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NPI 1770518490 · Spokane, WA · Ambulance
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American Medical Response Ambulance Service Inc is a ambulance provider located in Spokane, Washington. This profile covers 6 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 | American Medical Response Ambulance Service Inc |
| Address | 1425 N Washington St |
| City | Spokane |
| State | WA |
| ZIP | 99201 |
| Taxonomy | Ambulance |
| NPI Enumerated | July 11, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $29.1M |
| Medicare | $6.1M |
This provider reports $6.1M in total Medicare revenue and $29.1M in total Medicaid revenue, indicating a payer mix heavily weighted toward Medicaid by scale; Medicaid receipts are roughly five times larger than Medicare receipts, so the organization should be considered Medicaid-dominant in absolute revenue terms. The NPI was enumerated 2006-07-11 (~20 years ago), indicating long tenure and an established billing footprint across both programs.
The code mix is concentrated in emergency ground ambulance services and mileage, with the top Medicare revenue drivers being A0427 (Ambulance service, advanced life support, emergency transport, level 1), A0429 (Ambulance service, basic life support, emergency transport), and A0425 (Ground mileage). This pattern—high volumes of ALS- and BLS-emergency transports plus extensive mileage—is consistent with a high-throughput ground EMS operator focused on emergency response rather than non-emergency patient transfers.
Medicare revenue is highly concentrated: the precomputed top-3 Medicare codes account for 89.4% of the provider's Medicare revenue, dominated by A0427 at 52.2% and A0429 at 24.8%, with A0425 contributing 12.4%. Given the $6.1M Medicare total, these three codes drive the vast majority of Medicare receipts and therefore any Medicare policy, price, or volume changes for these codes would disproportionately affect Medicare revenue.
Medicaid revenue shows even larger concentration into the same three codes: the precomputed top-3 Medicaid codes account for 92.3% of Medicaid revenue, led by A0429 at 52.0%, A0427 at 21.8%, and A0425 at 18.4% of the $29.1M Medicaid total. This concentration indicates that Medicaid business is overwhelmingly composed of emergency BLS/ALS transports and mileage billing, making Medicaid reimbursements for these services the primary revenue engine for the provider.
Competitive standing on Medicare for the top codes is well above typical national volumes: A0427 ranks #67 of 6841 providers nationally (99th percentile; extreme outlier) and A0429 ranks #61 of 7808 providers nationally (99th percentile; extreme outlier), while A0425 ranks #130 of 8934 providers nationally (99th percentile; notably above typical national volume). Those national-level ranks identify this provider as an unusually large biller for emergency ambulance services and mileage compared with peers across the country.
State-level competitive positioning for Medicaid is similarly dominant: A0429 ranks #3 of 145 providers in-state (99th percentile; extreme outlier) and A0427 ranks #2 of 98 providers in-state (99th percentile; extreme outlier), with A0425 also ranking #3 of 168 in-state (99th percentile; extreme outlier). These in-state rankings indicate the provider is a major, potentially market-leading ambulance service in Washington for both BLS and ALS emergency transports and ground mileage billing.
Claim-level economics differ between payers: for A0427 the average paid per claim is $409 on Medicare versus $159 on Medicaid, for A0429 it is $343 on Medicare versus $161 on Medicaid, and for A0425 it is $7 on Medicare versus $34 on Medicaid. The provider combines higher Medicaid volumes with materially lower per-claim payments compared with Medicare, so overall Medicaid revenue dominance is driven by scale rather than higher unit pricing.
The combination of long tenure (NPI enumerated 2006-07-11 (~20 years ago)), extremely high ranks on core emergency transport codes, and heavy revenue concentration in A0427/A0429/A0425 suggests an operational model built around high-volume emergency ground transport. That specialization implies strategic exposure to reimbursement or utilization shifts for these specific ambulance and mileage codes, since the top three codes account for 89.4% of Medicare and 92.3% of Medicaid revenue respectively.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
6 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 7,770 | $410 | $3.2M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 4,400 | $340 | $1.5M |
| A0425 | Ground mileage, per statute mile | 107,640 | $10 | $753.5K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 2,300 | $210 | $491.1K |
| A0433 | Advanced life support, level 2 (als 2) | 190 | $600 | $112K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 170 | $260 | $43.8K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 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 |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 94,220 | $160 | $15.2M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 40,030 | $160 | $6.4M |
| A0425 | Ground mileage, per statute mile | 157,650 | $30 | $5.4M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 21,520 | $90 | $1.9M |
| A0433 | Advanced life support, level 2 (als 2) | 1,710 | $210 | $353.1K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 190 | $60 | $12K |
| A0999 | Unlisted ambulance service | 20 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Washington providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Washington median
7 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0999 | Unlisted ambulance service | 83 | 90 | 1,150 | $1,820 | $4.5M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 3 | 150 | 1,340 | $120 | $719.5K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 5 | 40 | 490 | $90 | $569.7K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 2 | 100 | 1,400 | $120 | $404.9K |
| A0425 | Ground mileage, per statute mile | 3 | 170 | 2,040 | $40 | $373.3K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 7 | 20 | 130 | $110 | $99.8K |
| A0433 | Advanced life support, level 2 (als 2) | 2 | 10 | 110 | $180 | $94.7K |
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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