Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or North Carolina for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to North Carolina only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. North Carolina (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Tender Loving Care Homes, Inc. (NPI 1053623140)

Tender Loving Care Homes, Inc. is a intellectual and/or developmental disabilities community based residential treatment facility provider located in Asheville, North Carolina. 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.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Tender Loving Care Homes, Inc.
Address	2 Walden Ridge Drive
City	Asheville
State	NC
ZIP	28803
Taxonomy	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NPI Enumerated	July 6, 2010

Payer Source	Total Paid
Medicaid	$13.1M
Medicare	$0

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
H0040	Assertive community treatment program, per diem	44,160	$270	$12M
H2015	Comprehensive community support services, per 15 minutes	4,270	$170	$743.2K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	4,560	$40	$159.7K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	3,430	$40	$126.9K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	1,000	$20	$17.1K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	100	$50	$4.9K
99494	A provider performs psychiatric collaborative care management (CoCM) for a patient receiving behavioral health treatment and regular psychiatric interspecialty consultation whose conditions are not…	70	$40	$3.1K
99493	A provider performs psychiatric collaborative care management (CoCM) for a patient receiving behavioral health treatment and regular psychiatric interspecialty consultation in collaboration and in…	40	$80	$2.9K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	50	$40	$2K
99492	A provider performs psychiatric collaborative care management (CoCM) for a patient receiving behavioral health treatment and regular psychiatric interspecialty consultation in collaboration and in…	10	$120	$1.6K

Showing 1–10 of 15

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other North Carolina providers billing the same CPT/HCPCS codes.

Claims Volume vs. North Carolina Distribution

Tender Loving Care Homes, Inc. — 0 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. North Carolina median

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0040	Assertive community treatment program, per diem	15	120	15,180	$230	$5M
H2015	Comprehensive community support services, per 15 minutes	172	250	10,060	$130	$2.4M
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	774	1,710	810	$80	$274.5K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	950	4,400	960	$60	$271.3K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	919	4,130	670	$50	$219.9K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	82	170	100	$80	$57.7K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	457	570	240	$20	$49K
99493	A provider performs psychiatric collaborative care management (CoCM) for a patient receiving behavioral health treatment and regular psychiatric interspecialty consultation in collaboration and in…	25	30	140	$70	$34.4K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	711	870	70	$90	$28.9K
99494	A provider performs psychiatric collaborative care management (CoCM) for a patient receiving behavioral health treatment and regular psychiatric interspecialty consultation whose conditions are not…	7	10	80	$70	$23.2K

Showing 1–10 of 15

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Carolina Rehabilitation Specialists, Inc.	NC	Speech-Language Pathologist	$0	$26.1M
Mountain Area Health Education Center, Inc.	NC	Federally Qualified Health Center (FQHC)	$0	$17.5M
The Bair Foundation	NC	Foster Care Agency	$0	$17.3M
The Arc Of North Carolina	NC	Community/Behavioral Health Agency	$0	$14.6M
Mountain Area Health Education Center, Inc.	NC	Federally Qualified Health Center (FQHC)	$0	$14.3M
Asheville Pediatric Associates	NC	Pediatrics Physician	$0	$10.9M
Asheville Children's Medical Center, P.A.	NC	Pediatrics Physician	$0	$9.4M
Crossroads Treatment Centers Of Asheville, PC	NC	Multi-Specialty Clinic/Center	$81.2K	$6.5M
Orthopaedic Surgery Center Of Asheville, LP	NC	Ambulatory Surgical Clinic/Center	$5.1M	$11.7K
William Bridges	NC	Retina Specialist (Ophthalmology) Physician	$4.1M	$0

Tender Loving Care Homes, Inc. — Billing Profile & Reimbursement Data

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Tender Loving Care Homes, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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References