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NPI 1396714101 · Fredericksburg, VA · Ambulance
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Lifecare Medical Transports, LLC is a ambulance provider located in Fredericksburg, Virginia. This profile covers 6 Medicare and 13 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 | Lifecare Medical Transports, LLC |
| Address | 1170 International Pkwy |
| City | Fredericksburg |
| State | VA |
| ZIP | 22406 |
| Taxonomy | Ambulance |
| NPI Enumerated | March 15, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $35.3M |
| Medicare | $2.4M |
Payer mix is heavily skewed toward Medicaid: Total Medicare revenue is $2.4M while Total Medicaid revenue is $35.3M, making Medicaid the dominant payer by scale for this ambulance/taxi-like provider. This suggests the business model is oriented toward state-covered non-emergency and stretcher transports rather than Medicare-driven emergency care.
Revenue is highly concentrated by a very small set of codes on both payers: the top three Medicare codes account for 88.6% of Medicare revenue and the top three Medicaid codes account for 82.9% of Medicaid revenue. That concentration means changes to reimbursement or utilization for those specific codes would materially affect overall income.
The code mix and dollar drivers indicate an operational focus on non-emergency and stretcher transport services: Medicare top codes include A0428, A0425, and A0429 (BLS non-emergency, ground mileage, BLS emergency), while Medicaid top codes are T2005, A0428, and A0425 (stretcher van, BLS non-emergency, ground mileage). High shares for T2005 on Medicaid and A0428 on Medicare point to a fleet and staffing model optimized for stretcher and BLS non-emergency trips rather than a specialty-critical care operation.
Competitive standing in-state for Medicaid is dominant on several marquee codes: T2005 ranks #1 of 124 providers in-state (100th percentile; extreme outlier, far above typical state volume) and A0428 ranks #1 of 73 providers in-state (100th percentile; extreme outlier, far above typical state volume), while A0425 ranks #2 of 273 in-state (100th percentile; extreme outlier). These rank positions indicate this provider is a primary NEMT/stretcher supplier in Virginia for Medicaid populations.
National competitive standing on Medicare shows above-typical volume for core ground-transport services but not exclusively so: A0428 ranks #109 of 2772 providers nationally (96th percentile; notably above typical national volume) and A0425 ranks #146 of 8934 providers nationally (98th percentile; notably above typical national volume), whereas A0429 is more typical at the 90th percentile. In short, the provider is a high-volume national participant for BLS non-emergency and mileage but not an extreme national outlier on emergency BLS.
Claim-level volumes underline an operational emphasis on mileage and repeat trips: Medicare shows 102.3K claims for A0425 and 5.5K claims for A0428, while Medicaid shows 109.1K claims for A0425, 76.5K claims for A0428, and 44K claims for T2005. Those large claim counts and the presence of both high mileage and stretcher-trip codes are consistent with frequent, routinized non-emergency transports across a broad service area.
Concentration of revenue in a few high-volume NEMT/stretcher codes creates both an opportunity and a concentration risk: with T2005 making up 44.9% of this provider's Medicaid revenue and A0428 representing 47.7% of Medicare revenue, payer policy changes, prior authorization rules, or rate adjustments targeting these codes could quickly change the provider’s revenue profile. This profile also suggests potential negotiating leverage with Medicaid managed care plans given the provider’s dominant in-state positions.
The provider has established tenure in the market, with NPI enumerated on 2006-03-15 (~20 years ago), which supports the interpretation of these patterns as sustained operational strategy rather than a short-term spike. Longevity combined with the in-state dominance on key Medicaid codes points to an entrenched non-emergency/stretcher transport business serving the state Medicaid population.
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) | 5,480 | $210 | $1.1M |
| A0425 | Ground mileage, per statute mile | 102,280 | $10 | $715.9K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 730 | $350 | $254K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 450 | $250 | $113.1K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 220 | $400 | $89K |
| A0434 | Specialty care transport (sct) | 100 | $690 | $67.2K |
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.
13 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| T2005 | Non-emergency transportation; stretcher van | 44,030 | $360 | $15.9M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 76,500 | $120 | $9.3M |
| A0425 | Ground mileage, per statute mile | 109,050 | $40 | $4.1M |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 7,560 | $240 | $1.8M |
| A0130 | Non-emergency transportation: wheelchair van | 22,900 | $70 | $1.6M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 17,210 | $60 | $1.1M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 6,230 | $130 | $796.9K |
| T2049 | Non-emergency transportation; stretcher van, mileage; per mile | 44,010 | $10 | $484.1K |
| T2003 | Non-emergency transportation; encounter/trip | 1,020 | $110 | $116.3K |
| S0215 | Non-emergency transportation; mileage, per mile | 2,890 | $40 | $101K |
Showing 1–10 of 13
How this provider's Medicaid billing volume and revenue compare to other Virginia providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Virginia median
13 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| T2005 | Non-emergency transportation; stretcher van | 1 | 120 | 760 | $250 | $656.3K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 1 | 70 | 1,160 | $80 | $511.5K |
| T2003 | Non-emergency transportation; encounter/trip | 595 | 860 | 4,410 | $30 | $437.1K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 28 | 200 | 1,250 | $90 | $326K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 11 | 220 | 1,390 | $80 | $307.1K |
| A0130 | Non-emergency transportation: wheelchair van | 23 | 390 | 1,430 | $50 | $278.2K |
| A0425 | Ground mileage, per statute mile | 2 | 270 | 2,410 | $20 | $166.7K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 1 | 30 | 250 | $130 | $149.4K |
| S0215 | Non-emergency transportation; mileage, per mile | 155 | 560 | 890 | $30 | $113.2K |
| A0434 | Specialty care transport (sct) | 2 | 10 | 80 | $200 | $43.4K |
Showing 1–10 of 13
Other providers in the same ZIP code as Lifecare Medical Transports, LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Pedialac Nursing Services LLC | VA | Home Health Agency | $0 | $7M |
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