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NPI 1861594707 · Middlebury, VT · Ambulance
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Middlebury Volunteer Ambulance Association, Inc is a ambulance provider located in Middlebury, Vermont. This profile covers 6 Medicare and 6 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 | Middlebury Volunteer Ambulance Association, Inc |
| Address | 55 Collins Dr |
| City | Middlebury |
| State | VT |
| ZIP | 05753 |
| Taxonomy | Ambulance |
| NPI Enumerated | September 1, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $1.3M |
| Medicare | $508.9K |
MIDDLEBURY VOLUNTEER AMBULANCE ASSOCIATION, INC is an ambulance-service provider by taxonomy and its billed services are concentrated in emergency and basic/advanced life-support transports plus ground mileage, as shown by heavy revenue from A0427 (ALS emergency), A0429 (BLS emergency) and A0425 (ground mileage). The code mix — emergency ALS and BLS combined with large counts of mileage claims — indicates an operation focused on transport response and community EMS rather than elective/non-transport services.
Medicare revenue is $508.9K and is highly concentrated: the precomputed top 3 Medicare codes account for 83.1% of Medicare revenue, led by A0427 ($156K, 31.1%), A0425 ($146.9K, 29.3%), and A0429 ($114.2K, 22.7%). Those three codes dominate the provider’s Medicare book of business, so shifts in emergency ALS/BLS utilization or mileage reimbursement would disproportionately affect Medicare receipts.
Medicaid revenue totals $1.3M and is even more concentrated: the precomputed top 3 Medicaid codes account for 94.2% of Medicaid revenue, with A0429 ($437.8K, 34.3%), A0427 ($399.6K, 31.3%), and A0425 ($364.5K, 28.6%) comprising nearly all Medicaid billing. This mirrors the Medicare mix but at larger scale under Medicaid, reinforcing that emergency transport and mileage are the core Medicaid services billed.
The provider’s payer mix is Medicaid-heavy: lifetime Medicaid revenue ($1.3M) exceeds lifetime Medicare revenue ($508.9K), so Medicaid is the larger revenue source on file. This makes Medicaid policy, rates and in-state competition particularly important to the provider’s financial profile.
Against national Medicare peers the provider’s volumes on top codes are generally in the middle-to-higher percentiles but not dominant: A0427 ranks #1867 of 6841 (73rd percentile), A0425 ranks #1169 of 8934 (87th percentile), and A0429 ranks #1598 of 7808 (79th percentile), which characterizes the organization as a typical/modest national participant in these ambulance codes rather than an outlier or national leader. The percentiles indicate respectable activity for an ambulance operator but not market-leading scale at the national level.
Within Vermont Medicaid peers the provider reports typical-to-strong in-state volumes for its main codes — A0429 ranks #11 of 40 (74th percentile), A0427 ranks #12 of 48 (77th percentile) and A0425 ranks #13 of 60 (80th percentile) — suggesting it is a solid regional competitor for core emergency transport and mileage services. A notable exception is A0434 (Specialty care transport) where the provider ranks #1 of 5 and is labeled "notably above typical state volume" despite that code generating only $2.5K of Medicaid revenue, indicating a relative in-state specialty positioning on that narrow service line.
Observed average paid-per-claim differences between payers reflect distinct reimbursement patterns: for A0427 Medicare avg paid/claim is $391 versus Medicaid $222, for A0429 Medicare avg paid/claim is $329 versus Medicaid $186, and for A0425 Medicare avg paid/claim is $8 versus Medicaid $66. Those payer-specific rate differences imply that revenue sensitivity to utilization will vary by payer and by code, with mileage and emergency transports affected differently under Medicare and Medicaid.
The provider has an established presence with its NPI enumerated 2006-09-01 (~20 years ago), consistent with the multi-thousand claim counts recorded on mileage and emergency transport codes (for example, 18.4K Medicare claims for A0425 and 5.5K Medicaid claims for A0425). Tenure plus the high mileage claim counts point to a longstanding, operationally active community EMS service focused on transports rather than ancillary non-transport billing lines.
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 |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 400 | $390 | $156K |
| A0425 | Ground mileage, per statute mile | 18,370 | $10 | $146.9K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 350 | $330 | $114.2K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 290 | $210 | $61.4K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 60 | $250 | $14.1K |
| A0434 | Specialty care transport (sct) | 10 | $680 | $9.5K |
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.
6 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 2,350 | $190 | $437.8K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 1,800 | $220 | $399.6K |
| A0425 | Ground mileage, per statute mile | 5,520 | $70 | $364.5K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 580 | $120 | $71K |
| A0434 | Specialty care transport (sct) | 150 | $20 | $2.5K |
| A0394 | Als specialized service disposable supplies; iv drug therapy | 10 | $20 | $320 |
How this provider's Medicaid billing volume and revenue compare to other Vermont providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Vermont median
6 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 11 | 40 | 580 | $190 | $370.2K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 12 | 50 | 590 | $220 | $265.7K |
| A0425 | Ground mileage, per statute mile | 13 | 60 | 1,570 | $50 | $160.5K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 9 | 20 | 690 | $100 | $151.9K |
| A0394 | Als specialized service disposable supplies; iv drug therapy | 16 | 20 | 120 | $30 | $11.2K |
| A0434 | Specialty care transport (sct) | 1 | 10 | 20 | $140 | $6.3K |
Other providers in the same ZIP code as Middlebury Volunteer Ambulance Association, Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Specialized Community Care, Inc | VT | Community/Behavioral Health Agency | $0 | $60.9M |
| Counseling Service Of Addison County | VT | Developmental Disabilities Clinic/Center | $0 | $59.6M |
| Counseling Service Of Addison County, Inc | VT | Clinic/Center | $0 | $22.1M |
| Middlebury Pediatric Dentistry, PLLC | VT | Pediatric Dentistry | $0 | $2.9M |
| Rainbow Pediatrics | VT | Pediatric Adolescent Medicine Physician | $0 | $1.8M |
| Porter Hospital, Inc | VT | Family Medicine Physician | $0 | $1.3M |
| Brian Collins | VT | Pediatric Dentistry | $0 | $606.8K |
| Middlebury Family Health | VT | Health Maintenance Organization | $0 | $547.3K |
| Amy Gregory | VT | Ophthalmology Physician | $306.6K | $0 |
| Elizabeth Keathley | VT | Clinical Psychologist | $0 | $303.3K |
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