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NPI 1861499139 · Fort Wayne, IN · Land Ambulance
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Three Rivers Ambulance Authority is a land ambulance provider located in Fort Wayne, Indiana. 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 | Three Rivers Ambulance Authority |
| Address | 525 Hayden St |
| City | Fort Wayne |
| State | IN |
| ZIP | 46802 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | July 1, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $16.9M |
| Medicare | $1.6M |
Public-payer mix is heavily Medicaid-skewed: lifetime Medicaid revenue is $16.9M compared with $1.6M in Medicare, indicating Medicaid drives the bulk of this provider’s billed public-payer volume. This profile is effectively Medicaid-dominant in scale rather than balanced across the two payers.
Revenue is highly concentrated in a small set of transport codes: the top three Medicare codes account for 87.9% of this provider’s Medicare revenue and the top three Medicaid codes account for 95.1% of this provider’s Medicaid revenue. That concentration shows the business is narrowly reliant on a few ambulance service codes rather than a diversified set of clinical or ancillary services.
Service mix points to a core ground-ambulance emergency transport operation: A0429 (basic life support, emergency transport), A0427 (advanced life support, emergency transport), and A0425 (ground mileage) are the top revenue drivers for both payers, which is consistent with an organization focused on emergency BLS/ALS transport and mileage-based ground operations. The presence of A0428 and A0433 in secondary positions reinforces a mix of non-emergency BLS and higher-acuity ALS capabilities.
Medicare competitive standing is mixed by code: for Medicare, A0429 ranks #175 of 7808 providers (98th percentile) and is described as notably above typical national volume, signaling strong national-scale activity on BLS emergency transports. By contrast, Medicare volumes for A0427 and A0425 are in more typical national bands (A0427 at the 93th percentile and A0425 at the 90th percentile), so dominance is concentrated mainly in A0429 rather than across all Medicare transport codes.
The provider is a dominant in-state Medicaid ambulance player: for Medicaid, A0429 ranks #2 of 195 providers (99th percentile) and A0427 ranks #3 of 181 providers (99th percentile), with A0425 at rank #5 of 327 providers (99th percentile) and labeled an extreme outlier. Those state-level ranks and labels indicate this entity is among the largest in Indiana for both BLS and ALS emergency transports and for mileage-based billing.
Payer rate dynamics show materially lower Medicaid per-claim payments but much higher Medicaid volume: A0429 is paid $313 avg/claim in Medicare versus $161 avg/claim in Medicaid, and A0427 is $373 avg/claim in Medicare versus $181 avg/claim in Medicaid. This pattern suggests the organization relies on Medicaid volume to generate overall revenue despite lower per-claim reimbursement on those same transport codes.
High operational concentration creates exposure to policy or contract changes affecting ambulance transport codes: because the top three codes comprise 87.9% of Medicare revenue and 95.1% of Medicaid revenue, shifts in reimbursement rules, medical necessity reviews for emergency transport, or changes in state Medicaid ambulance policy could have outsized impact on total revenue. The profile implies limited revenue diversification to absorb such shocks.
Long-standing local presence with high claimed mileage and transport counts: the provider’s NPI was enumerated 2005-07-01 (~21 years ago), and Medicaid claim volumes include large absolute counts such as 93.6K claims for A0425 and 49.2K claims for A0429, reflecting sustained, high-volume ground-ambulance operations over many years. That tenure plus large claim counts supports its competitive dominance in-state for core ambulance services.
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 |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 2,090 | $310 | $653.9K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 1,520 | $370 | $566.6K |
| A0425 | Ground mileage, per statute mile | 24,320 | $10 | $170.3K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 810 | $200 | $159.8K |
| A0433 | Advanced life support, level 2 (als 2) | 50 | $550 | $26.2K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 20 | $240 | $5.5K |
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 |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 49,170 | $160 | $7.9M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 36,110 | $180 | $6.5M |
| A0425 | Ground mileage, per statute mile | 93,630 | $20 | $1.7M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 9,850 | $60 | $541.5K |
| A0433 | Advanced life support, level 2 (als 2) | 640 | $280 | $177.8K |
| A0998 | Ambulance response and treatment, no transport | 2,840 | $40 | $116.3K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 40 | $30 | $1.3K |
| 96372 | A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician… | 70 | $20 | $980 |
| A0888 | Noncovered ambulance mileage, per mile (e.g., for miles traveled beyond closest appropriate facility) | 1,380 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Indiana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Indiana median
9 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) | 3 | 180 | 1,730 | $180 | $744.6K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 2 | 200 | 1,130 | $160 | $730.5K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 20 | 110 | 1,050 | $60 | $342.7K |
| A0425 | Ground mileage, per statute mile | 5 | 330 | 2,010 | $30 | $266.8K |
| A0433 | Advanced life support, level 2 (als 2) | 3 | 20 | 70 | $390 | $141K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 40 | 60 | 210 | $120 | $112.3K |
| A0998 | Ambulance response and treatment, no transport | 2 | 30 | 160 | $50 | $27.5K |
| 96372 | A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician… | 378 | 490 | 300 | $20 | $22.8K |
| A0888 | Noncovered ambulance mileage, per mile (e.g., for miles traveled beyond closest appropriate facility) | 3 | 10 | 1,380 | $1 | $120 |
Other providers in the same ZIP code as Three Rivers Ambulance Authority, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| St. Joseph Health System, LLC | IN | General Acute Care Hospital | $0 | $25.4M |
| Neighborhood Health Clinics, Inc | IN | Clinic/Center | $0 | $12.1M |
| Fort Wayne Community Schools | IN | Local Education Agency (LEA) | $0 | $10.6M |
| Fort Wayne Medical Education Program | IN | Family Medicine Physician | $0 | $5.8M |
| Lamplight Inn Of Fort Wayne, LLC | IN | Assisted Living Facility | $0 | $4.7M |
| Shcs, Inc | IN | Home Health Agency | $0 | $3M |
| Angel Corps | IN | Home Health Agency | $0 | $2.6M |
| Terrell Bond | IN | Family Medicine Physician | $309.9K | $0 |
| Naveen Lal | IN | Cardiovascular Disease Physician | $243.6K | $0 |
| Louis Lopez | IN | Cardiovascular Disease Physician | $230.7K | $0 |
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