer revenue stream on the lifetime totals reported.
Competitive standing on Medicare shows modest national participation rather than dominance: A0427 ranks #1324 of 6841 nationally (around the 81st percentile) and is described as typical; A0425 ranks #1445 of 8934 (84th percentile) and A0429 ranks #2192 of 7808 (72nd percentile). These ranks indicate the provider posts unremarkable but not negligible volumes nationally for its main ambulance codes.
In-state Medicaid standing is mid-level for the key codes: A0427 ranks #12 of 36 in-state (69th percentile) and A0425 ranks #15 of 57 (75th percentile), while A0429 is weaker at #22 of 34 (36th percentile). This pattern suggests the provider is a meaningful but not dominant Medicaid ambulance supplier in South Dakota for ALS and mileage services.
Payment-per-claim patterns differ markedly between payers: for A0427 the average paid/claim is $497 on Medicare versus $158 on Medicaid, and for A0429 it is $414 on Medicare versus $123 on Medicaid; conversely, A0425 ground mileage shows $8 average paid/claim on Medicare versus $38 on Medicaid. These per-claim divergences indicate material payer-level reimbursement differences across the same service codes and may affect revenue sensitivity to payer mix.
The provider has a long-tenured billing record with NPI enumeration on 2005-10-30 (~21 years ago), consistent with an established local EMS operation whose lifetime Medicare and Medicaid revenues ($540.7K and $302.3K respectively) reflect a focused, stable emergency transport business rather than diversified healthcare offerings.
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 |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 580 | $500 | $286.8K |
| A0425 | Ground mileage, per statute mile | 14,390 | $10 | $115.1K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 240 | $410 | $98.5K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 80 | $260 | $20.9K |
| A0433 | Advanced life support, level 2 (als 2) | 20 | $710 | $14.8K |
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.
3 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 1,240 | $160 | $195.1K |
| A0425 | Ground mileage, per statute mile | 2,270 | $40 | $86.2K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 180 | $120 | $21.6K |
How this provider's Medicaid billing volume and revenue compare to other South Dakota providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. South Dakota median
3 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 12 | 40 | 270 | $180 | $281.6K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 22 | 30 | 300 | $150 | $195.3K |
| A0425 | Ground mileage, per statute mile | 15 | 60 | 680 | $50 | $106.2K |
Other providers in the same ZIP code as Spearfish Emergency Ambulance Service, ranked by combined Medicare and Medicaid revenue.
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