Statistical flag only — not an accusation of fraud
This provider's $111.4M in total Medicare payments ranks in the 99th percentile of Ambulance Service Provider providers nationally.
Their average markup ratio of 6.25x is significantly above the specialty median of 4.1x.
This provider has been statistically flagged with a risk score of 72/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.
| Year | Avg Submitted | Avg Paid | Markup Ratio | Gap per Service | Total Payments | Services | Beneficiaries |
|---|---|---|---|---|---|---|---|
| 2014 | $151.61 | $27.35 | 5.54x | $124.26 | $8.2M | 300.2K | 9 |
| 2015 | $144.49 | $26.49 | 5.45x | $118.00 | $11.1M | 420.8K | 9 |
| 2016 | $150.03 | $24.82 | 6.04x | $125.21 | $10.7M | 432.8K | 10 |
| 2017 | $146.88 | $24.70 | 5.95x | $122.18 | $11.5M | 464.2K | 9 |
| 2018 | $152.31 | $26.13 | 5.83x | $126.18 | $12.0M | 457.6K | 9 |
| 2019 | $174.50 | $27.19 | 6.42x | $147.31 | $12.1M | 443.5K | 9 |
| 2020 | $183.69 | $27.20 | 6.75x | $156.49 | $11.1M | 409.4K | 8 |
| 2021 | $195.11 | $27.73 | 7.04x | $167.38 | $11.9M | 430.4K | 10 |
| 2022 | $205.57 | $29.97 | 6.86x | $175.60 | $11.8M | 393.6K | 9 |
| 2023 | $214.08 | $33.49 | 6.39x | $180.59 | $11.0M | 328.0K | 9 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 160.8K | $29.2M | $181.82 | 5.48x |
| A0431 | Ambulance service, conventional air services, transport, one way (rotary wing) | 7.2K | $24.8M | $3.4K | 7.66x |
| A0425 | Ground mileage, per statute mile | 3.5M | $22.5M | $6.34 | 5.31x |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 58.7K | $19.5M | $332.43 | 5.32x |
| A0436 | Rotary wing air mileage, per statute mile | 265.7K | $6.6M | $24.69 | 10.51x |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 17.7K | $5.0M | $280.80 | 4.94x |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 9.8K | $2.0M | $209.68 | 5.92x |
| A0433 | Advanced life support, level 2 (als 2) | 1.8K | $863.0K | $487.02 | 5.40x |
| A0434 | Specialty care transport (sct) | 1.3K | $751.1K | $581.32 | 13.27x |
| A0430 | Ambulance service, conventional air services, transport, one way (fixed wing) | 47 | $136.0K | $2.9K | 6.22x |
| A0435 | Fixed wing air mileage, per statute mile | 13.5K | $109.4K | $8.11 | 20.83x |
This provider submits charges 6.25 times higher than what Medicare actually pays.
A markup ratio of 6.25x means for every $100 Medicare pays, this provider initially charges $625. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Other Ambulance Service Provider providers in TX for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Acadian Ambulance Service Of Texas Llc | Beaumont, TX | $193.0M | ⚠️ Flagged |
| Lone Star Ambulance 1, Llc | Corpus Christi, TX | $142.8M | ✓ Clear |
| Lifenet, Inc. | Texarkana, TX | $84.5M | ✓ Clear |
| City Of Houston | Houston, TX | $76.2M | ✓ Clear |
| Metropolitan Area Ems Authority | Fort Worth, TX | $73.8M | ✓ Clear |
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Last Updated: February 2026 (data through 2023, the latest CMS release)
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.
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