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NPI 1851343537 · Skokie, IL · Land Ambulance
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Medical Express Ambulance Service, Inc is a land ambulance provider located in Skokie, Illinois. This profile covers 6 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 | Medical Express Ambulance Service, Inc |
| Address | 5650 Howard St |
| City | Skokie |
| State | IL |
| ZIP | 60077 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | May 17, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $22.3M |
| Medicare | $1.9M |
Medicaid-dominant payer mix: this provider reports Total Medicare revenue of $1.9M versus Total Medicaid revenue of $22.3M, indicating Medicaid is the primary revenue source by a large margin. Analysts should treat this entity as effectively Medicaid-focused when evaluating scale, network leverage, or contract negotiations.
High revenue concentration in a few codes for both payers: the top 3 Medicare codes by revenue account for 85.3% of the provider's Medicare revenue, while the top 3 Medicaid codes account for 77.0% of its Medicaid revenue. This concentration means changes in reimbursement or utilization for a small set of transport codes would materially affect overall revenue.
Medicare top-code prominence: A0428 (BLS non-emergency) is the dominant Medicare line with 5.4K claims, $211 avg paid/claim, and $1.1M revenue (59.9% of this provider's total Medicare revenue), and it ranks #110 of 2772 nationally (96th percentile; notably above typical national volume for this code). That placement marks the provider as a nationally significant biller for BLS non-emergency ambulance service on Medicare.
Medicare secondary lines are focused on mileage and specialty care: A0425 (ground mileage) and A0434 (specialty care transport) together make up the remainder of the concentrated Medicare mix (they are part of the top-3 set that totals 85.3%). A0434 shows strong relative activity as well (297 claims, $703 avg paid/claim, $208.8K revenue; rank #56 of 591, 91st percentile), indicating the provider also handles higher-acuity interfacility/SCT transfers on Medicare.
State-level Medicaid prominence on core ambulance services: A0428, A0425, and A0434 are the top Medicaid revenue drivers (together 77.0% of Medicaid revenue), with large claim volumes — e.g., A0428: 68.5K claims, $131 avg paid/claim, $9M revenue (40.2% of Medicaid revenue) and a rank of #4 of 81 in-state (96th percentile). Although many of these Medicaid ranks are characterized in the source as "typical, unremarkable volume," the raw ranks show the provider is among the highest-volume in-state billers for core transport lines.
Notable in-state specializations beyond basic BLS: the provider bills materially for specialty care transport (A0434: 13.6K claims, $251 avg paid/claim, $3.4M revenue, rank #3 of 27 in-state) and for oxygen and life-sustaining supplies (A0422: 22.8K claims, $387.4K revenue, rank #3 of 66 in-state; 97th percentile; notably above typical state volume for this code). These patterns suggest regular handling of higher-acuity or equipment-dependent transports on Medicaid.
Operational footprint implied by code mix and volumes: large counts of A0425 ground-mileage claims (39.4K Medicare claims; 123.4K Medicaid claims) and substantial A0130 wheelchair-van billing (24.2K Medicaid claims) indicate a mixed fleet operating both stretcher/ALS/BLS ambulances and wheelchair/van transports, with heavy utilization of mileage-based billing. That mix is consistent with a provider offering both non-emergency scheduled transports and higher-acuity specialty/interfacility moves.
Established operator: the NPI was enumerated on 2006-05-17 (~20 years ago), indicating long tenure in the market. Given the combination of longevity plus the high-volume rankings on several core codes, the organization appears to be an entrenched regional ambulance operator with particular strength on Medicaid business.
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 |
|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 5,430 | $210 | $1.1M |
| A0425 | Ground mileage, per statute mile | 39,420 | $10 | $275.9K |
| A0434 | Specialty care transport (sct) | 300 | $700 | $208.8K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 470 | $350 | $161.9K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 240 | $410 | $97.2K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 80 | $260 | $21.4K |
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.
11 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 68,530 | $130 | $9M |
| A0425 | Ground mileage, per statute mile | 123,450 | $40 | $4.8M |
| A0434 | Specialty care transport (sct) | 13,570 | $250 | $3.4M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 8,010 | $240 | $1.9M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 7,650 | $190 | $1.5M |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 2,710 | $230 | $610.6K |
| A0130 | Non-emergency transportation: wheelchair van | 24,190 | $20 | $532.3K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 22,790 | $20 | $387.4K |
| A0120 | Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems | 17,210 | $10 | $206.5K |
| T2001 | Non-emergency transportation; patient attendant/escort | 2,070 | $10 | $12.4K |
Showing 1–10 of 11
How this provider's Medicaid billing volume and revenue compare to other Illinois providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Illinois median
11 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0120 | Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems | 3 | 20 | 2,610 | $40 | $4.5M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 34 | 360 | 1,340 | $910 | $4M |
| A0434 | Specialty care transport (sct) | 3 | 30 | 330 | $680 | $3.4M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 30 | 340 | 1,050 | $770 | $2.8M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 4 | 80 | 1,580 | $140 | $1.8M |
| A0130 | Non-emergency transportation: wheelchair van | 5 | 30 | 4,930 | $30 | $833.1K |
| A0425 | Ground mileage, per statute mile | 7 | 450 | 2,450 | $40 | $602.5K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 4 | 60 | 350 | $200 | $269.4K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 3 | 70 | 800 | $10 | $56.8K |
| T2001 | Non-emergency transportation; patient attendant/escort | 2 | 10 | 190 | $10 | $9.6K |
Showing 1–10 of 11
Other providers in the same ZIP code as Medical Express Ambulance Service, Inc, ranked by combined Medicare and Medicaid revenue.
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