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 Washington for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Washington 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. Washington (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.

Providence Health & Services Washington (NPI 1063524346)

Field	Value
Entity Type	Organization
Organization	Providence Health & Services Washington
Address	2811 S 102nd St
City	Tukwila
State	WA
ZIP	98168
Taxonomy	Home Health Agency
NPI Enumerated	August 31, 2006

Payer Source	Total Paid
Medicaid	$4.4M
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

23 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0151	Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes	27,040	$60	$1.7M
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	19,580	$60	$1.2M
G0152	Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes	14,740	$70	$972.6K
G0300	Direct skilled nursing services of a licensed practical nurse (LPN) in the home health or hospice setting, each 15 minutes	4,090	$40	$163.7K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	1,040	$110	$116K
97162	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	1,220	$60	$72.2K
97163	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history of a patient with three or more personal factors that may affect care, assess a clinical…	1,120	$60	$66K
97166	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of moderate analytic complexity, which includes analysis of occupational profile, problem–focused assessment…	1,170	$60	$65.5K
G0155	Services of clinical social worker in home health or hospice settings, each 15 minutes	140	$90	$13.4K
97168	The occupational therapist (OT) performs a re–evaluation focusing on changes in the patient's functional, environment, or medical status that results in a revised plan of care; re–evaluation includes…	190	$60	$10.8K

Showing 1–10 of 23

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Washington Distribution

Providence Health & Services Washington — 3 of 18 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. Washington median

23 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
Q5001	Hospice or home health care provided in patient's home/residence	19	70	870	$160	$452.5K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	176	280	1,920	$40	$262.1K
G0151	Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes	1	60	2,650	$40	$188.7K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	476	480	1,160	$30	$180.9K
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	2	80	1,640	$40	$136.1K
G0300	Direct skilled nursing services of a licensed practical nurse (LPN) in the home health or hospice setting, each 15 minutes	7	40	1,070	$70	$135K
G0152	Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes	1	50	650	$40	$87K
97162	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	29	150	190	$40	$36.1K
97163	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history of a patient with three or more personal factors that may affect care, assess a clinical…	6	50	60	$40	$25K
97166	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of moderate analytic complexity, which includes analysis of occupational profile, problem–focused assessment…	7	50	220	$40	$21.9K

Showing 1–10 of 23

Nearby Providers

Other providers in the same ZIP code as Providence Health & Services Washington, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
American Medical Response Ambulance Service Inc	WA	Ambulance	$5.2M	$32.6M
Providence Health & Services - Washington	WA	Home Infusion Therapy Pharmacy	$16.6K	$22M
Option Care Enterprises, Inc.	WA	Home Infusion Therapy Pharmacy	$0	$18.9M
Cellnetix Labs, LLC	WA	Clinical Medical Laboratory	$1.1M	$8.4M
Providence Health & Services - Washington	WA	Community Based Hospice Care Agency	$0	$9.2M
Healthpoint	WA	Federally Qualified Health Center (FQHC)	$0	$8M
Seattle Drug And Narcotic Center Inc	WA	Substance Abuse Rehabilitation Facility	$0	$6.8M
Padmaraj V. Angolkar D.d.s., M.d.s.	WA	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$5.5M
Northwest Kidney Centers	WA	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4.9M
Victor Marfo	WA	Endodontics	$0	$3.4M

Providence Health & Services Washington — Billing Profile & Reimbursement Data

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Providence Health & Services Washington — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References