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

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

R&a Home Care (NPI 1073972097)

Field	Value
Entity Type	Organization
Organization	R&a Home Care
Address	7255 S Havana St Ste 130
City	Centennial
State	CO
ZIP	80112
Taxonomy	Home Health Agency
NPI Enumerated	February 18, 2016

Payer Source	Total Paid
Medicaid	$83.4M
Medicare	$0

Key Findings

This provider has no Medicare billing on file (none) and is effectively a Medicaid-focused operator; lifetime Medicaid revenue on file is $83.4M, making Medicaid the sole material public payer in the dataset for R&A HOME CARE. The absence of Medicare activity means comparisons to national Medicare peers are not applicable and analyses should focus on state Medicaid dynamics.

Revenue is highly concentrated: the top three Medicaid codes (T1019, S5130, H0038) together account for 94.0% of the provider's total Medicaid revenue. T1019 alone represents $60.4M (72.4% of Medicaid revenue), followed by S5130 at $12.8M (15.3%) and H0038 at $5.2M (6.3%), showing reliance on a very small set of service lines.

The code mix indicates an operational focus on hands-on home- and community-based supports rather than clinical home health care: T1019 (personal care services, per 15 minutes) and S5130 (homemaker service, per 15 minutes) are the dominant services by dollars, with H0038 (self-help/peer services) providing a smaller but material contribution. This pattern suggests the agency’s business model centers on personal care and homemaker assistance and includes peer/self-help supports rather than skilled nursing or therapy lines.

Although T1019 is the major revenue driver, the provider’s competitive standing on that code is upper-decile but characterized as routine: T1019 is reported as 52.6K claims, $1149 avg paid/claim, $60.4M revenue and ranks #48 of 475 providers in-state (90th percentile; typical, unremarkable volume for this code). Similarly, S5130 (25.5K claims, $502 avg paid/claim, $12.8M revenue) ranks #39 of 342 (89th percentile; typical, unremarkable volume), while H0038 (8.7K claims, $604 avg paid/claim, $5.2M revenue) ranks #77 of 276 (72th percentile; typical, unremarkable volume). These rank/percentile placements indicate the provider is a solid, upper-quartile participant on its top services but not a statistically exceptional outlier.

Beyond the top three, a small tail of codes contributes the remainder of revenue and appears modest in scale: S5150 ($2.5M, 3.0% of Medicaid revenue) ranks #26 of 86 (71th percentile); H2021 ($1.7M, 2.0%) ranks #32 of 102 (69th percentile); T2021 ($515K, 0.6%) ranks #243 of 290 (16th percentile); and S5151 ($269.4K, 0.3%) ranks #24 of 37 (36th percentile). These smaller lines are consistent with the provider’s emphasis on community-based, non-skilled supports and do not materially diversify revenue away from the top three codes.

The extreme revenue concentration in a few non-clinical service codes creates exposure to reimbursement or policy changes that affect personal care and homemaker services: because T1019, S5130, and H0038 alone make up 94.0% of Medicaid revenue, changes to rates, coverage criteria, or utilization management for those codes would materially impact total Medicaid receipts. Analysts should flag this concentration when assessing financial resilience or contracting risk.

Tenure on file is established: the provider’s NPI was enumerated 2016-02-18 (~10 years ago), indicating roughly a decade of enrollment and claims history to evaluate operational trends and peer comparisons. This tenure supports using the available claims and rank data to assess established market position rather than a very recent market entry.

Medicaid: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	52,570	$1,150	$60.4M
S5130	Homemaker service, nos; per 15 minutes	25,480	$500	$12.8M
H0038	Self‑help/peer services, per 15 minutes	8,690	$600	$5.2M
S5150	Unskilled respite care, not hospice; per 15 minutes	3,430	$730	$2.5M
H2021	Community-based wrap-around services, per 15 minutes	2,520	$680	$1.7M
T2021	Day habilitation, waiver; per 15 minutes	530	$970	$515K
S5151	Unskilled respite care, not hospice; per diem	340	$800	$269.4K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

R&a Home Care — 0 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0038	Self‑help/peer services, per 15 minutes	77	280	2,330	$210	$4.8M
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	48	480	5,200	$150	$3.5M
T2021	Day habilitation, waiver; per 15 minutes	243	290	3,700	$160	$2.3M
S5130	Homemaker service, nos; per 15 minutes	39	340	3,530	$80	$1.2M
H2021	Community-based wrap-around services, per 15 minutes	32	100	960	$100	$1.1M
S5150	Unskilled respite care, not hospice; per 15 minutes	26	90	1,540	$130	$1M
S5151	Unskilled respite care, not hospice; per diem	24	40	640	$130	$453.2K

Nearby Providers

Other providers in the same ZIP code as R&a Home Care, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratory Corporation Of America	CO	Clinical Medical Laboratory	$14.9M	$77.8M
Antonina Health Care LLC	CO	Home Health Agency	$0	$36.6M
Highpointe Services	CO	Developmentally Disabled Services Day Training Agency	$0	$24M
Radiology Imaging Associates, PC	CO	Diagnostic Radiology Physician	$0	$18.8M
Mairik Adult Day Care	CO	Adult Day Care Clinic/Center	$0	$16.3M
Dawson Thomas, Inc.	CO	Home Health Agency	$0	$8.8M
South Metro Fire Rescue Fire Protection District	CO	Land Ambulance	$2.2M	$6.1M
Apria Healthcare LLC	CO	Durable Medical Equipment & Medical Supplies	$0	$7.7M
Amerita, Inc.	CO	Home Infusion Therapy Pharmacy	$0	$7.4M
1st Allergy, Asthma And Pediatrics Too, Inc.	CO	Specialist	$0	$6.8M

R&a Home Care — Billing Profile & Reimbursement Data

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R&a Home Care — 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