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

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

Vitra Health, Inc. (NPI 1073887246)

Field	Value
Entity Type	Organization
Organization	Vitra Health, Inc.
Address	150 Wood Road
City	Braintree
State	MA
ZIP	02184
Taxonomy	Adult Care Home Facility
NPI Enumerated	March 5, 2012

Payer Source	Total Paid
Medicaid	$108.8M
Medicare	$0

Key Findings

VITRA HEALTH, INC. is registered as an Adult Care Home Facility in BRAINTREE, MA with an NPI enumerated on 2012-03-05 (~14 years ago), indicating roughly a decade-and-a-half of Medicaid billing history to analyze. The taxonomy and tenure together suggest an established residential or housing-focused care operation rather than a newer entrant or outpatient-only provider.

This provider has no Medicare billing on file and reports $108.8M in lifetime Medicaid revenue, making its public payment profile effectively single-payer Medicaid. Analysts should treat Medicaid as the sole source of reported federal program revenue when evaluating payer exposure or benchmarking.

Revenue concentration is extremely high: the top three Medicaid codes together account for 100.0% of this provider's total Medicaid revenue, with S5140 representing 85.3% of Medicaid revenue, H0043 representing 14.3%, and T1028 representing 0.4%. This concentration means a small number of service lines drive the entirety of reported Medicaid income.

The code mix — S5140 (Foster care, adult; per diem), H0043 (Supported housing, per diem), and T1028 (Assessment of home, physical and family environment) — points to bed-based foster/adult care and supported housing as the core business lines, with ancillary environmental assessments. Per-claim averages ($185 for S5140, $102 for H0043, $256 for T1028) and the large per-diem claim counts imply routine, day-to-day residential service delivery rather than episodic medical procedures.

On statewide competitiveness for S5140, the provider ranks #13 of 158 (92th percentile; typical, unremarkable volume for this code), and for H0043 it ranks #12 of 105 (89th percentile; typical, unremarkable volume). Those positions indicate VITRA HEALTH is above the median in volume for these common residential/service codes but is not necessarily a dominant statewide leader.

For T1028, the provider ranks #3 of 32 (94th percentile; notably above typical state volume for this code), signaling a comparatively strong standing in conducting home/environment assessments relative to in-state peers. This suggests a niche capability or emphasis on pre-placement or suitability assessments that is materially stronger than most peers.

The overwhelming reliance on S5140 (85.3% of Medicaid revenue) creates a concentrated revenue profile that could make the provider sensitive to state rate-setting, eligibility or programmatic changes in adult foster care funding; H0043 (14.3%) provides some diversification but remains a secondary line. From a contracting and audit-preparedness perspective, payer negotiations or policy shifts affecting per-diem foster care payments should be considered material to financial stability.

Operational scale is evident in claims volume: 501.8K claims billed for S5140 and 152.1K claims for H0043, with a further 1.7K claims for T1028, together producing the reported $108.8M in Medicaid revenue. These volumes reflect sustained, high-frequency residential and supported-housing activity rather than sporadic or low-volume services.

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5140	Foster care, adult; per diem	501,790	$190	$92.8M
H0043	Supported housing, per diem	152,090	$100	$15.5M
T1028	Assessment of home, physical and family environment, to determine suitability to meet patient's medical needs	1,720	$260	$439.6K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

Vitra Health, Inc. — 0 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5140	Foster care, adult; per diem	13	160	48,640	$110	$19.5M
H0043	Supported housing, per diem	12	110	22,180	$90	$5.3M
T1028	Assessment of home, physical and family environment, to determine suitability to meet patient's medical needs	3	30	50	$220	$87.4K

Nearby Providers

Other providers in the same ZIP code as Vitra Health, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Peabody Resident Services Inc	MA	Adult Care Home Facility	$0	$105.7M
South Shore Elder Services Inc	MA	Case Management Agency	$0	$60.7M
Medical Resources Home Health Corp	MA	Home Health Agency	$0	$26.6M
Vatra Adhc, LLC	MA	Adult Day Care Clinic/Center	$0	$12.9M
Habilitation Assistance Corporation	MA	Developmentally Disabled Services Day Training Agency	$0	$9.6M
South Shore Hospital Inc.	MA	Home Health Agency	$0	$7.9M
Encompass Health Rehabilitation Hospital Of Braintree, LLC	MA	Rehabilitation Hospital	$0	$6.6M
Marathon Health Solutions, LLC	MA	Home Health Agency	$0	$6.4M
Mehnaz Khan	MA	Ophthalmology Physician	$871.2K	$37.7K
Caroline Sizer	MA	Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician	$823.2K	$0

Vitra Health, Inc. — Billing Profile & Reimbursement Data

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Vitra Health, Inc. — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References