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NPI 1558457176 · Sheffield, AL · Ambulance
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Northwest Alabama Health Services, LLC is a ambulance provider located in Sheffield, Alabama. 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 | Northwest Alabama Health Services, LLC |
| Address | 1300 S Montgomery Ave |
| City | Sheffield |
| State | AL |
| ZIP | 35660 |
| Taxonomy | Ambulance |
| NPI Enumerated | October 4, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $2.3M |
| Medicare | $1.3M |
NORTHWEST ALABAMA HEALTH SERVICES, LLC appears to operate as a ground ambulance provider with a mix of emergency and non-emergency transports; its top Medicare codes are A0427 (ALS 1 emergency), A0429 (BLS emergency) and A0425 (ground mileage), and the Medicaid side is similarly dominated by A0425 (ground mileage), A0429 and A0427. The presence of both ALS and BLS emergency codes plus high mileage billing indicates a service model that responds to both urgent 911-type calls and transports that cover substantial distances. This combination is consistent with a mixed emergency/transport-focused ambulance operation rather than a specialty or hospital-based service.
Revenue concentration is high on both payers: the top 3 Medicare codes account for 76.4% of Medicare revenue, and the top 3 Medicaid codes account for 81.5% of Medicaid revenue. That concentration indicates the business is heavily dependent on a small set of transport and mileage services rather than a broader set of ancillary ambulance codes. Payers and analysts should treat fluctuations in claims or reimbursement for these core codes as material to the entity’s overall financial performance.
On scale, lifetime Medicaid revenue ($2.3M) exceeds lifetime Medicare revenue ($1.3M), making Medicaid the larger revenue source for this provider. This payer mix suggests operational exposure to state Medicaid reimbursement schedules and policies in Alabama; shifts in state-level rates or mileage payment rules could have greater impact on the provider’s cash flow than changes in Medicare policy.
Nationally for Medicare billing the provider posts healthy percentile placements on its largest codes: A0425 (ground mileage) ranks in the 95th percentile, A0429 in the 94th percentile, and A0427 in the 89th percentile versus national peers. These percentiles indicate above-typical national volumes for those services — the provider is a notable regional contributor of billed ground mileage and emergency transports within the ambulance sector, though its rank positions are described as “typical, unremarkable volume” in the source data, so it should be viewed as a sizable but not dominant national player.
Within Alabama Medicaid comparisons, the provider ranks near the top statewide on key codes: A0425 is #15 of 131 providers (89th percentile), A0429 is #10 of 93 (90th percentile), and A0427 is #17 of 102 (84th percentile). Those in-state standings indicate the provider is a major regional supplier of mileage and basic/advanced life support transports in Alabama and likely competes closely with a small set of other high-volume local ambulance services.
Specific code-level signals warrant attention: A0425 (ground mileage) is a primary revenue driver for Medicaid (41.2% of Medicaid revenue) and also a top Medicare driver (23.2% of Medicare revenue), showing mileage billing is a central revenue stream across payers. The Medicaid average paid per claim for A0425 ($37) contrasts with the Medicare average per claim ($7) as reported, signaling material differences in per-claim reimbursement between payers that will affect unit economics for long-distance transports.
Claims mix shows many low-dollar but high-count items on Medicaid (e.g., A0425 with 26.2K claims and A0429 with 8.1K claims), reflecting a high-volume operational footprint at scale in the state rather than reliance on a few high-dollar encounters. Conversely, Medicare counts for the same codes are also large (e.g., 42.9K A0425 claims), confirming consistent emphasis on mileage-based and BLS/ALS emergency transports across both payers.
The provider has been enumerated for roughly 20 years (NPI registered 2006-10-04), indicating long tenure in the market. That longevity combined with concentrated revenue streams and above-typical national and in-state rankings on core ambulance codes suggests an established operational presence with experience managing ambulance transport workflows and payer billing nuances.
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) | 1,000 | $370 | $364.5K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1,070 | $300 | $324K |
| A0425 | Ground mileage, per statute mile | 42,860 | $10 | $300K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 1,420 | $180 | $251.7K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 100 | $230 | $23.2K |
| A0434 | Specialty care transport (sct) | 30 | $630 | $15.8K |
| A0433 | Advanced life support, level 2 (als 2) | 30 | $520 | $14.6K |
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 |
|---|---|---|---|---|
| A0425 | Ground mileage, per statute mile | 26,170 | $40 | $968.2K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 8,080 | $60 | $493.1K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 7,110 | $60 | $454.9K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 10,060 | $40 | $402.2K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 520 | $60 | $32.6K |
| A0382 | Bls routine disposable supplies | 30 | $20 | $820 |
| A0998 | Ambulance response and treatment, no transport | 500 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Alabama providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Alabama median
7 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0425 | Ground mileage, per statute mile | 15 | 130 | 3,610 | $40 | $394K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 17 | 100 | 1,850 | $90 | $379.6K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 17 | 80 | 2,590 | $40 | $248.6K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 10 | 90 | 1,170 | $70 | $209.8K |
| A0382 | Bls routine disposable supplies | 36 | 40 | 1,930 | $20 | $77.6K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 14 | 40 | 140 | $100 | $46.4K |
| A0998 | Ambulance response and treatment, no transport | 2 | 10 | 500 | $0 | $0 |
Other providers in the same ZIP code as Northwest Alabama Health Services, LLC, ranked by combined Medicare and Medicaid revenue.
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