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NPI 1700867447 · Beckley, WV · Land Ambulance
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Jan-care Ambulance Of Mcdowell County Inc is a land ambulance provider located in Beckley, West Virginia. This profile covers 4 Medicare and 4 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 | Jan-care Ambulance Of Mcdowell County Inc |
| Address | 117 South Fayette Street |
| City | Beckley |
| State | WV |
| ZIP | 25801 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | November 9, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $994.9K |
| Medicaid | $386.6K |
This provider’s payer mix is Medicare-weighted: reported lifetime Medicare revenue is $994.9K versus Medicaid revenue of $386.6K, so Medicare is the larger single payer for the practice. The absolute figures indicate meaningful scale on both public programs but a clear tilt toward Medicare as the primary revenue source.
Medicare revenue is highly concentrated in a narrow set of ambulance services: the precomputed top 3 Medicare codes account for 99.6% of Medicare revenue, driven by A0428 (64.7%, $650K revenue), A0425 (34.3%, $344.8K revenue), and A0426 (0.6%, $6.1K revenue). This concentration implies the provider’s Medicare business is overwhelmingly dependent on a small set of ground-ambulance service lines.
Medicaid revenue is similarly concentrated: the precomputed top 3 Medicaid codes account for 100.0% of Medicaid revenue, with A0428 representing 58.5% ($223.9K) and A0425 41.5% ($159K), while A0999 contributes $0 (0.0%). The Medicaid portfolio is essentially split between BLS non-emergency transport (A0428) and mileage (A0425), indicating a focused set of reimbursable activities under state Medicaid.
The code mix and claims/paid patterns point to a primarily ground BLS non-emergency transport operation with significant mileage billing. For example, A0428 shows 3.2K Medicare claims at $201 avg paid/claim ($650K revenue) and 9.7K Medicaid claims at $23 avg paid/claim ($223.9K revenue), while A0425 shows 49.3K Medicare claims at $7 avg paid/claim ($344.8K) and 8.4K Medicaid claims at $19 avg paid/claim ($159K). These patterns suggest the provider performs many mileage-line items and a high-volume of lower-paid Medicaid trips versus higher-paid Medicare BLS claims.
On national competitive standing for Medicare, the provider is active but not dominant: A0428 ranks #217 of 2772 (92th percentile; typical, unremarkable volume) and A0425 ranks #402 of 8934 (96th percentile; typical, unremarkable volume), indicating above-median placement on those core codes but not market leadership. Conversely, higher-acuity ambulance codes show limited traction—A0426 ranks #1192 of 1568 (23th percentile; typical, unremarkable volume) and A0429 ranks #7642 of 7808 (1th percentile; typical, unremarkable volume)—so ALS/emergency presence is minimal.
State-level competitive signals for Medicaid show a meaningful regional footprint without dominance: A0428 is #19 of 74 (75th percentile; typical, unremarkable volume) and A0425 is #41 of 137 (71th percentile; typical, unremarkable volume), which places the provider above the median in West Virginia on its two primary Medicaid codes but not at the top of the in-state market. Use of unlisted codes (A0999, #6 of 9, 38th percentile; typical, unremarkable volume) is modest and does not materially drive Medicaid revenue.
There are notable anomalies in recorded payments for certain Medicaid codes: A0999 shows 2.4K claims with $0 avg paid/claim ($0 revenue) and 94760 shows 171 claims with $0 avg paid/claim ($0 revenue). These entries indicate billed activity without recorded Medicaid payment on file and warrant attention in adjudication or record review processes, but they should be interpreted neutrally as zero recorded revenue rather than an inference of billing practices.
The provider has established tenure in the market, with its NPI enumerated on 2005-11-09 (~21 years ago), suggesting a long-standing local ambulance operation. Combined with the strong revenue concentration in BLS non-emergency transport and mileage, this longevity supports the interpretation of a specialized, established land-ambulance operator focused on routine ground transports.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 3,230 | $200 | $650K |
| A0425 | Ground mileage, per statute mile | 49,260 | $10 | $344.8K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 30 | $240 | $6.1K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 10 | $320 | $4.1K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 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.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 9,730 | $20 | $223.9K |
| A0425 | Ground mileage, per statute mile | 8,370 | $20 | $159K |
| 94760 | The provider takes a single measurement of the patient’s oxygen saturation using a sensor on the ear or finger. | 170 | $0 | $0 |
| A0999 | Unlisted ambulance service | 2,450 | $0 | $0 |
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
4 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0425 | Ground mileage, per statute mile | 41 | 140 | 2,710 | $100 | $955.9K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 19 | 70 | 3,360 | $110 | $830K |
| A0999 | Unlisted ambulance service | 6 | 10 | 2,680 | $10 | $21.9K |
| 94760 | The provider takes a single measurement of the patient’s oxygen saturation using a sensor on the ear or finger. | 39 | 70 | 220 | $10 | $15.1K |
Other providers in the same ZIP code as Jan-care Ambulance Of Mcdowell County Inc, ranked by combined Medicare and Medicaid revenue.
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