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NPI 1407815988 · Rosedale, MD · Land Ambulance
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Procare Ambulance Of Maryland Inc is a land ambulance provider located in Rosedale, Maryland. This profile covers 5 Medicare and 4 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 | Procare Ambulance Of Maryland Inc |
| Address | 9411 Philadelphia Rd Ste A |
| City | Rosedale |
| State | MD |
| ZIP | 21237 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | March 22, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.8M |
| Medicaid | $1.4M |
PROCARE AMBULANCE OF MARYLAND INC reports materially more Medicare than Medicaid revenue, with Total Medicare revenue: $3.8M versus Total Medicaid revenue: $1.4M, indicating Medicare is the larger revenue engine for the business. This payer mix suggests the operation derives the majority of its scale from Medicare-covered transports rather than Medicaid.
Revenue is highly concentrated in a very small set of ambulance codes on both payers: the precomputed top 3 Medicare codes account for 94.2% of this provider's total Medicare revenue, and the top 3 Medicaid codes account for 96.7% of this provider's total Medicaid revenue. Such concentration indicates a narrow service mix where a handful of transport types drive nearly all billed revenue, concentrating operational and contracting risk around those services.
Medicare billing is dominated by A0428 and A0425: A0428 shows 10.6K claims, $232 avg paid/claim, $2.5M revenue (64.7% of this provider's total Medicare revenue) and ranks #45 of 2772 providers nationally (98th percentile; extreme outlier, far above typical national volume for this code). A0425 shows 127.3K claims, $7 avg paid/claim, $890.8K revenue (23.4% of this provider's total Medicare revenue) and ranks #95 of 8934 providers nationally (99th percentile; extreme outlier). These two codes together underscore a business built around high-volume BLS non-emergency transports and extensive billed ground mileage in the Medicare population.
The Medicaid picture likewise centers on mileage and BLS: A0425 reports 21.3K claims, $49 avg paid/claim, $1M revenue (72.5% of this provider's total Medicaid revenue) and ranks #12 of 79 providers in-state (86th percentile), while A0428 reports 18.4K claims, $16 avg paid/claim, $294.7K revenue (20.4% of this provider's total Medicaid revenue) and ranks #5 of 23 providers in-state (82nd percentile). In-state ranks are solid but not extreme, indicating this provider is a meaningful Medicaid participant for ground mileage and BLS transports within Maryland.
The provider shows capacity for higher-acuity and specialized transports beyond routine BLS: Medicare includes A0434 (315 claims, $747 avg paid/claim, $235.3K revenue; ranks #53 of 591 nationally, 91st percentile) and A0426 (673 claims, $280 avg paid/claim, $188.4K revenue; ranks #47 of 1568 nationally, 97th percentile, notably above typical national volume). Medicaid also lists A0434 and A0426 among its top codes, though at smaller shares. This mix signals the operation supports specialty care transport and non-emergency ALS 1 activity in addition to high-volume BLS work.
Nationally, PROCARE is an outsized player on specific Medicare codes: A0428 and A0425 are labeled as extreme outliers by national percentile and rank, which positions the provider as a major volume source for those code lines in Medicare markets. In contrast, Maryland Medicaid ranks for the same codes are high but more typical (e.g., A0425 at the 86th percentile, A0428 at the 82nd percentile), so the provider is important in-state but not as uniquely dominant as it is on the national Medicare lists.
The provider has long tenure in the enrollment data (NPI enumerated: 2006-03-22 (~20 years ago)), suggesting an established operation that has sustained a consistent, concentrated ambulance service mix over time. Longevity combined with concentrated high-volume codes may support predictable service patterns for payers evaluating network capacity for non-emergency and mileage-heavy transports.
From a payer contracting and utilization-management perspective, the heavy reliance on a few codes—top 3 Medicare codes = 94.2% of Medicare revenue and top 3 Medicaid codes = 96.7% of Medicaid revenue—creates clear levers: adjustments to reimbursement or utilization rules for A0428 and A0425 would materially affect this provider's revenue profile. At the same time, the presence of specialty care and ALS 1 billing signals additional capability that payers should consider when assessing coverage, rate-setting, or capacity needs for higher-acuity interfacility transports.
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 |
|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 10,630 | $230 | $2.5M |
| A0425 | Ground mileage, per statute mile | 127,260 | $10 | $890.8K |
| A0434 | Specialty care transport (sct) | 320 | $750 | $235.3K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 670 | $280 | $188.4K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 70 | $440 | $32.2K |
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.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0425 | Ground mileage, per statute mile | 21,340 | $50 | $1M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 18,420 | $20 | $294.7K |
| A0434 | Specialty care transport (sct) | 590 | $90 | $54.1K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 1,580 | $30 | $47.5K |
How this provider's Medicaid billing volume and revenue compare to other Maryland providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Maryland median
4 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0425 | Ground mileage, per statute mile | 12 | 80 | 1,580 | $30 | $407.9K |
| A0434 | Specialty care transport (sct) | 5 | 10 | 590 | $240 | $332K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 5 | 20 | 5,240 | $30 | $289K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 5 | 10 | 880 | $90 | $154.2K |
Other providers in the same ZIP code as Procare Ambulance Of Maryland Inc, ranked by combined Medicare and Medicaid revenue.
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