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NPI 1366430738 · Westerly, RI · Land Ambulance
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The Westerly Ambulance Corps Inc is a land ambulance provider located in Westerly, Rhode Island. 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 | The Westerly Ambulance Corps Inc |
| Address | 30 Chestnut St |
| City | Westerly |
| State | RI |
| ZIP | 02891 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | October 11, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $902.2K |
| Medicare | $525.6K |
The provider’s Medicare revenue is concentrated in prehospital emergency transports: the top three Medicare codes account for 85.8% of Medicare revenue and are led by A0427 and A0429 (advanced life support and basic life support emergency transports). This mix indicates the operation is primarily an emergency transport service rather than a routine non-emergency fleet, with mileage (A0425) also contributing to billed services on Medicare.
Medicaid billing is even more tightly focused on a small set of transport codes: the top three Medicaid codes account for 99.0% of Medicaid revenue, dominated by A0429 and A0427. That extreme concentration on a narrow set of ambulance transport codes suggests most Medicaid revenue is generated by emergency transport activity and billed mileage rather than diversified ancillary services.
Payer mix favors Medicaid by scale: total Medicaid revenue is $902.2K compared with total Medicare revenue of $525.6K, so Medicaid is the larger single payer relationship on file. The data show substantially higher Medicaid claim volumes on comparable codes (for example, A0429 has 4.8K Medicaid claims vs. 453 Medicare claims), implying operational reliance on Medicaid transport demand.
National competitive standing on Medicare appears modest-to-typical for its top codes: A0427 ranks #1444 of 6841 providers (79th percentile), A0429 ranks #1246 of 7808 (84th percentile), and A0428 ranks #1109 of 2772 (60th percentile), each noted as "typical, unremarkable volume for this code." These percentiles place the provider above median national activity for several ambulance codes but not among the largest national operators.
State-level competitive standing on Medicaid shows mid-to-upper-tier placement for emergency transport codes: A0429 ranks #11 of 35 providers in-state (71th percentile) and A0427 ranks #13 of 39 (68th percentile), both described as "typical, unremarkable volume for this code." These ranks indicate the provider is a meaningful participant in Rhode Island Medicaid ambulance services but not the dominant statewide operator.
Operational reimbursement profile differs by payer: on Medicare A0427 generated 524 claims at $417 avg paid/claim for $218.5K revenue, while on Medicaid A0429 generated 4.8K claims at $100 avg paid/claim for $478.5K revenue. Those reported claim counts and average payments show Medicaid drives higher volume at lower per-claim reimbursement, whereas Medicare yields higher per-claim payments on advanced-life-support transports.
Mileage and non-emergency transports are secondary revenue streams: on Medicare A0425 (ground mileage) produced $59.9K (11.3% of Medicare revenue) and A0428 (BLS non-emergency) produced $75.9K (14.4% of Medicare revenue), while on Medicaid A0425 produced $122.5K (13.5% of Medicaid revenue) and A0428 only $5.3K (0.6% of Medicaid revenue). This pattern suggests the provider’s fleet bills both emergency and non-emergency transports but derives the bulk of revenue from emergency runs and mileage.
The provider has longstanding enrollment with an NPI enumerated on 2005-10-11 (~21 years ago), indicating multi-decade operational tenure in the market. That tenure, combined with the focused payer/coding footprint, supports the view of a stable, transport-centered ambulance service with established payer relationships in both Medicare and Medicaid.
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) | 520 | $420 | $218.5K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 450 | $350 | $158.6K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 350 | $220 | $75.9K |
| A0425 | Ground mileage, per statute mile | 8,550 | $10 | $59.9K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 60 | $260 | $15K |
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 |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 4,790 | $100 | $478.5K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 2,660 | $110 | $294.8K |
| A0425 | Ground mileage, per statute mile | 8,750 | $10 | $122.5K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 160 | $30 | $5.3K |
| 93005 | The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to… | 460 | $10 | $3.2K |
| 93041 | The provider records the electrical conduction of the heart to examine any abnormality in its functioning using a maximum of three leads. This code represents the technical component of the service… | 210 | $1 | $420 |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 30 | $10 | $180 |
How this provider's Medicaid billing volume and revenue compare to other Rhode Island providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Rhode Island median
7 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 5 | 10 | 19,390 | $60 | $1M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 11 | 40 | 1,830 | $80 | $362.7K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 13 | 40 | 1,250 | $80 | $273.1K |
| 93005 | The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to… | 26 | 80 | 120 | $80 | $124.6K |
| A0425 | Ground mileage, per statute mile | 12 | 50 | 2,550 | $10 | $72.5K |
| 93041 | The provider records the electrical conduction of the heart to examine any abnormality in its functioning using a maximum of three leads. This code represents the technical component of the service… | 14 | 30 | 260 | $20 | $13.7K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 9 | 10 | 60 | $1 | $3.6K |
Other providers in the same ZIP code as The Westerly Ambulance Corps Inc, ranked by combined Medicare and Medicaid revenue.
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