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NPI 1376541342 · Wakarusa, IN · Land Ambulance
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Tri-county Ambulance Service, Inc. is a land ambulance provider located in Wakarusa, Indiana. This profile covers 6 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 | Tri-county Ambulance Service, Inc. |
| Address | 615 Nelsons Pkwy |
| City | Wakarusa |
| State | IN |
| ZIP | 46573 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | July 13, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $5.6M |
| Medicare | $1.7M |
This provider’s payer mix is Medicaid‑heavy: Total Medicare revenue is $1.7M while Total Medicaid revenue is $5.6M, so Medicaid represents the larger share of its public-payer billing and appears to be the primary revenue driver across the lifetime data on file. Analysts should treat TRI-COUNTY AMBULANCE SERVICE, INC. as a Medicaid-dominant billing entity rather than a Medicare-focused operation.
Revenue concentration is high on a few transport codes for both payers: the top 3 Medicare codes account for 82.3% of Medicare revenue and the top 3 Medicaid codes account for 80.4% of Medicaid revenue. On Medicare, A0428 ($627.8K, 37.8%), A0425 ($501.5K, 30.2%), and A0429 ($237.7K, 14.3%) drive most receipts; on Medicaid, A0425 ($2.5M, 44.9%), A0428 ($1.5M, 26.8%), and A0130 ($489.8K, 8.7%) are the dominant contributors.
The code mix indicates TRI-COUNTY is primarily a ground ambulance and non‑emergency transport operator with both BLS and ALS capability: high revenue and claim counts for A0425 (ground mileage) and A0428 (BLS, non‑emergency) appear on both payers, and emergency BLS/ALS codes (A0429, A0427) also appear in the top Medicare and Medicaid lists. The presence of A0130 (wheelchair van) as a top Medicaid code further signals a substantial non‑emergency medical transportation (NEMT) component in its Medicaid business.
Competitive standing is mixed by payer and code: for Medicare A0425 ranks #251 of 8934 nationally (97th percentile) and is flagged as "notably above typical national volume", indicating unusually large mileage billing relative to peers, while A0428 (A0428 – Ambulance service, basic life support, non-emergency transport) ranks #221 of 2772 (92th percentile) but is labeled "typical, unremarkable volume"—so the provider shows a notable national footprint on mileage but otherwise a more modest national Medicare presence. Despite a modest total Medicare revenue base ($1.7M), the high national rank for A0425 suggests specialization or heavy utilization of long‑distance ground mileage in Medicare billing.
Within Indiana Medicaid, TRI-COUNTY is a regional leader on several NEMT and mileage measures: A0425 is ranked #12 of 327 in-state (97th percentile; labeled "typical, unremarkable volume"), A0428 is #9 of 112 (93th percentile; "notably above typical state volume"), and A0130 is #3 of 83 (98th percentile; "notably above typical state volume"). These state-level ranks plus the $2.5M and $1.5M revenues tied to A0425 and A0428 indicate a major role in state Medicaid ground transport and wheelchair van services.
Tenure is long-standing: the NPI was enumerated on 2005-07-13 (~21 years ago), which indicates the organization has an established operating history and a sustained presence in the local EMS/NEMT market. That longevity supports interpreting the observed billing patterns as stable business lines rather than transient activity.
Patterns differ meaningfully between payers: Medicare billing is concentrated in BLS non‑emergency (A0428) and mileage (A0425) with a nontrivial share from emergency BLS (A0429) and ALS (A0427), while Medicaid billing shows heavier reliance on mileage (A0425) and wheelchair van (A0130) in addition to BLS (A0428). This divergence suggests the provider’s Medicaid work skews more toward routine NEMT and wheelchair transports, whereas Medicare includes a mix of non‑emergency and emergency ambulance services.
Statistical flags worth attention: A0425 on Medicare is described as "notably above typical national volume," and in Medicaid A0428 and A0130 are described as "notably above typical state volume," highlighting unusually high activity in mileage, BLS state billing, and wheelchair van services relative to peers. Conversely, specialty care transport A0434 is a very small share of Medicare revenue ($10.4K, 0.6%) and ranks low nationally (#499 of 591, 13th percentile; labeled "typical, unremarkable volume"), which underscores that SCT is not a material service line for this provider.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
6 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 3,190 | $200 | $627.8K |
| A0425 | Ground mileage, per statute mile | 71,640 | $10 | $501.5K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 760 | $310 | $237.7K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 550 | $370 | $203.8K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 340 | $240 | $80.6K |
| A0434 | Specialty care transport (sct) | 20 | $650 | $10.4K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 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 | 40,130 | $60 | $2.5M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 24,770 | $60 | $1.5M |
| A0130 | Non-emergency transportation: wheelchair van | 21,290 | $20 | $489.8K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 4,040 | $90 | $379.6K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 5,950 | $60 | $362.8K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 3,120 | $120 | $361.7K |
| A0170 | Transportation ancillary: parking fees, tolls, other | 1,040 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Indiana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Indiana median
7 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) | 45 | 180 | 1,730 | $180 | $744.6K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 31 | 200 | 1,130 | $160 | $730.5K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 9 | 110 | 1,050 | $60 | $342.7K |
| A0425 | Ground mileage, per statute mile | 12 | 330 | 2,010 | $30 | $266.8K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 6 | 60 | 210 | $120 | $112.3K |
| A0130 | Non-emergency transportation: wheelchair van | 3 | 80 | 730 | $30 | $88.7K |
| A0170 | Transportation ancillary: parking fees, tolls, other | 3 | 10 | 480 | $1 | $240 |
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