Loading...
NPI 1427007368 · Richmond, KY · Land Ambulance
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Madison County Ems is a land ambulance provider located in Richmond, Kentucky. This profile covers 7 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 | Madison County Ems |
| Address | 556 S Keeneland Dr |
| City | Richmond |
| State | KY |
| ZIP | 40475 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | May 8, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $2.4M |
| Medicare | $1.2M |
MADISON COUNTY EMS appears to operate primarily as a land ambulance service focused on emergency ALS and mileage-driven transports; Medicare top codes are A0427, A0425 and A0428 and the Medicaid top codes overlap heavily with A0427, A0425 and A0429, indicating a mix of advanced life support emergency responses and high-volume mileage billing across both payers. The presence of A0427 as the single largest revenue code on both Medicare and Medicaid suggests a core operational emphasis on ALS emergency transport rather than non-transport or non-emergency services.
Revenue concentration is high for both payers: the precomputed top-3 Medicare codes account for 82.5% of the provider's Medicare revenue, and the top-3 Medicaid codes account for 92.0% of Medicaid revenue. This indicates the provider’s Medicare and Medicaid income streams are heavily dependent on a small set of ambulance transport services (ALS, mileage, and BLS-related codes), which concentrates financial risk on demand for those specific service lines.
The payer mix is skewed toward Medicaid in scale: lifetime Medicaid revenue is $2.4M versus $1.2M in Medicare, so Medicaid represents a materially larger share of reported lifetime revenue. While both payers are present, the provider is effectively more dependent on Medicaid volume and reimbursements for overall lifetime revenue.
Competitive standing differs by payer and code: for Medicare, A0427 ranks #528 of 6841 providers (92nd percentile) and A0425 ranks #572 of 8934 (94th percentile), which characterize the provider as a solid but not dominant national participant in those codes — typical, unremarkable volume relative to peers rather than a national leader. In contrast, Medicaid ranks show above-typical statewide concentration: A0427 and A0425 both rank #5 in-state (98th percentile), signaling that MADISON COUNTY EMS is a leading Medicaid ambulance billing entity in Kentucky for ALS emergency transports and mileage.
There are notable statistical outliers in the Medicaid data that warrant attention: A0422 (oxygen and oxygen supplies) ranks #2 of 85 providers in-state (99th percentile) and is labeled an extreme outlier, and both A0427 and A0425 are characterized as notably above typical state volume (98th percentile). These labels suggest the provider bills substantially more for certain ancillary supplies and core ALS transports in Medicaid than almost all in-state peers, which could reflect local demand patterns, coverage policies, or operational focus on supply usage.
Operational scale details reinforce a mileage-heavy business model: Medicaid shows 37K claims for A0425 (ground mileage) and 20.3K claims for A0427, while Medicare shows 36.7K claims for A0425 and 1.4K claims for A0427. The markedly larger Medicaid claim counts for the same codes imply that routine and emergency transports to Medicaid beneficiaries constitute the bulk of trip volume, particularly for mileage billing.
Tenure is long-standing: the NPI was enumerated on 2006-05-08 (approximately 20 years ago), indicating the provider has had stable enrollment and likely sustained operational presence in the market for two decades, which supports the accumulation of the lifetime revenue totals and the established patterns seen across both payers.
Service-mix nuance: Medicaid’s top three codes include T2005 (stretcher van) and A0429 (BLS emergency) in addition to ALS and mileage, with the top-3 share at 92.0%, suggesting that Medicaid encounters include a mixture of emergency ALS, BLS emergency, stretcher non-ambulatory transports, and high-mileage trips. By comparison, Medicare’s top-3 skew slightly more toward ALS and mileage (82.5%), so Medicare activity is somewhat narrower in service mix than Medicaid 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.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 1,400 | $370 | $515.9K |
| A0425 | Ground mileage, per statute mile | 36,680 | $10 | $330.1K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 840 | $190 | $163.2K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 470 | $310 | $144.5K |
| A0434 | Specialty care transport (sct) | 50 | $640 | $29.2K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 110 | $230 | $25.3K |
| A0433 | Advanced life support, level 2 (als 2) | 30 | $530 | $15.4K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 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 |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 20,250 | $60 | $1.2M |
| A0425 | Ground mileage, per statute mile | 37,030 | $20 | $703.5K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 8,090 | $40 | $355.8K |
| T2005 | Non-emergency transportation; stretcher van | 4,600 | $30 | $133.5K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 6,200 | $10 | $43.4K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 3,170 | $1 | $12.7K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 210 | $10 | $2.7K |
How this provider's Medicaid billing volume and revenue compare to other Kentucky providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Kentucky 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) | 5 | 180 | 3,250 | $60 | $321.8K |
| A0425 | Ground mileage, per statute mile | 5 | 190 | 5,590 | $20 | $225.7K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 10 | 170 | 1,580 | $50 | $186K |
| T2005 | Non-emergency transportation; stretcher van | 5 | 60 | 340 | $40 | $52.5K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 16 | 100 | 660 | $10 | $15.6K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 2 | 90 | 530 | $10 | $7.4K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 8 | 20 | 60 | $10 | $3K |
Other providers in the same ZIP code as Madison County Ems, ranked by combined Medicare and Medicaid revenue.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.