Loading...
NPI 1558300228 · Polson, MT · Land Ambulance
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Polson Ambulance, Inc. is a land ambulance provider located in Polson, Montana. This profile covers 5 Medicare and 10 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 | Polson Ambulance, Inc. |
| Address | 904 2nd St E |
| City | Polson |
| State | MT |
| ZIP | 59860 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | June 6, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $2.1M |
| Medicare | $459.3K |
Payer mix is Medicaid‑dominated: lifetime Medicaid revenue is $2.1M compared with Medicare revenue of $459.3K, so Medicaid represents the larger share of billed activity and revenue for this operator. Both payers are active on file, but the scale and volume indicate the business relies far more heavily on Medicaid reimbursements for overall revenue generation.
The code mix identifies POLSON AMBULANCE, INC. as a ground ambulance operator focused on emergency transport and mileage-based billing: Medicare and Medicaid top codes are A0425 (ground mileage), A0427 (ALS 1 emergency), and A0429 (BLS emergency). This mix — emergency ALS/BLS plus high mileage — is consistent with a rural or regional EMS provider that bills both transport and per‑mile charges as primary service lines.
Revenue concentration is high on a small set of transport and mileage codes for both payers: the top three Medicare codes (A0425, A0427, A0429) account for 86.7% of this provider’s Medicare revenue, and the top three Medicaid codes (A0429, A0427, A0425) account for 74.0% of Medicaid revenue. This concentration implies operational and financial dependence on emergency transports and mileage rather than a broad mix of ancillary services.
Medicare competitive standing is modest at the national level across the top transport codes. For Medicare, A0425 ranks #1251 of 8934 (86th percentile), A0427 ranks #2514 of 6841 (63th percentile), and A0429 ranks #1834 of 7808 (76th percentile) — each described in the source as "typical, unremarkable volume for this code," which suggests reasonable activity but not national dominance.
In-state competitive position on Medicaid is relatively strong for mileage and emergency transports. On Medicaid A0425 ranks #4 of 49 providers in-state (94th percentile), A0427 ranks #6 of 29 (82th percentile), and A0429 ranks #9 of 41 (80th percentile), indicating the provider is a leading regional participant on mileage-driven revenue and emergency transport within Montana. Medicaid supply codes (A0398 and A0382) also contribute meaningfully — each about 9% of Medicaid revenue and ranked #4 in-state — showing additional ancillary revenue from disposables.
Payment levels and revenue drivers differ by payer: the same transport codes show materially different average payments per claim between Medicare and Medicaid (for example, Medicare A0429 average paid/claim $409 vs Medicaid A0429 average paid/claim $159, and Medicare A0425 average paid/claim $8 vs Medicaid A0425 average paid/claim $71). These contrasts point to different reimbursement schedules and a Medicaid revenue strategy that relies more on volume (claims) whereas Medicare produces higher per‑claim payments on specific transports.
Tenure and stability: the provider’s NPI was enumerated on 2006-06-06 (~20 years ago), indicating long-standing participation in both Medicare and Medicaid programs. Together with concentrated but consistent code-level billing and meaningful in-state ranks, the profile is of an established ambulance operator with stable, transport-centric revenue streams.
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 |
|---|---|---|---|---|
| A0425 | Ground mileage, per statute mile | 17,290 | $10 | $138.3K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 280 | $490 | $134.5K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 300 | $410 | $121.5K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 150 | $310 | $47.6K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 50 | $250 | $12.9K |
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.
10 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 3,830 | $160 | $609.3K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 2,510 | $200 | $491K |
| A0425 | Ground mileage, per statute mile | 6,410 | $70 | $455K |
| A0398 | Als routine disposable supplies | 2,180 | $90 | $191.8K |
| A0382 | Bls routine disposable supplies | 2,870 | $70 | $189.1K |
| A0394 | Als specialized service disposable supplies; iv drug therapy | 1,300 | $60 | $76.7K |
| A0380 | Bls mileage (per mile) | 320 | $140 | $44.8K |
| A0390 | Als mileage (per mile) | 290 | $140 | $39.5K |
| 93041 | The provider records the electrical conduction of the heart to examine any abnormality in its functioning using a maximum of three leads. This code represents the technical component of the service… | 1,080 | $1 | $4.3K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 150 | $10 | $1.6K |
How this provider's Medicaid billing volume and revenue compare to other Montana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Montana median
10 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 9 | 40 | 450 | $160 | $374.1K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 6 | 30 | 240 | $180 | $270.7K |
| A0398 | Als routine disposable supplies | 4 | 10 | 490 | $130 | $167.4K |
| A0382 | Bls routine disposable supplies | 4 | 20 | 210 | $90 | $130K |
| A0394 | Als specialized service disposable supplies; iv drug therapy | 5 | 10 | 260 | $90 | $96.3K |
| A0380 | Bls mileage (per mile) | 13 | 30 | 180 | $60 | $63.9K |
| A0425 | Ground mileage, per statute mile | 4 | 50 | 390 | $30 | $48.3K |
| A0390 | Als mileage (per mile) | 7 | 20 | 110 | $20 | $42.3K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 5 | 10 | 310 | $10 | $7.8K |
| 93041 | The provider records the electrical conduction of the heart to examine any abnormality in its functioning using a maximum of three leads. This code represents the technical component of the service… | 5 | 10 | 310 | $1 | $4.4K |
Other providers in the same ZIP code as Polson Ambulance, Inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Polson School District 23 | MT | Local Education Agency (LEA) | $0 | $1.6M |
| Providence St Joseph Medical Center | MT | Family Medicine Physician | $0 | $1.1M |
| Montana Dental Group LLC | MT | General Practice Dentistry | $0 | $1M |
| Michael Windauer | MT | General Practice Dentistry | $0 | $673.1K |
| Kickin It Enterprises | MT | Clinical Social Worker | $0 | $659.3K |
| Providence St Joseph Medical Center | MT | Critical Access Hospital | $0 | $654.7K |
| Jeffrey Bird | MT | General Practice Dentistry | $0 | $619.1K |
| Kalispell Regional Medical Center Inc | MT | Family Medicine Physician | $0 | $418.9K |
| St Lukes Community Hospital | MT | Rural Health Clinic/Center | $0 | $403.3K |
| Shasta Baum-strait | MT | Mental Health Counselor | $0 | $360.7K |
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.