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

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

Consumer Direct Personal Care, LLC (NPI 1154456366)

Field	Value
Entity Type	Organization
Organization	Consumer Direct Personal Care, LLC
Address	100 Consumer Direct Way
City	Missoula
State	MT
ZIP	59808
Taxonomy	In Home Supportive Care Agency
NPI Enumerated	February 21, 2007

Payer Source	Total Paid
Medicaid	$49.1M
Medicare	$0

Key Findings

CONSUMER DIRECT PERSONAL CARE, LLC is a long-tenured In Home Supportive Care Agency based in Missoula, MT, with an NPI enumerated on 2007-02-21 (~19 years ago). Its reported payer footprint is effectively single-payer: there is no Medicare billing on file and total Medicaid revenue is $49.1M, indicating the organization operates primarily within Medicaid-funded long-term services and supports.

Revenue for this provider is highly concentrated: the precomputed top three Medicaid codes account for 98.7% of its total Medicaid revenue, with T1019 alone representing $45.9M (93.6% of Medicaid revenue). That degree of concentration means the provider’s financial performance is closely tied to reimbursement and utilization patterns for a single service category.

The code mix confirms a core business centered on in-home personal care and attendant services. T1019 (596.5K claims, $77 avg paid/claim) is the dominant line and is billed as personal care services per 15 minutes, while S5126 (63.8K claims, $30 avg paid/claim) reflects attendant care on a per diem basis and T2001 (12.1K claims, $49 avg paid/claim) captures non-emergency transportation escorts; together these codes describe a program focused on hands-on personal assistance and client transport rather than medical or acute care.

Competitive standing within Montana is consistently high for the provider’s core codes: T1019 ranks #3 of 38 providers in-state (95th percentile) but is labeled as having a "typical, unremarkable volume" for this code in the dataset, indicating that while the provider is among the largest billers, the observed volume falls within expected bounds for this service. S5126 also ranks #3 of 16 (87th percentile) and T2001 ranks #3 of 12 (82th percentile), both likewise described as "typical, unremarkable volume," which together portray a reliable top-tier state-level presence without anomalous statistical outlier status.

Operational scale is evident from claim counts: 596.5K claims for T1019, 63.8K for S5126 and 12.1K for T2001 signal sustained, high-volume delivery of personal care and attendant services. These volumes support the interpretation of an established community-based delivery model with substantial recurring utilization rather than episodic or one-off services.

Although the provider appears well-established in Medicaid personal care, the extreme revenue concentration (T1019 = 93.6%) creates a business risk if program rules, reimbursement rates, or eligibility criteria for that specific service change. Analysts should treat contract/reimbursement exposure for T1019 as the primary sensitivity in any financial or competitive assessment.

Beyond the top three codes, supplemental billing lines (for example S5130 homemaker service, A0080 volunteer vehicle miles, and S0215 mileage) are present at much smaller shares of total revenue; these ancillary services (each representing fractions of a percent of revenue) indicate the provider offers a broader set of non-medical supports and transportation options to complement its dominant personal-care operations.

Taken together, the data portray CONSUMER DIRECT PERSONAL CARE as a long-standing, Medicaid-focused in-home care operator with concentrated revenue tied to time-based personal care (T1019) and supporting attendant and transport services. Its consistent #3 rankings across multiple in-state code leaderboards position it as a major regional participant, though the dataset’s characterization of volumes as "typical, unremarkable" suggests its activity aligns with expected program norms rather than representing statistical outliers.

Medicaid: Complete Services Breakdown

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

6 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…	596,550	$80	$45.9M
S5126	Attendant care services; per diem	63,830	$30	$1.9M
T2001	Non-emergency transportation; patient attendant/escort	12,090	$50	$592.5K
S5130	Homemaker service, nos; per 15 minutes	10,950	$30	$328.6K
A0080	Non-emergency transportation, per mile - vehicle provided by volunteer (individual or organization), with no vested interest	31,080	$10	$217.5K
S0215	Non-emergency transportation; mileage, per mile	11,430	$10	$68.6K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Montana Distribution

Consumer Direct Personal Care, LLC — 0 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. Montana median

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5126	Attendant care services; per diem	3	20	5,400	$100	$111M
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…	3	40	6,240	$130	$14.6M
T2001	Non-emergency transportation; patient attendant/escort	3	10	1,730	$50	$264.4K
S5130	Homemaker service, nos; per 15 minutes	2	10	1,560	$30	$143.8K
A0080	Non-emergency transportation, per mile - vehicle provided by volunteer (individual or organization), with no vested interest	2	10	2,890	$10	$70.6K
S0215	Non-emergency transportation; mileage, per mile	4	20	1,250	$10	$41.3K

Nearby Providers

Other providers in the same ZIP code as Consumer Direct Personal Care, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Consumer Direct Care Network Virginia	MT	Home Health Agency	$0	$2.1B
Hkj Inc	MT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$15.2M
We Care Behavioral Health LLC	MT	Clinic/Center	$0	$14.8M
Partners In Home Care, Inc	MT	Nursing Care Agency	$0	$13M
Hkj Inc	MT	Case Management Agency	$0	$11.6M
Sunburst Health LLC	MT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$6.1M
Providence Health & Services Mt	MT	Family Medicine Physician	$0	$4.9M
Welltower Tenant Group LLC	MT	Assisted Living Facility	$0	$3.8M
Norco, Inc	MT	Durable Medical Equipment & Medical Supplies	$0	$3.8M
County Of Missoula School Dist 4	MT	Local Education Agency (LEA)	$0	$3.4M

Consumer Direct Personal Care, LLC — Billing Profile & Reimbursement Data

Sign up for Consumer Direct Personal Care, LLC — Billing Profile & Reimbursement Data policy alerts

Consumer Direct Personal Care, LLC — Billing Profile & Reimbursement Data

Sign up for Consumer Direct Personal Care, LLC — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References