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NPI 1689674467 · White Sulphur Springs, WV · Land Ambulance
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White Sulphur Springs Emergency Medical Services, Inc is a land ambulance provider located in White Sulphur Springs, West Virginia. 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 | White Sulphur Springs Emergency Medical Services, Inc |
| Address | 195 Bob White Lane |
| City | White Sulphur Springs |
| State | WV |
| ZIP | 24986 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | July 22, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $6.2M |
| Medicare | $766.7K |
This provider is overwhelmingly Medicaid-driven by scale: total Medicaid revenue is $6.2M compared with total Medicare revenue of $766.7K, indicating Medicaid is the dominant payer for the business. Analysts should treat Medicaid reimbursement trends and state policy as the primary drivers of cash flow and volume risk for this operation.
Revenue is highly concentrated in a few ground-ambulance codes on both payers: the precomputed top 3 Medicare codes by revenue account for 77.9% of Medicare revenue and the top 3 Medicaid codes by revenue account for 85.6% of Medicaid revenue. On Medicare the top contributors are A0425, A0427 and A0428; on Medicaid the top contributors are A0425, A0428 and A0429, signaling a narrow set of services that generate the bulk of receipts.
The code mix points to a traditional land-ambulance operation that monetizes mileage heavily while providing both basic and advanced life support transports. A0425 (ground mileage) is the single largest revenue driver in both payers (Medicare $414.2K, Medicaid $3.5M), while BLS and ALS transport codes (A0428, A0429, A0427) together constitute the bulk of clinical transport revenue, implying routine emergent and non-emergent patient movement is the core service line.
Nationally on Medicare the provider shows mixed market presence: A0425 ranks #371 of 8934 providers (96th percentile) but is labeled as "typical, unremarkable volume for this code," and other Medicare transport codes (A0427, A0428, A0429) sit in mid-percentile ranks (64th–75th). Taken together this suggests the provider is not an outlier nationally but does have above-average mileage volume for Medicare compared with many peers.
In-state competitive standing on Medicaid is relatively stronger for mileage and BLS transport: A0425 ranks #20 of 137 providers in-state (86th percentile) and A0428 ranks #17 of 74 (78th percentile), though available notes classify these as "typical, unremarkable volume for this code." These placements indicate an above-average regional footprint for basic ground-transport services, even if the activity is not characterized as exceptional by comparator descriptors.
Specialty care transport (A0434) and non-transport response (A0998) are present but minor contributors to revenue and show inconsistent standing across payers. On Medicare A0434 represents $54K (7.0% of Medicare revenue) with a 68th-percentile rank described as typical, while on Medicaid A0434 is only $26.9K (0.4% of Medicaid revenue) and ranks in the 25th percentile; A0998 is immaterial on Medicaid at $6.4K. This pattern indicates limited specialty/response-only activity and that SCT is not a major Medicaid revenue source for this entity.
The provider’s NPI was enumerated on 2005-07-22 (~21 years ago), indicating longstanding presence in its market. That tenure, combined with heavy reliance on a small set of transport and mileage codes, suggests operational continuity but also dependence on stable reimbursement for those specific codes.
Because A0425 (ground mileage) dominates both payers’ revenue—illustrated by Medicare $414.2K and Medicaid $3.5M—the business is exposed to mileage-rate changes or policy adjustments affecting ground-ambulance reimbursement. Given the precomputed concentration metrics (77.9% Medicare, 85.6% Medicaid in top 3 codes), payers and network strategists should view any changes to mileage or core BLS/ALS rates as having outsized impact on this provider’s financial performance.
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 |
|---|---|---|---|---|
| A0425 | Ground mileage, per statute mile | 51,770 | $10 | $414.2K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 280 | $360 | $102.5K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 530 | $160 | $86.4K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 280 | $300 | $84.2K |
| A0434 | Specialty care transport (sct) | 90 | $620 | $54K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 100 | $230 | $23.4K |
| A0433 | Advanced life support, level 2 (als 2) | 20 | $520 | $9.4K |
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 | 17,970 | $190 | $3.5M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 10,320 | $110 | $1.1M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 3,270 | $230 | $744.9K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 2,290 | $280 | $644.1K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 1,030 | $210 | $215.5K |
| A0434 | Specialty care transport (sct) | 60 | $460 | $26.9K |
| A0998 | Ambulance response and treatment, no transport | 210 | $30 | $6.4K |
How this provider's Medicaid billing volume and revenue compare to other West Virginia providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. West Virginia median
7 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0425 | Ground mileage, per statute mile | 20 | 140 | 2,710 | $100 | $955.9K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 17 | 70 | 3,360 | $110 | $830K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 27 | 100 | 840 | $260 | $730.3K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 28 | 110 | 950 | $220 | $703.7K |
| A0434 | Specialty care transport (sct) | 4 | 10 | 210 | $450 | $212.3K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 8 | 30 | 530 | $190 | $203K |
| A0998 | Ambulance response and treatment, no transport | 11 | 20 | 230 | $50 | $35.1K |
Other providers in the same ZIP code as White Sulphur Springs Emergency Medical Services, Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Rainelle Medical Center, Inc. | WV | Federally Qualified Health Center (FQHC) | $0 | $1.2M |
| Marilyn Glaser | WV | Family Medicine Physician | $60.9K | $214.5K |
| Randolph Modlin | WV | Cardiovascular Disease Physician | $184.7K | $0 |
| Republic Paging Inc. | WV | Ambulance | $177.3K | $230 |
| Breann Songer | WV | Family Medicine Physician | $48.8K | $0 |
| Greenbrier Clinic Surgery Center | WV | Ambulatory Surgical Clinic/Center | $48K | $0 |
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