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NPI 1770533176 · Winona, MS · Ambulance
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Medstat Ems Inc is a ambulance provider located in Winona, Mississippi. This profile covers 7 Medicare and 11 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 | Medstat Ems Inc |
| Address | 506 N Applegate St |
| City | Winona |
| State | MS |
| ZIP | 38967 |
| Taxonomy | Ambulance |
| NPI Enumerated | May 10, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $12.7M |
| Medicare | $3.1M |
MEDSTAT EMS INC’s billing mix is unambiguously ambulance/EMS-centered: the Medicare and Medicaid top codes are A0427 (ALS emergency), A0425 (ground mileage), and A0429 (BLS emergency), indicating core operations are emergency ambulance transports with substantial mileage-based activity. The presence of both ALS and BLS emergency transport codes at high volume suggests a mixed advanced/basic life support fleet rather than a single-service niche.
Revenue concentration on Medicare is high: the precomputed top three Medicare codes account for 87.3% of the provider’s total Medicare revenue, with A0427 contributing 42.6%, A0425 contributing 34.3%, and A0429 contributing 10.4% of Medicare revenue. That concentration signals dependency on a small set of transport services for most Medicare receipts.
Revenue concentration on Medicaid is even tighter: the precomputed top three Medicaid codes account for 91.0% of total Medicaid revenue, led by A0427 at 53.5%, A0429 at 19.9%, and A0425 at 17.6%. Medicaid receipts are therefore dominated by ALS emergency and BLS emergency transports plus mileage, reinforcing the EMS-specialty business profile in the state.
Payer mix is heavily weighted toward Medicaid in scale: total Medicaid revenue is $12.7M compared with total Medicare revenue of $3.1M, indicating Medicaid billing activity and revenue are materially larger than Medicare for this provider. This pattern makes the provider effectively Medicaid-dominant in revenue scale.
The provider is a prominent national outlier on specific Medicare metrics: Medicare A0425 (ground mileage) shows 131.4K claims and ranks #93 of 8934 providers nationally (99th percentile; extreme outlier), and Medicare A0427 (ALS emergency) ranks #192 of 6841 providers (97th percentile; notably above typical national volume). These rankings point to unusually high mileage and ALS emergency billing relative to national peers.
Within Mississippi Medicaid, MEDSTAT shows strong competitive standing for ALS emergency: Medicaid A0427 has 41.6K claims, $6.8M revenue and ranks #4 of 49 providers in-state (94th percentile; notably above typical state volume). Medicaid A0429 and A0425 also rank relatively high in-state (A0429: #7 of 39, 84th percentile; A0425: #6 of 54, 91th percentile), indicating the provider is one of the larger ambulance billers in-state for these services.
Payer rate and unit-payment patterns differ markedly between Medicare and Medicaid for the same services: for A0427 the avg paid/claim is $371 on Medicare versus $163 on Medicaid, for A0429 $309 on Medicare versus $165 on Medicaid, and for A0425 $8 on Medicare versus $37 on Medicaid. These per-claim differences, combined with the very high claim volumes (e.g., Medicare 131.4K claims for A0425 and Medicaid 60.4K claims for A0425), suggest that both price and volume shape total revenue differently across payers.
Several Medicaid-listed codes show nonzero claim counts but $0 avg paid/claim and $0 revenue (examples include A0422, A0392, A0888, A0398, A0999). The presence of many zero-paid line items indicates administrative reporting of supplies, noncovered mileage, or unremunerated codes in Medicaid reporting that generate claim activity without recorded Medicaid revenue.
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) | 3,520 | $370 | $1.3M |
| A0425 | Ground mileage, per statute mile | 131,380 | $10 | $1.1M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1,040 | $310 | $319.8K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 1,340 | $170 | $232.3K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 450 | $230 | $102.8K |
| A0433 | Advanced life support, level 2 (als 2) | 60 | $530 | $33.7K |
| A0434 | Specialty care transport (sct) | 30 | $620 | $19.3K |
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.
11 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 41,620 | $160 | $6.8M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 15,340 | $170 | $2.5M |
| A0425 | Ground mileage, per statute mile | 60,390 | $40 | $2.2M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 17,240 | $60 | $965.3K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 1,490 | $110 | $169.6K |
| A0433 | Advanced life support, level 2 (als 2) | 50 | $160 | $8.4K |
| A0392 | Als specialized service disposable supplies; defibrillation (to be used only in jurisdictions where defibrillation cannot be performed in bls ambulances) | 630 | $0 | $0 |
| A0398 | Als routine disposable supplies | 2,920 | $0 | $0 |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 1,390 | $0 | $0 |
| A0888 | Noncovered ambulance mileage, per mile (e.g., for miles traveled beyond closest appropriate facility) | 2,650 | $0 | $0 |
Showing 1–10 of 11
How this provider's Medicaid billing volume and revenue compare to other Mississippi providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Mississippi median
11 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) | 4 | 50 | 4,400 | $160 | $1.9M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 7 | 40 | 2,590 | $160 | $1.4M |
| A0425 | Ground mileage, per statute mile | 6 | 50 | 5,330 | $30 | $618.3K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 6 | 40 | 2,320 | $50 | $325.3K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 4 | 20 | 180 | $70 | $38.6K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 3 | 10 | 790 | $20 | $24.9K |
| A0433 | Advanced life support, level 2 (als 2) | 5 | 10 | 100 | $150 | $24.2K |
| A0398 | Als routine disposable supplies | 3 | 10 | 1,260 | $1 | $18K |
| A0888 | Noncovered ambulance mileage, per mile (e.g., for miles traveled beyond closest appropriate facility) | 11 | 30 | 1,360 | $1 | $250 |
| A0999 | Unlisted ambulance service | 4 | 10 | 890 | $1 | $90 |
Showing 1–10 of 11
Other providers in the same ZIP code as Medstat Ems Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| North Central Planning And Development District | MS | Case Management Agency | $0 | $21.6M |
| Tyler Holmes Memorial Hospital | MS | Critical Access Hospital | $0 | $6.4M |
| Rcg Mississippi, Inc. | MS | End-Stage Renal Disease (ESRD) Treatment Clinic/Center | $0 | $1.4M |
| Precious Hands Adult Daycare | MS | Adult Day Care Clinic/Center | $0 | $1.2M |
| Jacquelyn Lucas | MS | Optometrist | $10.7K | $786.9K |
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