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NPI 1467402032 · Grants Pass, OR · Ambulance
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American Medical Response Northwest Inc is a ambulance provider located in Grants Pass, Oregon. This profile covers 6 Medicare and 8 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 | American Medical Response Northwest Inc |
| Address | 401 Nw F St |
| City | Grants Pass |
| State | OR |
| ZIP | 97526 |
| Taxonomy | Ambulance |
| NPI Enumerated | May 12, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $7.7M |
| Medicare | $1.4M |
AMERICAN MEDICAL RESPONSE NORTHWEST INC operates as an ambulance service (taxonomy: Ambulance) with its billing dominated by transport-level codes—chiefly A0427 (ALS emergency), A0429 (BLS emergency) and A0425 (ground mileage). The presence of high-revenue emergency transport codes alongside mileage and non-emergency transport codes indicates an operation configured for frequent emergency responses and routine patient movement rather than a purely non-emergency or hospice transport niche.
Revenue concentration is pronounced on both payers: the top 3 Medicare codes account for 91.5% of this provider's total Medicare revenue, and the top 3 Medicaid codes account for 97.6% of its total Medicaid revenue. This concentration signals that a small set of ambulance transport services drives almost all billed revenue, making overall performance highly sensitive to utilization and rate changes for those specific codes.
The provider’s payer mix is heavily weighted toward Medicaid in scale: total Medicare revenue is $1.4M while total Medicaid revenue is $7.7M. In practical terms, Medicaid is the primary revenue source by magnitude, so contract or policy changes on the Medicaid side would have a larger impact on overall financials than equivalent Medicare changes.
On Medicaid the operation is large for ALS emergency transports: A0427 produced 26.1K claims and $6.3M revenue (81.6% of this provider's total Medicaid revenue) and ranks #7 of 88 providers in-state (93th percentile; typical, unremarkable volume for this code). That rank places the provider among the leading in-state billers for ALS emergency transport under Medicaid, reflecting extensive Medicaid-driven emergency activity within its service area.
Medicare performance shows a strong upper-decile presence for the same emergency ALS code but at much smaller scale: A0427 on Medicare has 2.1K claims and $822K revenue (58.1% of this provider's total Medicare revenue) and ranks #326 of 6841 providers nationally (95th percentile; typical, unremarkable volume for this code). This combination—high national percentile but modest absolute Medicare revenue compared with Medicaid—suggests it is a notable regional participant on Medicare for ALS emergency services but not a large national-scale Medicare operator.
Ground mileage billing is a consistent operational feature across payers: A0425 appears with 34.6K Medicare claims ($7 avg paid/claim, $242.2K revenue) and 34.1K Medicaid claims ($13 avg paid/claim, $442.7K revenue). The large claim counts but lower average paid/claim for mileage indicate frequent long or multiple-leg responses where mileage contributes materially to total revenue without being a high-paying line item per claim.
The NPI was enumerated on 2006-05-12 (~20 years ago), indicating long tenure in the market. This longevity, combined with top-code concentration on emergency transports, points to an established operational footprint focused on ALS/BLS emergency services and routine mileage-based transports rather than a newly entered or experimental service model.
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 |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 2,110 | $390 | $822K |
| A0425 | Ground mileage, per statute mile | 34,590 | $10 | $242.2K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 710 | $330 | $231.5K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 180 | $250 | $45K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 220 | $200 | $44.5K |
| A0433 | Advanced life support, level 2 (als 2) | 60 | $560 | $30.6K |
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.
8 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 26,130 | $240 | $6.3M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 5,000 | $160 | $789.7K |
| A0425 | Ground mileage, per statute mile | 34,050 | $10 | $442.7K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 2,450 | $30 | $68.7K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 730 | $70 | $47.6K |
| A0433 | Advanced life support, level 2 (als 2) | 160 | $240 | $38.2K |
| A0998 | Ambulance response and treatment, no transport | 60 | $290 | $17.8K |
| S0215 | Non-emergency transportation; mileage, per mile | 350 | $40 | $15.4K |
How this provider's Medicaid billing volume and revenue compare to other Oregon providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Oregon median
8 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) | 7 | 90 | 2,490 | $240 | $2M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 16 | 70 | 1,600 | $170 | $661.9K |
| A0433 | Advanced life support, level 2 (als 2) | 4 | 10 | 410 | $240 | $238.9K |
| A0998 | Ambulance response and treatment, no transport | 15 | 20 | 230 | $200 | $212.5K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 8 | 30 | 340 | $70 | $141.2K |
| A0425 | Ground mileage, per statute mile | 8 | 110 | 2,790 | $10 | $134.1K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 3 | 20 | 270 | $100 | $56.5K |
| S0215 | Non-emergency transportation; mileage, per mile | 10 | 10 | 580 | $1 | $47K |
Other providers in the same ZIP code as American Medical Response Northwest Inc, ranked by combined Medicare and Medicaid revenue.
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