Loading...
NPI 1801871934 · Bloomington, MN · Emergency Medicine Physician
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Emergency Physicians Professional Association is a emergency medicine physician provider located in Bloomington, Minnesota. This profile covers 0 Medicare and 28 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 | Emergency Physicians Professional Association |
| Address | 4300 Marketpointe Drive |
| City | Bloomington |
| State | MN |
| ZIP | 55435 |
| Taxonomy | Emergency Medicine Physician |
| NPI Enumerated | December 13, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $72.7M |
| Medicare | $0 |
EMERGENCY PHYSICIANS PROFESSIONAL ASSOCIATION reports $72.7M in lifetime Medicaid revenue and has no Medicare billing on file, making its public reimbursement footprint effectively single‑payer (Medicaid). Its NPI was enumerated on 2005-12-13 (~21 years ago), indicating long-term operation in the market but little to no participation in Medicare fee-for-service revenue streams as reported here.
Revenue concentration is extreme: the top three Medicaid codes (99285, 99284, 99283) collectively account for 92.4% of this provider's total Medicaid revenue. Individually those codes represent 42.4% (99285), 34.8% (99284), and 15.2% (99283) of Medicaid revenue, showing the business is highly dependent on a narrow set of emergency department E/M services.
The code mix is characteristic of a high-volume emergency medicine practice focused on ED evaluation and management. Dominance of high-acuity ED codes 99285 and 99284, together with substantial volume of 99283, indicates routine handling of a full spectrum of ED acuity from low to high complexity; the presence of critical care code 99291 further shows the group delivers time-intensive care for the most acute presentations.
State-level competitive standing on core ED services is dominant: the provider ranks #1 in-state for 99285 (350.4K claims; $30.8M revenue; 100th percentile), 99284 (389.3K claims; $25.3M revenue; 100th percentile), and 99283 (306.9K claims; $11M revenue; 100th percentile). The precomputed labels identify these positions as "extreme outlier" volumes, meaning this entity bills far above typical state peers for standard ED E/M codes.
Beyond E/Ms, ancillary procedure patterns reinforce an ED procedural footprint: 93010 (296.5K claims; $1.2M revenue; 1.6% of Medicaid revenue) ranks #1 in-state and is described as an "extreme outlier," while wound repair codes 12001 (5.7K claims; $130.4K) and 12011 (4.6K claims; $127.6K) also rank #1. Common ED procedures such as incision and drainage (10060; 1.6K claims; $88.7K) likewise rank at or near the top of state peers, signaling that the practice performs high volumes of front-line emergency procedures.
The provider delivers measurable critical care and advanced airway interventions in addition to E/M services: 99291 (23.8K claims; $2.4M revenue; 3.3% of Medicaid revenue) ranks #3 of 48 providers in-state (96th percentile; described as notably above typical), and 31500 (1.3K claims; $97.1K) ranks #2 of 5 (75th percentile). These data indicate capability to manage critically ill patients and perform emergent airway procedures at scale within the ED setting.
Operational scale is substantial by claim counts on flagship codes: 99284 shows 389.3K claims and 99285 shows 350.4K claims, with 99283 at 306.9K claims. Those absolute claim volumes — each identified as far above typical state volume — imply a centralized or multi-site coverage model with continuous high patient throughput rather than a low-volume specialty practice.
The heavy Medicaid concentration and near-absence of Medicare exposure present both strategic clarity and risk: the practice is positioned as a Medicaid-focused emergency services provider, but its financial performance and market power are tied closely to Medicaid policy, rates, and networks. Any material changes in Medicaid reimbursement or contracting could have outsized impact given that 92.4% of Medicaid revenue stems from three ED E/M codes and Medicare is not represented in the reported billing mix.
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.
28 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99285 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making. | 350,430 | $90 | $30.8M |
| 99284 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making. | 389,260 | $70 | $25.3M |
| 99283 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making. | 306,910 | $40 | $11M |
| 99291 | Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is… | 23,850 | $100 | $2.4M |
| 93010 | The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram. | 296,530 | $1 | $1.2M |
| 99282 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making. | 42,280 | $20 | $887.9K |
| 99220 | N/A | 2,890 | $100 | $297.7K |
| 12001 | This CPT code is used for the simple repair of superficial wounds to the scalp, neck, axillae, external genitalia, trunk, and/or extremities (including the hands and feet) that are 2.5 cm or less in… | 5,670 | $20 | $130.4K |
| 12011 | This CPT code is used for the simple repair of superficial wounds to the face, ears, eyelids, nose, lips, and/or mucous membranes, that are 2.5 cm or less in size. | 4,560 | $30 | $127.6K |
| 31500 | The provider inserts a flexible tube into the trachea (windpipe) typically via the mouth in an emergency situation to maintain an open airway in a patient with a compromised airway. | 1,350 | $70 | $97.1K |
Showing 1–10 of 28
How this provider's Medicaid billing volume and revenue compare to other Minnesota providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Minnesota median
28 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99285 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making. | 1 | 160 | 580 | $170 | $1.8M |
| 99284 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making. | 1 | 210 | 980 | $140 | $1.7M |
| 99283 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making. | 1 | 220 | 1,730 | $120 | $1.3M |
| 99291 | Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is… | 3 | 50 | 310 | $130 | $678K |
| 99223 | The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the… | 96 | 100 | 250 | $100 | $399.5K |
| 99282 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making. | 2 | 150 | 500 | $110 | $293.1K |
| 99220 | N/A | 4 | 30 | 530 | $100 | $192.5K |
| 93308 | The provider performs a limited or follow–up transthoracic echocardiography to obtain a two dimensional (2D) image of the heart through the chest wall. It is a limited examination of a focused… | 5 | 20 | 190 | $50 | $163.2K |
| 64400 | The provider injects an anesthetic agent and/or steroid close to each branch of fifth cranial nerve, also called the trigeminal nerve, a mixed cranial nerve that is composed of three large branches —… | 1 | 10 | 590 | $80 | $91K |
| 31500 | The provider inserts a flexible tube into the trachea (windpipe) typically via the mouth in an emergency situation to maintain an open airway in a patient with a compromised airway. | 2 | 10 | 240 | $80 | $79.4K |
Showing 1–10 of 28
Other providers in the same ZIP code as Emergency Physicians Professional Association, ranked by combined Medicare and Medicaid revenue.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.