Loading...
NPI 1508823857 · Lexington, KY · Land Ambulance
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Lexington Fayette Urban County Government is a land ambulance provider located in Lexington, Kentucky. This profile covers 4 Medicare and 3 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 | Lexington Fayette Urban County Government |
| Address | 219 E Third St |
| City | Lexington |
| State | KY |
| ZIP | 40507 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | April 28, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $7.6M |
| Medicare | $2.4M |
Service line and code mix show a classic emergency ground-ambulance operation: the provider is listed under Land Ambulance taxonomy and its revenue is dominated by emergency transport codes A0427 (ALS 1) and A0429 (BLS emergency), with ground mileage A0425 also present. This mix indicates primary activity is emergency patient transport rather than non-emergency or interfacility-only work, with mileage billed alongside ALS/BLS runs.
Medicare revenue is concentrated in a very small set of transport codes: the top 3 Medicare codes by revenue account for 99.2% of this provider's total Medicare revenue, driven largely by A0427 ($1.6M; 4.4K claims; $364 avg paid/claim, 65.5% of Medicare revenue) and A0429 ($634K; 2.1K claims; $306 avg paid/claim, 25.9% of Medicare revenue). A0425 (ground mileage) contributes the remaining Medicare share reported ($190.3K, 7.8% of Medicare revenue).
Medicaid billing is even more concentrated and at far larger scale: the top 3 Medicaid codes by revenue account for 100.0% of this provider's total Medicaid revenue, led by A0427 ($4M; 60.3K claims; $66 avg paid/claim, 52.2% of Medicaid revenue) and A0429 ($2.7M; 50.9K claims; $54 avg paid/claim, 36.1% of Medicaid revenue), with A0425 contributing $891.4K (11.7%). The raw claim counts for Medicaid (60.3K, 50.9K, 111.4K) show extremely high utilization of emergency transport and mileage within the state payer population.
Payer mix favors Medicaid by scale: lifetime Medicaid revenue is $7.6M compared with Medicare revenue of $2.4M, so Medicaid revenue is the primary revenue stream for this entity. Analysts should treat the organization as effectively Medicaid-dominant in terms of dollars and operational load.
Competitive standing differs by payer: for Medicare the provider ranks in the 98th percentile nationally on both A0427 (#151 of 6841) and A0429 (#180 of 7808), described in the source as "notably above typical" national volume for those codes, indicating a major national-level presence for those ambulance services. In Medicaid the provider is a statewide outlier and likely a dominant capacity: A0427 ranks #1 of 176 (100th percentile, "extreme outlier"), A0429 ranks #2 of 169 (99th percentile, "extreme outlier"), and A0425 ranks #2 of 189 (99th percentile, "extreme outlier").
Operational and reimbursement signal: the large Medicaid claim volumes with relatively low avg paid/claim ($66 and $54 for A0427/A0429) suggest the provider moves high patient volumes at Medicaid reimbursement rates, while Medicare reimbursements per claim are materially higher ($364 and $306). This pattern is consistent with a public or contracted municipal ambulance service handling a high caseload of Medicaid beneficiaries while receiving higher per-claim Medicare payments for fewer claims.
Billing concentration creates business sensitivity: because the top 3 Medicare codes account for 99.2% of Medicare revenue and the top 3 Medicaid codes account for 100.0% of Medicaid revenue, the provider's financial performance is highly dependent on emergency transport and mileage reimbursement policies for those specific HCPCS codes. Any payer policy changes, contract renegotiations, or shifts in case mix for A0427/A0429/A0425 could have outsized impact on both revenue and operations.
Tenure and continuity: the NPI was enumerated on 2006-04-28 (~20 years ago), indicating a long-standing presence in the market. That tenure combined with extreme in-state volumes on Medicaid codes suggests established operational capacity and likely ongoing role as a primary county or municipal ambulance 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.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 4,410 | $360 | $1.6M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 2,070 | $310 | $634K |
| A0425 | Ground mileage, per statute mile | 27,180 | $10 | $190.3K |
| A0433 | Advanced life support, level 2 (als 2) | 40 | $500 | $20.2K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 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.
3 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 60,330 | $70 | $4M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 50,890 | $50 | $2.7M |
| A0425 | Ground mileage, per statute mile | 111,430 | $10 | $891.4K |
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
3 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) | 1 | 180 | 3,250 | $60 | $321.8K |
| A0425 | Ground mileage, per statute mile | 2 | 190 | 5,590 | $20 | $225.7K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 2 | 170 | 1,580 | $50 | $186K |
Other providers in the same ZIP code as Lexington Fayette Urban County Government, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Just Family, Inc | KY | Adult Day Care Clinic/Center | $0 | $9.8M |
| New Vista Of The Bluegrass Inc | KY | Mental Health Clinic/Center (Including Community Mental Health Center) | $130.4K | $0 |
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.