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NPI 1851530521 · Portsmouth, OH · Ambulance
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Portsmouth Emergency Ambulance Service Inc is a ambulance provider located in Portsmouth, Ohio. This profile covers 6 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 | Portsmouth Emergency Ambulance Service Inc |
| Address | 2796 Gallia Street |
| City | Portsmouth |
| State | OH |
| ZIP | 45662 |
| Taxonomy | Ambulance |
| NPI Enumerated | February 19, 2009 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $18.7M |
| Medicare | $3.6M |
PORTSMOUTH EMERGENCY AMBULANCE SERVICE INC is an ambulance-taxonomy provider whose top revenue-driving codes are consistent with a mixed non-emergency and emergency transport operation; the Medicare top codes include A0428 (BLS non-emergency) and A0427 (ALS emergency), while Medicaid billing shows large volumes in A0428, A0425 (ground mileage), and A0130 (wheelchair van), indicating substantial non-emergency medical transportation (NEMT) activity alongside emergency response. The presence of both high-volume mileage (A0425) and wheelchair-van codes (A0130, S0209) on the Medicaid side suggests routine, scheduled transports in addition to 911 and urgent transports.
Medicare revenue is heavily concentrated: the precomputed top-3 Medicare codes account for 86.0% of the provider's Medicare revenue, with A0428 reported at 36.3%, A0425 at 34.9%, and A0427 at 14.7% of Medicare revenue. This concentration implies the provider’s Medicare business is largely driven by a narrow set of ambulance and mileage services rather than a broad mix of CPT codes.
Medicaid revenue is similarly concentrated but with a slightly different emphasis: the precomputed top-3 Medicaid codes account for 70.9% of Medicaid revenue, led by A0425 at 27.5%, A0428 at 26.0%, and A0427 at 17.5%. In addition to ambulance trip codes, modular NEMT codes A0130 (wheelchair van) and S0209 (wheelchair van mileage) also contribute meaningfully to Medicaid revenue, reflecting a dual role in both stretcher/wheelchair transports and standard ambulance runs.
The provider’s payer mix is Medicaid-dominant in scale: reported lifetime Medicaid revenue is $18.7M compared with $3.6M in lifetime Medicare revenue, so Medicaid represents the substantially larger portion of billed revenue. Because both payers show meaningful activity, the business appears to operate across payers but relies far more on Medicaid volumes and reimbursement streams.
Competitive standing on Medicare shows unusually high national volume for mileage and BLS non-emergency: A0425 ranks #76 of 8934 providers nationally (99th percentile; extreme outlier) and A0428 ranks #79 of 2772 (97th percentile; notably above typical national volume), while A0427 is at a 92th percentile rank #516 of 6841 (typical/unremarkable). These national percentiles indicate the provider is a major outlier for mileage and high-volume BLS non-emergency trips at the national level, while its ALS emergency volume is within a common range.
State-level competitive standing on Medicaid demonstrates market dominance for multiple codes: A0428 ranks #1 of 126 providers in-state (100th percentile; extreme outlier), A0425 ranks #3 of 675 (100th percentile; extreme outlier), and A0130 and S0209 both rank #1 in-state (100th percentile; extreme outliers). Additional high-percentile positions for A0427 (#7 of 505, 99th percentile) and A0429 (#6 of 475, 99th percentile) reinforce that this provider is a leading in-state participant, particularly for mileage, BLS non-emergency, and wheelchair-van services.
Operational metrics reinforce a high-mileage, high-volume transport model: Medicaid A0425 shows 177.1K claims with $29 avg paid/claim and $5.1M revenue, while Medicare A0425 shows 142.3K claims with $9 avg paid/claim and $1.3M revenue, reflecting very large claim counts for mileage across both payers and meaningful per-claim payment differences between Medicaid and Medicare. The combination of large mileage claim counts and sizeable wheelchair-van volumes (Medicaid A0130 75.3K claims, $25 avg paid/claim, $1.9M revenue) points to frequent, distance-based routing and routine NEMT contracts or utilization.
The provider has established tenure in the Medicare/Medicaid billing universe, with an NPI enumeration date of 2009-02-19 (~17 years ago). That longevity, combined with concentrated high-volume billing and dominant in-state ranks, suggests an entrenched operational footprint in regional NEMT and ambulance services rather than a newly emergent or marginal operator.
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) | 7,150 | $190 | $1.3M |
| A0425 | Ground mileage, per statute mile | 142,250 | $10 | $1.3M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 1,420 | $380 | $539.7K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1,290 | $320 | $411.5K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 390 | $240 | $92K |
| A0433 | Advanced life support, level 2 (als 2) | 20 | $550 | $9.4K |
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.
9 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0425 | Ground mileage, per statute mile | 177,120 | $30 | $5.1M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 112,760 | $40 | $4.8M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 29,150 | $110 | $3.3M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 33,540 | $80 | $2.8M |
| A0130 | Non-emergency transportation: wheelchair van | 75,320 | $30 | $1.9M |
| S0209 | Wheelchair van, mileage, per mile | 75,330 | $10 | $678K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 690 | $160 | $111.6K |
| T2005 | Non-emergency transportation; stretcher van | 40 | $30 | $1.4K |
| A0433 | Advanced life support, level 2 (als 2) | 10 | $110 | $1.3K |
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) | 1 | 130 | 3,720 | $50 | $544.7K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 7 | 510 | 1,080 | $120 | $365.4K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 6 | 480 | 880 | $90 | $260K |
| A0130 | Non-emergency transportation: wheelchair van | 1 | 150 | 3,580 | $20 | $208K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 31 | 80 | 380 | $80 | $132.1K |
| A0425 | Ground mileage, per statute mile | 3 | 680 | 2,020 | $10 | $98.4K |
| S0209 | Wheelchair van, mileage, per mile | 1 | 150 | 3,580 | $10 | $73.5K |
| A0433 | Advanced life support, level 2 (als 2) | 14 | 10 | 110 | $130 | $64.3K |
| T2005 | Non-emergency transportation; stretcher van | 3 | 10 | 790 | $20 | $11.2K |
Other providers in the same ZIP code as Portsmouth Emergency Ambulance Service Inc, ranked by combined Medicare and Medicaid revenue.
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