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NPI 1942277124 · Cullman, AL · Ambulance
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Health Care Authority Of Cullman is a ambulance provider located in Cullman, Alabama. This profile covers 7 Medicare and 5 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 | Health Care Authority Of Cullman |
| Address | 601 2nd Ave Sw |
| City | Cullman |
| State | AL |
| ZIP | 35055 |
| Taxonomy | Ambulance |
| NPI Enumerated | March 7, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $1.7M |
| Medicare | $1.4M |
HEALTH CARE AUTHORITY OF CULLMAN is classified under the Ambulance taxonomy and its billed services are overwhelmingly transport-focused; the Medicare top codes are A0427, A0425, and A0428 and these reflect advanced life support emergency transport, ground mileage, and basic life support non-emergency transport respectively. This code mix indicates the operation is principally a ground ambulance transport provider that performs both emergency ALS runs and routine BLS transports rather than being oriented toward non-transport services or specialty outpatient care.
Medicare revenue is concentrated in a small set of transport codes: total Medicare revenue is $1.4M and the provider's top 3 Medicare codes account for 81.3% of that Medicare revenue. In particular, A0427 represents 34.4% of Medicare revenue, A0425 represents 32.3%, and A0428 represents 14.6%, showing reliance on ALS emergency trips and mileage as the core Medicare revenue drivers.
Medicaid billing is even more concentrated on a few transport codes: total Medicaid revenue is $1.7M and the top 3 Medicaid codes account for 87.3% of Medicaid revenue. A0425 (ground mileage) alone accounts for 47.8% of Medicaid revenue, A0427 (ALS emergency) 23.9%, and A0429 (BLS emergency) 15.6%, signalling heavy dependence on mileage and emergency transport under Medicaid.
Payer mix shows Medicaid is slightly larger than Medicare for this provider — Medicaid revenue of $1.7M exceeds Medicare revenue of $1.4M — so the organization is not single‑payer and derives meaningful volume from both programs. Operationally, this means any changes in state Medicaid reimbursement for mileage or emergency transport would have an outsized effect given the concentration of Medicaid revenue in A0425 and A0427.
The provider’s competitive standing varies by code and payer: for Medicare, A0425 ranks #409 of 8934 providers nationally (95th percentile) and A0427 ranks #576 of 6841 (92th percentile), and both are described as having "typical, unremarkable volume for this code," indicating a strong national presence on mileage and ALS emergency services but within a modest overall Medicare revenue base. For Medicaid, A0425 ranks #30 of 131 in-state (78th percentile) and A0427 ranks #23 of 102 in-state (78th percentile), where both are likewise labeled "typical, unremarkable volume for this code," suggesting the provider is a solid regional participant rather than a dominant statewide leader.
Claim-level and payment patterns differ materially between payers for the same codes: Medicare shows 48.7K claims for A0425 with an average paid/claim of $9, while Medicaid shows 14.2K claims for A0425 with an average paid/claim of $58. This disparity in claim counts and per-claim payments implies different utilization and reimbursement regimes between Medicare and Medicaid for mileage-based billing, which has implications for revenue sensitivity to payer-specific policy or rate changes.
The provider demonstrates operational longevity with an NPI enumeration date of 2006-03-07 (~20 years ago), supporting interpretation of these billing patterns as established practice rather than a short-term spike. Combined with the high concentration of revenue in a few transport codes, tenure suggests the organization has a stable, transport-centric service line that has been sustained over many years.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 1,280 | $360 | $465.9K |
| A0425 | Ground mileage, per statute mile | 48,650 | $10 | $437.9K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 1,060 | $190 | $197.7K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 530 | $310 | $162.9K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 250 | $230 | $57.8K |
| A0433 | Advanced life support, level 2 (als 2) | 30 | $530 | $17.9K |
| A0434 | Specialty care transport (sct) | 20 | $640 | $14.7K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 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.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0425 | Ground mileage, per statute mile | 14,230 | $60 | $825.2K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 5,720 | $70 | $411.8K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 3,500 | $80 | $269.5K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 3,840 | $40 | $157.6K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 580 | $110 | $62.4K |
How this provider's Medicaid billing volume and revenue compare to other Alabama providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Alabama median
5 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0425 | Ground mileage, per statute mile | 30 | 130 | 3,610 | $40 | $394K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 23 | 100 | 1,850 | $90 | $379.6K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 32 | 80 | 2,590 | $40 | $248.6K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 21 | 90 | 1,170 | $70 | $209.8K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 13 | 40 | 140 | $100 | $46.4K |
Other providers in the same ZIP code as Health Care Authority Of Cullman, ranked by combined Medicare and Medicaid revenue.
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