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NPI 1942357090 · Cape Girardeau, MO · Ambulance
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Cape County Private Ambulance Service, Inc. is a ambulance provider located in Cape Girardeau, Missouri. 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 | Cape County Private Ambulance Service, Inc. |
| Address | 1458 N Kingshighway St |
| City | Cape Girardeau |
| State | MO |
| ZIP | 63701 |
| Taxonomy | Ambulance |
| NPI Enumerated | January 4, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $5.5M |
| Medicare | $1.3M |
Payer mix is Medicaid-dominant: lifetime Medicaid revenue is $5.5M compared with $1.3M in Medicare, so the provider’s scale is driven more by Medicaid billing than by Medicare. This makes the organization effectively Medicaid-led in its revenue base rather than balanced or Medicare-led. Analysts should treat Medicaid patterns as primary when evaluating growth or contract risk.
Service-line profile indicates a ground emergency-transport focus: the top revenue codes for both payers are emergency and mileage-focused ambulance codes (A0427, A0429, and A0425), showing the operation primarily performs ground emergency ALS/BLS transports and bills substantial mileage. The prominence of A0427 (advanced life support, emergency transport) and A0429 (basic life support, emergency transport) across payers points to an emergency-response orientation rather than a niche non-emergency transport business.
Medicare revenue is highly concentrated: the precomputed top-3 Medicare codes account for 85.5% of this provider’s total Medicare revenue, led by A0427 (40.8% of Medicare revenue, $513.3K) and followed by A0429 (22.6%, $284.2K) and A0425 (22.1%, $278.7K). This concentration means Medicare performance for these three codes will largely determine overall Medicare revenue variance for the provider. Given that concentration, changes in reimbursement or utilization for any one of these codes would materially affect the Medicare revenue line.
Medicaid revenue is even more concentrated: the precomputed top-3 Medicaid codes account for 95.3% of total Medicaid revenue, with A0427 (38.3%, $2.1M), A0425 (34.7%, $1.9M), and A0429 (22.3%, $1.2M) dominating. That extreme concentration makes Medicaid exposure highly dependent on emergency transport and mileage reimbursement policies in-state, so payer contracting or policy shifts affecting those codes would have outsized revenue impact.
Competitive standing on Medicare is typical nationally rather than dominant: for key Medicare codes the provider ranks in high percentiles but is described as “typical, unremarkable volume” — e.g., A0427 ranks #517 of 6841 (92th percentile), A0429 ranks #562 of 7808 (93th percentile), and A0425 ranks #531 of 8934 (94th percentile). Those ranks indicate the provider is not a national outlier or market leader for these codes, but it does operate at volumes comparable to many peers. Lower-volume Medicare services such as A0433 (rank #1124 of 1632, 27th percentile) show some codes have below-peer utilization.
Competitive standing in-state for Medicaid is stronger and more top-tier: A0427 ranks #14 of 171 in-state (92th percentile), A0425 ranks #15 of 203 (93th percentile), and A0429 ranks #16 of 135 (89th percentile), which positions the provider as a leading ambulance operator in Missouri for its highest-revenue Medicaid services. High in-state claim volumes (e.g., 10.6K Medicaid claims for A0427 and 23.7K Medicaid claims for A0425) reinforce that this provider is a major local supplier of emergency ambulance and mileage-billed services.
Operational intensity is evident from claim counts and mileage billing across payers: Medicare shows 39.8K claims for A0425 (ground mileage) and Medicaid shows 23.7K claims for A0425, while emergency transport counts are also substantial (Medicare A0427 1.4K claims, Medicaid A0427 10.6K claims). Those claim volumes and the combination of high mileage billing suggest frequent long-distance or numerous patient transports rather than occasional local movements, and they imply logistics and fuel/mileage cost exposure are material operational considerations.
Tenure and scale: the provider’s NPI was enumerated 2007-01-04 (~19 years ago), indicating long-tenured participation in Medicare/Medicaid programs. Despite that longevity, lifetime revenues are modest in absolute terms ($1.3M Medicare, $5.5M Medicaid), characterizing the organization as a stable, regionally significant ambulance operator rather than a large multi-site ambulance system.
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) | 1,420 | $360 | $513.3K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 940 | $300 | $284.2K |
| A0425 | Ground mileage, per statute mile | 39,820 | $10 | $278.7K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 760 | $190 | $145K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 130 | $230 | $29.7K |
| A0433 | Advanced life support, level 2 (als 2) | 20 | $530 | $8.4K |
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 |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 10,570 | $200 | $2.1M |
| A0425 | Ground mileage, per statute mile | 23,700 | $80 | $1.9M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 7,310 | $170 | $1.2M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 4,410 | $40 | $189.7K |
| A0998 | Ambulance response and treatment, no transport | 480 | $130 | $59.5K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 120 | $80 | $8.9K |
How this provider's Medicaid billing volume and revenue compare to other Missouri providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Missouri median
6 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) | 14 | 170 | 1,670 | $230 | $1.1M |
| A0425 | Ground mileage, per statute mile | 15 | 200 | 3,230 | $90 | $827.5K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 16 | 140 | 1,010 | $200 | $803.7K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 13 | 60 | 880 | $160 | $725.7K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 24 | 40 | 220 | $350 | $320.8K |
| A0998 | Ambulance response and treatment, no transport | 10 | 30 | 300 | $120 | $129.4K |
Other providers in the same ZIP code as Cape County Private Ambulance Service, Inc., ranked by combined Medicare and Medicaid revenue.
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