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NPI 1952352478 · Windsor Locks, CT · Physiological Laboratory
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Raytel Cardiac Services, Inc. is a physiological laboratory provider located in Windsor Locks, Connecticut. This profile covers 2 Medicare and 1 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 | Raytel Cardiac Services, Inc. |
| Address | 1000 Old County Cir Ste 110 |
| City | Windsor Locks |
| State | CT |
| ZIP | 06096 |
| Taxonomy | Physiological Laboratory |
| NPI Enumerated | May 12, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.7M |
| Medicaid | $150.3K |
Service-line profile: Billing is concentrated in home INR monitoring services, specifically the supply/management and initial demonstration of patient-operated INR testing equipment. Medicare claims for G0249 total 51.2K claims with $53 avg paid/claim producing $2.7M in revenue, and Medicare G0248 adds 608 claims at $79 avg paid/claim for $48K, while Medicaid reporting likewise centers on G0249 (12.1K claims, $12 avg paid/claim, $145.5K).
Medicare revenue concentration: The provider's Medicare program is highly concentrated with the precomputed top 3 Medicare codes accounting for 100.0% of Medicare revenue and a single code, G0249, making up 98.3% of total Medicare revenue ($2.7M). This indicates the practice’s Medicare business is effectively built around one primary service line.
Medicaid revenue concentration: Medicaid billing is effectively single-code driven — the precomputed top 3 Medicaid codes account for 100.0% of Medicaid revenue and G0249 alone represents 100.0% of the provider's total Medicaid revenue ($145.5K). This shows Medicaid activity mirrors Medicare in service focus but at a much smaller revenue scale.
Payer mix and scale: The provider’s Medicare revenue ($2.7M) far exceeds Medicaid revenue ($150.4K), indicating a Medicare-dominant payer mix for overall scale and likely operational emphasis. While both payers bill for the same core service (G0249), the Medicaid revenue pool is an order of magnitude smaller in absolute dollars.
Competitive standing for Medicare G0249: The provider ranks #4 of 65 nationally for G0249, placing it in the 95th percentile for this code, which positions it among the higher national billers for home INR supplies; the dataset characterizes its volume for this code as "typical, unremarkable," suggesting its activity level is high in rank but consistent with expected practice patterns for dedicated INR monitoring suppliers.
Competitive standing for Medicaid G0249: In-state Medicaid reporting shows the provider as #1 of 1 for G0249 with a 0th percentile label and a note that no state peer volume comparison is available, implying it is the only entity in the state-level Medicaid dataset reporting this service rather than necessarily being comparatively dominant by volume.
Reimbursement and utilization patterns: There is a clear divergence in per-claim reimbursement between payers for G0249 — Medicare average paid/claim is $53 (51.2K claims) compared with Medicaid average paid/claim of $12 (12.1K claims) — which contributes to Medicare producing the majority of revenue despite both payers having substantial claim counts for the same code. This reimbursement gap likely drives the provider’s heavier revenue reliance on Medicare.
Tenure and operational implication: The provider’s NPI has been enumerated since 2006-05-12 (~20 years ago), indicating long-tenured presence in this clinical niche; combined with tightly concentrated billing around G0249/G0248, the pattern is consistent with a stable, specialized physiological laboratory operation focused on anticoagulation home monitoring services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| G0249 | Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage… | 51,180 | $50 | $2.7M |
| G0248 | Demonstration, prior to initiation of home inr monitoring, for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage… | 610 | $80 | $48K |
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.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| G0249 | Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage… | 12,130 | $10 | $145.5K |
How this provider's Medicaid billing volume and revenue compare to other Connecticut providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Connecticut median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| G0249 | Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage… | 1 | 10 | 12,130 | $10 | $150.3K |
Other providers in the same ZIP code as Raytel Cardiac Services, Inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Windsor Locks Lions Charities Inc. | CT | Ambulance | $204.8K | $978.7K |
| Windsor Locks Public Schools | CT | Local Education Agency (LEA) | $0 | $1.1M |
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.