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NPI 1780829366 · Columbus, OH · Ambulance
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Cems Of Ohio Inc is a ambulance provider located in Columbus, Ohio. This profile covers 7 Medicare and 9 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 | Cems Of Ohio Inc |
| Address | 3699 Paragon Drive |
| City | Columbus |
| State | OH |
| ZIP | 43228 |
| Taxonomy | Ambulance |
| NPI Enumerated | December 10, 2008 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $13.6M |
| Medicare | $5.2M |
Service-line profile: CEMS OF OHIO INC bills predominantly for ambulance transport services, with its top Medicare and Medicaid revenue drivers being A0425 (ground mileage), A0428 (BLS non-emergency transport), and A0426 (ALS 1 non-emergency). The presence of A0434 (specialty care transport) and wheelchair-van codes (A0130, S0209) in Medicaid suggests a mixed fleet offering both standard ambulance and non-emergency wheelchair/van transports. This mix is consistent with an organization operating high-volume non-emergency patient transport and some specialty transport capability rather than an EMS-first-response-only model.
Revenue concentration — Medicare: The provider’s Medicare revenue is highly concentrated, with the top three Medicare codes accounting for 93.8% of total Medicare revenue; A0425 alone contributes $2.5M (47.5% of Medicare revenue) and A0428 contributes $1.9M (36.0% of Medicare revenue). This concentration indicates the business is largely driven by mileage and routine non-emergency BLS transports on the Medicare side rather than a broad spread of CPT activity.
Revenue concentration — Medicaid: On the Medicaid side the top three codes account for 86.7% of total Medicaid revenue, led by A0428 at $5.8M (42.8%) and A0425 at $4.5M (33.2%). The Medicaid billing profile reinforces a heavy dependence on non-emergency BLS transports and mileage for revenue, with ALS 1 (A0426) representing the third-largest Medicaid revenue stream at $1.5M (10.7%).
Payer mix and scale: CEMS OF OHIO INC reported $5.2M in Medicare revenue versus $13.6M in Medicaid revenue, indicating Medicaid is the larger payer relationship by reported dollars. Both payers are material to the business, but the provider’s operations appear to be more Medicaid-weighted in scale and revenue contribution.
Competitive standing — Medicare: For several Medicare codes this provider is a national outlier: A0425 ranks #13 of 8934 nationally (100th percentile; extreme outlier) and A0426 ranks #3 of 1568 nationally (100th percentile; extreme outlier), while A0428 ranks #53 of 2772 (98th percentile; notably above typical national volume). These rankings describe a provider that is an unusually large national producer of ambulance mileage and ALS 1 non-emergency services on Medicare.
Competitive standing — Medicaid (in-state): The provider is a dominant Medicaid player in Ohio for its top codes: A0428 ranks #2 of 126 in-state (99th percentile; extreme outlier), A0425 ranks #5 of 675 in-state (99th percentile; extreme outlier), and A0426 ranks #1 of 76 in-state (100th percentile; extreme outlier). Those state-level ranks indicate market leadership in both mileage and non-emergency ALS/BLS transport within Ohio’s Medicaid system.
Statistical-outlier interpretation: Multiple codes are labeled as “extreme outlier” or “notably above typical,” which signals that CEMS OF OHIO INC’s volumes for ground mileage (A0425), non-emergency BLS (A0428), and ALS 1 non-emergency (A0426) are far above typical peer activity. Analysts should treat these as structural business-scale differences — a concentrated, high-volume transport provider — rather than routine mid-size provider behavior.
Tenure and operational longevity: The provider’s NPI was enumerated on 2008-12-10 (~18 years ago), indicating a longstanding presence in the market. That tenure, combined with the high-volume billing footprint across both Medicare and Medicaid, suggests sustained operational capacity and an established role in non-emergency and specialty patient transport in its service area.
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 | 312,540 | $10 | $2.5M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 9,530 | $200 | $1.9M |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 2,270 | $240 | $543.2K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 440 | $380 | $165.1K |
| A0433 | Advanced life support, level 2 (als 2) | 130 | $550 | $69.2K |
| A0434 | Specialty care transport (sct) | 100 | $650 | $61.6K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 100 | $320 | $32.9K |
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.
9 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 89,970 | $70 | $5.8M |
| A0425 | Ground mileage, per statute mile | 122,360 | $40 | $4.5M |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 17,330 | $80 | $1.5M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 6,720 | $130 | $840.1K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 6,180 | $80 | $506.7K |
| A0130 | Non-emergency transportation: wheelchair van | 8,670 | $20 | $173.3K |
| A0434 | Specialty care transport (sct) | 1,240 | $110 | $132.5K |
| S0209 | Wheelchair van, mileage, per mile | 8,660 | $10 | $112.5K |
| A0433 | Advanced life support, level 2 (als 2) | 320 | $170 | $55.9K |
How this provider's Medicaid billing volume and revenue compare to other Ohio providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Ohio median
9 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 2 | 130 | 3,720 | $50 | $544.7K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 37 | 510 | 1,080 | $120 | $365.4K |
| A0434 | Specialty care transport (sct) | 10 | 20 | 660 | $190 | $317.7K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 43 | 480 | 880 | $90 | $260K |
| A0130 | Non-emergency transportation: wheelchair van | 44 | 150 | 3,580 | $20 | $208K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 1 | 80 | 380 | $80 | $132.1K |
| A0425 | Ground mileage, per statute mile | 5 | 680 | 2,020 | $10 | $98.4K |
| S0209 | Wheelchair van, mileage, per mile | 44 | 150 | 3,580 | $10 | $73.5K |
| A0433 | Advanced life support, level 2 (als 2) | 6 | 10 | 110 | $130 | $64.3K |
Other providers in the same ZIP code as Cems Of Ohio Inc, ranked by combined Medicare and Medicaid revenue.
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