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NPI 1992758247 · Baton Rouge, LA · Emergency Medicine Physician
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Professional Emergency Physician Associates, LLC is a emergency medicine physician provider located in Baton Rouge, Louisiana. This profile covers 0 Medicare and 15 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 | Professional Emergency Physician Associates, LLC |
| Address | 5000 Hennessy Blvd |
| City | Baton Rouge |
| State | LA |
| ZIP | 70808 |
| Taxonomy | Emergency Medicine Physician |
| NPI Enumerated | May 18, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $28.4M |
| Medicare | $0 |
This entity reports no Medicare billing on file and $28.4M in lifetime Medicaid revenue, making its observed activity effectively single-payer (Medicaid) in scale. Analysts should treat Medicare comparisons as not applicable for this NPI because Total Medicare revenue is listed as none (no Medicare billing on file).
Revenue is highly concentrated in three emergency-department E/M codes: 99285 accounts for $18.6M (65.5%), 99284 for $8.1M (28.5%), and 99283 for $1.3M (4.4%), and the top 3 codes together account for 98.4% of the provider's total Medicaid revenue. This concentration indicates nearly all Medicaid receipts are driven by ED evaluation-and-management visits.
The provider’s taxonomy is Emergency Medicine Physician and the code mix (dominated by 99285, 99284, 99283) is consistent with a high-volume emergency department model focused on E/M services. The predominance of 99285 (high level of medical decision making) implies frequent management of higher-acuity ED presentations rather than outpatient or routine primary care encounters.
For 99285 this provider is a statewide outlier: 99285 ranks #1 of 237 providers in-state (100th percentile; extreme outlier), signaling a dominant position in high-acuity Medicaid ED visits within Louisiana. That rank, combined with $18.6M in revenue from that code, marks the practice as a major in-state provider for serious ED care billed to Medicaid.
99284 and 99283 show different competitive positions: 99284 generates $8.1M and ranks #8 of 266 (97th percentile; notably above typical state volume), while 99283 contributes $1.3M and ranks #54 of 266 (80th percentile; typical, unremarkable volume). This suggests the group treats both moderate- and lower-acuity ED cases but is especially prominent for moderate-to-high acuity work.
Critical care and diagnostic interpretations appear but represent a small share of revenue: 99291 (critical care) is 2.6K claims for $266.8K (0.9% of Medicaid revenue) and ranks #25 of 145 (83th percentile), while 93010 (ECG interpretation) is 61.2K claims for $183.7K (0.6% of Medicaid revenue) and ranks #9 of 277 (97th percentile; notably above typical). These entries indicate some provision of critical care services and high ECG interpretation volume, but neither drives overall Medicaid revenue.
Several codes show high claim counts with $0 average paid/claim—examples include G9744 (3.6K claims, $0), 99053 (14.2K claims, $0), and 99217 (673 claims, $0). The presence of large numbers of zero-paid claims suggests non-reimbursed reporting (administrative, eligibility, or facility-level pass-through entries) that inflate claim counts without contributing to Medicaid revenue and should be considered when evaluating operational scale from claims alone.
The NPI was enumerated on 2006-05-18 (~20 years ago), indicating a long-tenured enrollment in the Medicare/Medicaid system. When combined with the high-volume, high-acuity Medicaid billing profile and top-state rankings, this tenure supports the interpretation of an established emergency medicine operation with a sustained regional presence in Baton Rouge, LA.
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.
15 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99285 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making. | 206,750 | $90 | $18.6M |
| 99284 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making. | 115,530 | $70 | $8.1M |
| 99283 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making. | 32,400 | $40 | $1.3M |
| 99291 | Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is… | 2,590 | $100 | $266.8K |
| 93010 | The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram. | 61,250 | $1 | $183.7K |
| 99223 | The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the… | 130 | $60 | $8.1K |
| 99238 | The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the… | 60 | $30 | $1.8K |
| 99220 | N/A | 30 | $60 | $1.7K |
| 99225 | N/A | 30 | $20 | $610 |
| 99239 | The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the… | 10 | $40 | $530 |
Showing 1–10 of 15
How this provider's Medicaid billing volume and revenue compare to other Louisiana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Louisiana median
15 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99284 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making. | 8 | 270 | 9,980 | $110 | $2.6M |
| 99285 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making. | 1 | 240 | 4,030 | $130 | $2M |
| 99283 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making. | 54 | 270 | 11,250 | $90 | $1.8M |
| 99282 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making. | 153 | 170 | 1,260 | $70 | $322.4K |
| 99291 | Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is… | 25 | 150 | 340 | $120 | $204.6K |
| 99223 | The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the… | 301 | 510 | 250 | $70 | $89.6K |
| 99239 | The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the… | 196 | 220 | 240 | $40 | $72.4K |
| 99220 | N/A | 55 | 70 | 160 | $80 | $53.7K |
| 93010 | The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram. | 9 | 280 | 1,410 | $1 | $46.9K |
| 99238 | The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the… | 243 | 350 | 180 | $40 | $44.4K |
Showing 1–10 of 15
Other providers in the same ZIP code as Professional Emergency Physician Associates, LLC, ranked by combined Medicare and Medicaid revenue.
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