Loading...
NPI 1912997248 · Madison, WI · Land Ambulance
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
City Of Madison is a land ambulance provider located in Madison, Wisconsin. This profile covers 4 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 | City Of Madison |
| Address | 314 W Dayton St |
| City | Madison |
| State | WI |
| ZIP | 53703 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | October 27, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $8.3M |
| Medicare | $2M |
CITY OF MADISON operates as a land ambulance provider focused on emergency transports: its top codes are A0427 (ALS1 emergency transport), A0429 (BLS emergency transport), and multiple mileage codes (A0425, A0380, A0390), indicating primary revenue drivers are point-to-point ground ambulance services rather than ancillary or non-transport services. The code mix (ALS and BLS emergency transport plus mileage) is consistent with an ambulance service that routinely bills for both basic and advanced life-support emergency responses.
This provider’s payer mix is heavily weighted to Medicaid: total Medicaid revenue is $8.3M compared with total Medicare revenue of $2M, so Medicaid is the dominant revenue source on a lifetime basis. Analysts should treat this entity as effectively Medicaid-majority for revenue risk and utilization modeling.
Medicare revenue is highly concentrated in a few transport codes: the top 3 Medicare codes account for 98.5% of this provider’s Medicare revenue, led by A0427 (47.6% of Medicare revenue), A0429 (41.9%), and A0425 (9.0%). Those three codes being nearly exhaustive of Medicare receipts signals that machine-level changes to transport rates or utilization of these codes would materially move Medicare revenue.
Medicaid revenue is likewise concentrated: the top 3 Medicaid codes account for 94.6% of Medicaid revenue, with A0429 (51.0% of Medicaid revenue) and A0427 (37.9%) dominating and A0380 contributing 5.7%. This concentration around BLS/ALS emergency transports and BLS mileage indicates Medicaid performance and policy changes for these specific codes will drive most of the provider’s Medicaid financial outcomes.
On national Medicare competitive standing, A0429 ranks #139 of 7808 providers (98th percentile) and is described as "notably above typical" national volume, while A0427 ranks #272 of 6841 providers (96th percentile) but is characterized as "typical, unremarkable" for that code. Those mixed signals mean the provider is an above-typical performer nationally on the BLS emergency transport code but not uniformly dominant across all top Medicare codes.
On state Medicaid competitive standing the provider is a leading volume participant: A0429 ranks #4 of 153 providers in-state (98th percentile) and A0427 ranks #3 of 166 (99th percentile), both labeled "notably above typical" for the state. This combination of top-tier in-state ranks for the two primary transport codes positions CITY OF MADISON as a major Medicaid ambulance operator within Wisconsin.
Operationally the claim counts show heavy BLS utilization in Medicaid versus Medicare: for example, A0429 has 30.7K Medicaid claims and 2.6K Medicare claims while A0427 has 19.2K Medicaid claims and 2.5K Medicare claims, reflecting much larger Medicaid service volumes by count. These claim-count disparities underscore that the provider’s day-to-day workload and utilization are concentrated in Medicaid-funded emergency transport activity.
CITY OF MADISON has an established tenure (NPI enumerated 2005-10-27 (~21 years ago)), which together with its concentrated transport revenue and high in-state ranks suggests a stable, long-running ambulance operation. Analysts should consider this longevity when assessing network stability, contract negotiations, and the potential operational impact of reimbursement changes to A0429/A0427 and associated mileage codes.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 2,470 | $390 | $954.3K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 2,590 | $320 | $839.2K |
| A0425 | Ground mileage, per statute mile | 25,810 | $10 | $180.7K |
| A0433 | Advanced life support, level 2 (als 2) | 50 | $560 | $29.3K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 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) | 30,680 | $140 | $4.2M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 19,180 | $160 | $3.1M |
| A0380 | Bls mileage (per mile) | 19,690 | $20 | $472.6K |
| A0390 | Als mileage (per mile) | 12,350 | $30 | $345.9K |
| A0425 | Ground mileage, per statute mile | 18,350 | $10 | $91.8K |
| A0433 | Advanced life support, level 2 (als 2) | 30 | $280 | $8.7K |
How this provider's Medicaid billing volume and revenue compare to other Wisconsin providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Wisconsin 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) | 4 | 150 | 450 | $150 | $480.6K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 3 | 170 | 690 | $150 | $372.4K |
| A0433 | Advanced life support, level 2 (als 2) | 4 | 10 | 490 | $210 | $114.5K |
| A0380 | Bls mileage (per mile) | 4 | 110 | 290 | $30 | $113.7K |
| A0390 | Als mileage (per mile) | 5 | 140 | 440 | $50 | $103.4K |
| A0425 | Ground mileage, per statute mile | 3 | 160 | 770 | $10 | $20.6K |
Other providers in the same ZIP code as City Of Madison, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Madison Metropolitan School District | WI | Local Education Agency (LEA) | $0 | $4.1M |
| William Kemp | WI | Neurological Surgery Physician | $396.1K | $0 |
| Matthew Witek | WI | Radiation Oncology Physician | $131.2K | $0 |
| Deborah Williams | WI | Internal Medicine Physician | $116.2K | $0 |
| George Leydon | WI | Family Medicine Physician | $72.9K | $0 |
| Peter Mason | WI | Cardiovascular Disease Physician | $66K | $0 |
| Sofia Masri | WI | Advanced Heart Failure and Transplant Cardiology Physician | $46.4K | $0 |
| Lisa Schmaltz | WI | Diagnostic Radiology Physician | $44.3K | $0 |
| Paul Estrada | WI | Gastroenterology Physician | $31.4K | $0 |
| Robert Factor | WI | Psychiatry Physician | $29.1K | $0 |
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.