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NPI 1386905016 · Hayward, CA · Ambulance
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Falck Northern California Corp. is a ambulance provider located in Hayward, California. This profile covers 4 Medicare and 15 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 | Falck Northern California Corp. |
| Address | 28333 Industrial Blvd |
| City | Hayward |
| State | CA |
| ZIP | 94545 |
| Taxonomy | Ambulance |
| NPI Enumerated | May 29, 2012 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $65.1M |
| Medicare | $11.3M |
FALCK NORTHERN CALIFORNIA CORP. operates squarely as an ambulance transport provider: its Medicare and Medicaid revenue is dominated by emergency transport codes and mileage. The top Medicare codes listed are A0427 (ALS 1 emergency), A0429 (BLS emergency) and A0425 (ground mileage), and the top Medicaid codes are A0429, A0427 and A0425, indicating primary operations are emergency ALS/BLS response and high-volume patient transport rather than ancillary clinic services. The NPI was enumerated 2012-05-29 (~14 years ago), consistent with an established EMS operation in Hayward, CA.
Revenue concentration is extremely high within a narrow code mix for both payers: the top 3 Medicare codes account for 99.0% of this provider's total Medicare revenue and the top 3 Medicaid codes account for 98.1% of this provider's total Medicaid revenue. This level of concentration shows the business is highly specialized in a few transport-related services rather than a broad set of billable procedures.
The provider’s payer mix is skewed heavily toward Medicaid in scale: reported lifetime Medicare revenue is $11.3M while lifetime Medicaid revenue is $65.1M, making Medicaid the dominant revenue source by a wide margin. Given those magnitudes, Medicaid volumes and revenues are the primary driver of overall financial footprint and likely of operational capacity planning.
On Medicare the provider is a national high-volume outlier for emergency ambulance services: A0427 generated $6.9M (61.4% of the provider’s Medicare revenue) with rank #13 of 6841 providers nationally and is labeled an "extreme outlier," while A0429 generated $3.6M (31.6% of Medicare revenue) with rank #23 of 7808 providers and is also an "extreme outlier." These ranks and labels indicate national-scale leadership in emergency ALS/BLS emergency transports on the Medicare side.
State-level competitive standing on Medicaid likewise shows dominance for emergency BLS transports: A0429 produced $31.3M (48.0% of Medicaid revenue) with rank #4 of 386 providers in-state and is characterized as an "extreme outlier." A0427 produced $28.4M (43.6% of Medicaid revenue) with rank #12 of 248 providers in-state and is described as "notably above typical state volume," together making the provider one of the largest Medicaid ambulance operators in California for emergency transports.
Ground mileage (A0425) appears as a high-claim-volume but smaller-revenue component across both payers: Medicare shows 97K claims for A0425 ($7 avg paid/claim, $679.3K revenue, 6.0% of Medicare revenue) and Medicaid shows 190.4K claims for A0425 ($22 avg paid/claim, $4.2M revenue, 6.4% of Medicaid revenue). Although mileage contributes a modest share of revenue, the very large claim counts imply heavy fleet utilization and long transport distances or many short trips billed by mile, which is operationally significant even if lower-paid per-claim.
Average paid-per-claim levels differ between payers for the same service lines: for example, A0427 is paid $502 avg/claim on Medicare (Medicare revenue $6.9M) versus $336 avg/claim on Medicaid (Medicaid revenue $28.4M), and A0429 is paid $419 avg/claim on Medicare ($3.6M) versus $317 avg/claim on Medicaid ($31.3M). These paired figures signal a reimbursement mix where Medicaid drives volume while Medicare pays higher rates per emergency-transport claim, a dynamic that will affect margins and payer negotiations.
Beyond the two dominant emergency transport codes, other billed services are present but account for only small shares of Medicaid revenue: examples include A0428 ($465.8K, 0.7%), A0433 ($223.3K, 0.3%), T2005 ($98.9K, 0.2%) and assorted ECG codes with minimal revenue. This pattern reinforces that the provider’s competitive and operational focus is concentrated on ambulance transport rather than ancillary non-emergency or diagnostic services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 13,840 | $500 | $6.9M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 8,520 | $420 | $3.6M |
| A0425 | Ground mileage, per statute mile | 97,040 | $10 | $679.3K |
| A0433 | Advanced life support, level 2 (als 2) | 160 | $730 | $115.8K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 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.
15 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 98,740 | $320 | $31.3M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 84,660 | $340 | $28.4M |
| A0425 | Ground mileage, per statute mile | 190,390 | $20 | $4.2M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 6,560 | $70 | $465.8K |
| A0433 | Advanced life support, level 2 (als 2) | 640 | $350 | $223.3K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 17,180 | $10 | $171.8K |
| A0434 | Specialty care transport (sct) | 700 | $160 | $108.3K |
| T2005 | Non-emergency transportation; stretcher van | 3,800 | $30 | $98.9K |
| A0380 | Bls mileage (per mile) | 3,910 | $20 | $78.2K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 510 | $70 | $36.3K |
Showing 1–10 of 15
How this provider's Medicaid billing volume and revenue compare to other California providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. California median
15 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 | 250 | 2,420 | $220 | $3.7M |
| T2005 | Non-emergency transportation; stretcher van | 48 | 130 | 1,560 | $140 | $1.9M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 4 | 390 | 1,270 | $220 | $1.5M |
| A0130 | Non-emergency transportation: wheelchair van | 344 | 350 | 8,830 | $30 | $1.2M |
| A0380 | Bls mileage (per mile) | 189 | 310 | 7,380 | $40 | $1.1M |
| A0425 | Ground mileage, per statute mile | 9 | 580 | 3,120 | $30 | $963.2K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 65 | 190 | 2,470 | $80 | $674.3K |
| A0434 | Specialty care transport (sct) | 33 | 60 | 700 | $350 | $672.4K |
| 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… | 504 | 760 | 1,930 | $20 | $196K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 32 | 80 | 280 | $130 | $148.2K |
Showing 1–10 of 15
Other providers in the same ZIP code as Falck Northern California Corp., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| National Labs Inc | CA | Clinical Medical Laboratory | $6M | $51.4M |
| Alameda Health System | CA | Federally Qualified Health Center (FQHC) | $0 | $32.8M |
| Predicine, Inc. | CA | Clinical Medical Laboratory | $601.3K | $12.3M |
| Qaiser Niaz | CA | Hematology & Oncology Physician | $1.9M | $0 |
| Rishi Kapila | CA | Hospitalist Physician | $500.1K | $0 |
| Rock Liu | CA | Surgery Physician | $77.7K | $0 |
| Jeffrey Yeoh | CA | Certified Registered Nurse Anesthetist | $61.5K | $0 |
| Hans Han | CA | Physician Assistant | $36.2K | $0 |
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