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NPI 1972640381 · Rosebud, SD · Paramedic
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Rosebud Sioux Tribe Ambulance Service is a paramedic provider located in Rosebud, South Dakota. This profile covers 3 Medicare and 9 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 | Rosebud Sioux Tribe Ambulance Service |
| Address | 15 Circle Dr |
| City | Rosebud |
| State | SD |
| ZIP | 57570 |
| Taxonomy | Paramedic |
| NPI Enumerated | February 1, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $6.1M |
| Medicare | $406K |
This provider is heavily Medicaid-focused in scale: lifetime Medicaid revenue is $6.1M compared with $406K in Medicare, indicating Medicaid accounts for the vast majority of billed services and receipts. The gap in magnitude suggests operations and contracts are oriented primarily toward state Medicaid and non-emergency transport programs rather than Medicare-driven business lines.
Revenue concentration differs by payer. For Medicare, the top 3 codes account for 100.0% of this provider's total Medicare revenue, with A0427 alone representing 66.8% of Medicare revenue; for Medicaid, the top 3 codes account for 83.7% of total Medicaid revenue, driven by A0427 (51.6%), A0425 (18.9%), and S0215 (13.2%). These concentrations show both payers’ receipts are dominated by a small set of transport-related codes.
The code mix signals an ambulance/medical-transport operation that provides both emergency advanced life support and basic life support as well as significant mileage-based and non-emergency transport services. High shares for A0427 (advanced life support emergency) and A0429 (basic life support emergency) together with strong Medicaid S0215 and A0425 activity indicate the organization runs a blended emergency response and non-emergency/mileage-based transport business.
Competitive standing diverges between payers and at different geographic scales. On Medicare billing for A0427, A0429, and A0425 the provider ranks in typical national ranges (A0427 at the 80th percentile, A0429 at the 73th percentile, A0425 at the 79th percentile), characterizing it as a modest or typical national participant rather than a dominant national player for those codes. In contrast, its Medicaid footprint is statewide-dominant for multiple lines: A0427 ranks #1 of 36 providers in-state (100th percentile, described as an extreme outlier) and S0215 ranks #1 of 16 providers in-state (100th percentile, notably above typical state volume).
Specific Medicaid code-level outlier signals are notable for network planning and contracting: A0427 is an extreme outlier in-state with 15.5K claims and $3.2M revenue, A0425 is an extreme outlier in-state (17.5K claims, $1.2M), and S0215 is also at the top statewide (7.2K claims, $809.1K). These placements suggest the provider occupies a leading role in both emergency ALS transports and large-volume mileage/non-emergency transport within the state Medicaid market.
Medicare claim-level economics are different: Medicare A0427 shows 549 claims with $491 avg paid/claim and $269.6K revenue, while A0429 has 249 claims at $407 avg paid/claim and $101.3K revenue; A0425 contributes 10.8K claims but only $32.4K revenue on Medicare. This contrast—fewer, higher-paid emergency transports on Medicare versus massive mileage and volume on Medicaid—highlights differing reimbursement mixes and utilization patterns by payer.
The provider’s operational profile includes notable non-emergency and specialty transport activity beyond standard emergency ambulance runs. Medicaid-level ranks of #1 for A0120, A0390, and A0394 in-state (each flagged as 100th percentile or notably above typical) and the presence of S0215 as a top revenue source imply substantial mini-bus/organized transport and mileage-billing services that serve Medicaid populations.
The NPI tenure provides additional context for market presence: NPI enumerated (registered) on 2007-02-01 (~19 years ago), indicating a long-standing provider likely embedded in local EMS and Medicaid transport networks. That longevity, combined with the statewide outlier status on key Medicaid codes, supports the interpretation of an established, dominant Medicaid transport operator in its state market.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
3 rows
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 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.
9 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 15,460 | $200 | $3.2M |
| A0425 | Ground mileage, per statute mile | 17,520 | $70 | $1.2M |
| S0215 | Non-emergency transportation; mileage, per mile | 7,160 | $110 | $809.1K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 3,990 | $200 | $805.4K |
| A0394 | Als specialized service disposable supplies; iv drug therapy | 3,200 | $30 | $96K |
| A0120 | Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems | 7,440 | $10 | $37.2K |
| A0390 | Als mileage (per mile) | 570 | $50 | $29.8K |
| A0380 | Bls mileage (per mile) | 140 | $150 | $21.1K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 620 | $10 | $8.7K |
How this provider's Medicaid billing volume and revenue compare to other South Dakota providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. South Dakota median
9 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) | 1 | 40 | 270 | $180 | $281.6K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 3 | 30 | 300 | $150 | $195.3K |
| S0215 | Non-emergency transportation; mileage, per mile | 1 | 20 | 900 | $100 | $169.9K |
| A0425 | Ground mileage, per statute mile | 3 | 60 | 680 | $50 | $106.2K |
| A0394 | Als specialized service disposable supplies; iv drug therapy | 1 | 10 | 1,750 | $30 | $49.4K |
| A0380 | Bls mileage (per mile) | 5 | 10 | 110 | $80 | $12.4K |
| A0390 | Als mileage (per mile) | 1 | 10 | 100 | $70 | $10K |
| A0120 | Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems | 1 | 20 | 1,060 | $10 | $9.9K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 2 | 10 | 170 | $10 | $3.5K |
Other providers in the same ZIP code as Rosebud Sioux Tribe Ambulance Service, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Rosebud Indian Health Service | SD | General Acute Care Hospital | $0 | $22.2M |
| Guardian Flight LLC | SD | Air Ambulance | $336.5K | $3.3M |
| Total Renal Care Inc | SD | End-Stage Renal Disease (ESRD) Treatment Clinic/Center | $0 | $2M |
| Rosebud Sioux Tribe -chr | SD | Private Vehicle | $0 | $304.3K |
| Anne Cowles | SD | Family Nurse Practitioner | $23.7K | $0 |
| Shannelle Rico | SD | Family Medicine Physician | $8K | $0 |
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