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NPI 1861758914 · Lexington, KY · Air Ambulance
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Phi Health, LLC is a air ambulance provider located in Lexington, Kentucky. This profile covers 2 Medicare and 2 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 | Phi Health, LLC |
| Address | 151 N Eagle Creek Dr |
| City | Lexington |
| State | KY |
| ZIP | 40509 |
| Taxonomy | Air Ambulance |
| NPI Enumerated | April 3, 2012 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $13.2M |
| Medicare | $2M |
PHI HEALTH, LLC is coded as an Air Ambulance operation and its billed activity is concentrated in rotary wing air-transport services: the top Medicare and Medicaid revenue-driving codes are A0431 (ambulance service, conventional air services, one way (rotary wing)) and A0436 (rotary wing air mileage, per statute mile), reflecting an operational model built around one-way rotary-wing patient transports and per-mile billing. Medicare shows 285 A0431 claims with $4556 avg paid/claim and 21.4K A0436 claims with $32 avg paid/claim, while Medicaid shows 6.6K claims for each A0431 and A0436 with $1939 and $60 avg paid/claim respectively, underscoring routine mileage-plus-transport billing.
Revenue concentration is extreme by payer: the precomputed top three Medicare codes account for 100.0% of this provider's total Medicare revenue and the precomputed top three Medicaid codes account for 100.0% of this provider's total Medicaid revenue, indicating virtually all billed revenue is captured in a very narrow set of air-ambulance CPT/HCPCS codes. This concentration implies the provider's financial performance is highly dependent on the reimbursement and utilization dynamics of these specific codes.
Within Medicare, A0431 and A0436 together account for the entirety of recorded Medicare revenue: A0431 represents 65.5% and A0436 represents 34.5% of this provider's total Medicare revenue, against total Medicare revenue of $2M. Nationally the provider ranks #34 of 348 for A0431 (90th percentile) and #31 of 348 for A0436 (91th percentile), which the underlying data characterizes as typical, unremarkable volume for these codes despite the high percentile placement.
Within Medicaid, A0431 dominates the payer mix: A0431 contributes 97.0% of this provider's total Medicaid revenue and A0436 contributes 3.0%, against total Medicaid revenue of $13.2M. A0431 is reported as an extreme outlier in-state (rank #1 of 20, 100th percentile) and A0436 is also top-ranked in-state (rank #1 of 9, 100th percentile; described as notably above typical state volume), indicating statewide dominance for rotary-wing transport billing.
Payer mix is heavily skewed toward Medicaid: lifetime totals show $2M in Medicare revenue versus $13.2M in Medicaid revenue, meaning Medicaid accounts for the substantial majority of recorded public-payer revenue and the organization is effectively Medicaid-dominated rather than single-payer. This asymmetry suggests state Medicaid policy and contracts will have outsized impact on the provider's revenue profile.
Competitive standing is mixed by geography: nationally the provider appears as a high-percentile but operationally typical participant for key Medicare air-ambulance codes, while within Kentucky it is a dominant market player for these codes—particularly A0431 where it ranks #1 in-state and is labeled an extreme outlier. For payers and analysts this combination implies modest national footprint for Medicare adjudications but significant market power and volume concentration within the state Medicaid market.
The provider has an established tenure, with NPI enumerated on 2012-04-03 (~14 years ago), supporting the likelihood that the Medicaid-dominant billing pattern reflects sustained local operational presence rather than a new entrant spike. Longevity combined with being the top in-state biller for A0431 suggests entrenched service provision for rotary-wing transports in its region.
There are material differences in avg paid/claim across payers for the same codes that are relevant for rate- and contract-level analysis: A0431 averages $4556 per claim in Medicare versus $1939 per claim in Medicaid, while A0436 averages $32 per claim in Medicare versus $60 per claim in Medicaid. These payer-specific price patterns, together with the near-total revenue concentration in two codes, mean reimbursement rate changes, mileage policies, or utilization controls for rotary-wing transports could materially and rapidly affect the provider's revenues.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 2 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.
How this provider's Medicaid billing volume and revenue compare to other Kentucky providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Kentucky median
Other providers in the same ZIP code as Phi Health, LLC, ranked by combined Medicare and Medicaid revenue.
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