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NPI 1427049402 · Anson, ME · Ambulance
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Anson Madison Ambulance Service is a ambulance provider located in Anson, Maine. 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)
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $1.2M |
| Medicare | $245.5K |
ANSON MADISON AMBULANCE SERVICE is a long-tenured ambulance provider, with its NPI enumerated on 2005-10-31 (~21 years ago), indicating sustained operation in the market and likely established relationships with local payers and facilities. That tenure supports a stable operational profile consistent with routine emergency and non-emergency transport services.
Revenue is concentrated in a small set of procedures for both payers: the top 3 Medicare codes account for 83.4% of Medicare revenue, and the top 3 Medicaid codes account for 93.9% of Medicaid revenue. This concentration indicates that a handful of transport services drive nearly all billed revenue rather than a broad mix of ancillary services.
Medicaid is the larger payer relationship by scale for this provider: total Medicaid revenue is $1.2M versus total Medicare revenue of $245.5K, showing the organization is primarily serving Medicaid-covered transports in dollar terms. This payer mix suggests operational focus on populations and routes that generate Medicaid volume.
Across Medicare claims, A0427 (ALS 1 emergency), A0425 (ground mileage), and A0429 (BLS emergency) dominate revenue, together representing 83.4% of the provider's Medicare receipts; this mix points to a combined emergency-response and mileage-based billing model with both advanced and basic life support emergency transports comprising the bulk of Medicare activity. The presence of substantial A0425 mileage revenue (6.5K claims) indicates frequent transport distances are a meaningful revenue driver on Medicare.
For Medicaid, A0427, A0425, and A0429 likewise drive the business, accounting for 93.9% of Medicaid revenue with A0427 alone representing $605.3K (49.7% of Medicaid revenue). The Medicaid mix is strongly weighted toward ALS emergency transports and mileage, reflecting similar operational emphasis across payers but at higher volume and revenue on the Medicaid side (e.g., 2.6K A0427 claims and 5.2K A0425 claims).
Competitive standing differs by payer and code: on Medicare, A0427 ranks at the 59th national percentile and A0425 at the 69th percentile, indicating modest, typical national participation rather than dominance for these ambulance codes. On Medicaid in-state comparisons, A0427 ranks #26 of 103 providers (75th percentile) and A0425 ranks #27 of 138 providers (81st percentile), suggesting ANSON MADISON is an above-average Medicaid competitor in Maine for those key codes but not the top statewide leader.
Individual code volumes show operational emphasis differences: Medicaid A0425 ground mileage claims are 5.2K compared with Medicare A0425 at 6.5K, while Medicaid A0427 claims (2.6K) far exceed Medicare A0427 claims (236), reinforcing that most emergency ALS transports are billed to Medicaid rather than Medicare. This pattern implies local demographics or contracts yielding higher Medicaid utilization for emergency and mileage-based transports.
None of the top codes appear as statistical extreme outliers in the provided descriptors; the percentile ranks are described as typical or above-typical rather than extreme, which indicates the provider operates within expected regional and national ranges for ambulance services and is not exhibiting unusually high or anomalous billing behavior for these codes.
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 |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 240 | $450 | $106.4K |
| A0425 | Ground mileage, per statute mile | 6,530 | $10 | $65.3K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 100 | $370 | $35.8K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 150 | $240 | $35K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 20 | $290 | $6.3K |
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 |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 2,570 | $240 | $605.3K |
| A0425 | Ground mileage, per statute mile | 5,170 | $70 | $356.9K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 690 | $260 | $182.3K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 570 | $130 | $73.9K |
How this provider's Medicaid billing volume and revenue compare to other Maine providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Maine median
4 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) | 26 | 100 | 670 | $200 | $363.5K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 45 | 100 | 660 | $180 | $316.3K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 22 | 40 | 590 | $90 | $243.4K |
| A0425 | Ground mileage, per statute mile | 27 | 140 | 1,400 | $50 | $201.8K |
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