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NPI 1598877268 · Port Huron, MI · Land Ambulance
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Tri Hospital Emergency Medical Services Corporation is a land ambulance provider located in Port Huron, Michigan. This profile covers 7 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 | Tri Hospital Emergency Medical Services Corporation |
| Address | 309 Grand River Ave |
| City | Port Huron |
| State | MI |
| ZIP | 48060 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | August 31, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $8.9M |
| Medicare | $1.8M |
TRI HOSPITAL EMERGENCY MEDICAL SERVICES CORPORATION operates as a land ambulance provider with a code mix dominated by advanced life support emergency transports and extensive ground mileage billing. Its Medicare and Medicaid top codes (A0427, A0425, A0428) align with a mixed emergency and non-emergency transport operation, and the provider reported $1.8M in total Medicare revenue and $8.9M in total Medicaid revenue, indicating the organization’s core business is ambulance transport rather than facility-based care.
Revenue is highly concentrated in a small set of transport codes: the top 3 Medicare codes by revenue account for 86.9% of this provider's total Medicare revenue, and the top 3 Medicaid codes by revenue account for 87.3% of this provider's total Medicaid revenue. This concentration means A0427, A0425, and A0428 effectively drive the bulk of reimbursement on both payers and represent the greatest operational and reimbursement risk/opportunity for contracting or utilization management.
The payer mix is strongly Medicaid-weighted: Medicaid revenue ($8.9M) is materially larger than Medicare revenue ($1.8M), so commercial and state Medicaid strategies will affect overall volume and revenue more than Medicare-focused changes. For contract negotiations or network planning, treat this provider as Medicaid-dominant while still acknowledging a meaningful Medicare footprint.
On Medicare, A0427 is the single largest line item—$1M and 53.9% of the provider's Medicare revenue—and the provider ranks #259 of 6841 providers nationally (96th percentile; typical, unremarkable volume for this code). A0425 (61.9K claims, $433K, 23.3% of Medicare revenue) ranks #296 of 8934 providers nationally (97th percentile; notably above typical national volume for this code), so the provider shows above-typical national mileage volume combined with a typical-level ALS emergency transport profile.
On Medicaid, A0427 likewise dominates with $4.7M in revenue (52.4% of this provider's total Medicaid revenue) and a strong in-state standing (ranks #11 of 163 providers in-state, 94th percentile; typical, unremarkable volume for this code). A0425 contributes $2.4M (27.2% of Medicaid revenue) and ranks #19 of 199 providers in-state (91th percentile; typical, unremarkable volume for this code), indicating the provider is a major in-state mileage and ALS emergency transporter for Medicaid beneficiaries.
Operationally, ground mileage billing is a prominent feature of the business model: the provider reported 61.9K Medicare claims for A0425 with a $7 avg paid/claim and 31.4K Medicaid claims for A0425 with a $77 avg paid/claim, highlighting both high mileage volume and a large absolute Medicaid mileage revenue stream. Those volumes, alongside significant counts for A0427 (2.7K Medicare claims and 20.6K Medicaid claims), imply frequent long-distance or high-frequency transports rather than a narrow specialty niche.
There are notable zero-dollar paid-code patterns on the Medicaid side that merit attention: A0422 shows 5.3K claims with $0 avg paid/claim and $0 revenue while ranking #3 of 30 providers in-state (93th percentile; notably above typical state volume for this code), and A0888 shows 45 claims with $0 avg paid/claim and $0 revenue (ranks #2 of 3 providers in-state, 50th percentile; typical, unremarkable volume for this code). These entries indicate reported utilization that did not produce paid Medicaid revenue, which is relevant for audit, coverage, or eligibility discussions without implying any specific cause.
The provider demonstrates some service diversification beyond routine transports: Medicare shows $93.2K from A0434 (specialty care transport, 5.0% of Medicare revenue) and smaller ALS2 activity (A0433 $22.6K), while Medicaid includes monoclonal-antibody infusion codes such as M0245 ($40.9K, 0.5% of Medicaid revenue, ranks #8 of 48 in-state, 85th percentile) and scattered M0244/M0243 activity. These items suggest capability for higher-acuity transfers and occasional in-home or residence-based infusion services in addition to core ALS/BLS ground transports.
The provider’s NPI has been enumerated since 2006-08-31 (~20 years ago), indicating long tenure in the market; combined with high in-state rank for core Medicaid codes and high national percentiles for key Medicare codes, this profile is consistent with an established regional ambulance operator with significant Medicaid footprint and above-typical mileage volumes.
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) | 2,650 | $380 | $1M |
| A0425 | Ground mileage, per statute mile | 61,850 | $10 | $433K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 900 | $200 | $178.9K |
| A0434 | Specialty care transport (sct) | 140 | $650 | $93.2K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 270 | $300 | $83.3K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 190 | $240 | $44K |
| A0433 | Advanced life support, level 2 (als 2) | 40 | $540 | $22.6K |
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.
10 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 20,640 | $230 | $4.7M |
| A0425 | Ground mileage, per statute mile | 31,380 | $80 | $2.4M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 4,640 | $150 | $687K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 2,750 | $220 | $597.6K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 3,150 | $150 | $476.3K |
| M0245 | Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring | 110 | $390 | $40.9K |
| M0244 | Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring in the home or residence; this includes a beneficiary's… | 20 | $690 | $11K |
| M0243 | Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring | 10 | $400 | $5.1K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 5,300 | $0 | $0 |
| A0888 | Noncovered ambulance mileage, per mile (e.g., for miles traveled beyond closest appropriate facility) | 50 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Michigan providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Michigan median
10 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) | 11 | 160 | 1,880 | $230 | $1.3M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 20 | 70 | 1,790 | $130 | $1M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 49 | 150 | 1,570 | $150 | $951.3K |
| A0425 | Ground mileage, per statute mile | 19 | 200 | 2,950 | $50 | $648.5K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 7 | 50 | 540 | $220 | $285.3K |
| M0244 | Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring in the home or residence; this includes a beneficiary's… | 3 | 10 | 20 | $540 | $23.3K |
| M0243 | Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring | 42 | 50 | 50 | $270 | $20.2K |
| M0245 | Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring | 8 | 50 | 40 | $260 | $15.2K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 3 | 30 | 290 | $1 | $1 |
| A0888 | Noncovered ambulance mileage, per mile (e.g., for miles traveled beyond closest appropriate facility) | 2 | 10 | 50 | $0 | $0 |
Other providers in the same ZIP code as Tri Hospital Emergency Medical Services Corporation, ranked by combined Medicare and Medicaid revenue.
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