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NPI 1568497428 · Pierre, SD · Ambulance
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American Medical Response Ambulance Service Inc is a ambulance provider located in Pierre, South Dakota. This profile covers 5 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 | American Medical Response Ambulance Service Inc |
| Address | 1154 E Sioux Ave |
| City | Pierre |
| State | SD |
| ZIP | 57501 |
| Taxonomy | Ambulance |
| NPI Enumerated | July 11, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $310.3K |
| Medicaid | $261.1K |
The provider’s billed services are squarely ambulance/EMS operations with an emphasis on emergency advanced life support: the top Medicare revenue driver is A0427 (ALS 1 emergency) at $217.6K (437 claims, $498 avg paid/claim), and the Medicaid top driver is the same code at $203.8K (1.5K claims, $140 avg paid/claim). Both payers also show heavy use of ground mileage (A0425) and basic-life-support emergency transport (A0429 on Medicare), indicating the organization performs a high volume of transports plus distance-based billing. This code mix is consistent with an ambulance provider focused on emergency response rather than non-emergent medical transport.
Revenue concentration is pronounced for both payers: the top 3 Medicare codes account for 93.4% of the provider’s Medicare revenue, and the top 3 Medicaid codes account for 100.0% of the provider’s Medicaid revenue. That level of concentration means the business’s financial performance is closely tied to a very small set of transport and mileage codes (notably A0427, A0429, and A0425), so changes in reimbursement or utilization for those codes would materially affect total revenue.
The provider is not single‑payer: lifetime Medicare revenue is $310.3K while lifetime Medicaid revenue is $261.1K, so both payers are material to the overall book of business. Medicare is the larger single payer by the figures provided ($310.3K vs $261.1K), but Medicaid constitutes a substantial portion of activity on its own, indicating a dual-payer operational footprint rather than exclusive dependence on one program.
Nationally for Medicare, the provider’s A0427 activity sits at a modest position: A0427 ranks #1706 of 6841 providers (75th percentile), which is neither top-tier dominance nor an outlier but indicates solid, routine ALS emergency volume at the national level. Other Medicare codes such as A0429 (rank #4210 of 7808, 46th percentile) and A0425 (rank #3533 of 8934, 60th percentile) are described as typical, unremarkable volumes, so the provider appears to be a modest, service-line focused competitor rather than a national market leader.
Within South Dakota Medicaid, the provider shows a relatively strong in‑state standing on its primary ALS emergency code: A0427 ranks #8 of 36 providers in-state (80th percentile), suggesting above-average market share for ALS emergency transports locally. By contrast A0425 (rank #16 of 57, 73rd percentile) is more middle-tier and A0394 (rank #4 of 4, 0th percentile) represents a very small in-state niche line (1.0% of Medicaid revenue, $2.5K), so competitive strength is concentrated in emergency ALS transports rather than ancillary supply codes.
There is a marked difference in average payment rates for the same service between payers: A0427 is paid at $498 avg/claim on Medicare versus $140 avg/claim on Medicaid, while claim volumes for that code differ (437 Medicare claims vs 1.5K Medicaid claims). This pattern produces materially different revenue per-claim economics across payers and explains why comparable services can generate disparate revenue totals despite differing claim counts.
The provider has an established tenure in the NPI registry (enumerated 2006-07-11, ~20 years ago), which combined with concentrated code usage suggests a stable, long-running ambulance operation focused on a narrow set of transport services. Longevity plus concentrated ALS billing tends to reflect an operational specialization rather than recent market entry or rapid service diversification.
Available percentile labels for the top codes characterize the provider’s volumes as largely 'typical, unremarkable' rather than extreme outliers: multiple codes on both Medicare and Medicaid are explicitly described as typical, and lower percentiles on A0433 and A0428 for Medicare (23th and 19th percentiles respectively) indicate limited activity in ALS level 2 and non-emergency BLS services. Overall, the data do not show unusual statistical outliers but rather a concentrated, routine EMS billing profile centered on emergency ALS and mileage.
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) | 440 | $500 | $217.6K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 90 | $420 | $36.1K |
| A0425 | Ground mileage, per statute mile | 4,510 | $10 | $36.1K |
| A0433 | Advanced life support, level 2 (als 2) | 20 | $720 | $10.8K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 40 | $260 | $9.5K |
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.
How this provider's Medicaid billing volume and revenue compare to other South Dakota providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. South Dakota 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) | 8 | 40 | 270 | $180 | $281.6K |
| A0425 | Ground mileage, per statute mile | 16 | 60 | 680 | $50 | $106.2K |
| A0394 | Als specialized service disposable supplies; iv drug therapy | 4 | 10 | 1,750 | $30 | $49.4K |
Other providers in the same ZIP code as American Medical Response Ambulance Service Inc, ranked by combined Medicare and Medicaid revenue.
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