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 1174856892)

Field	Value
Entity Type	Organization
Organization	Providence Health & Services - Washington
Address	1615 75th St Sw Ste 210
City	Everett
State	WA
ZIP	98203
Taxonomy	Home Health Agency
NPI Enumerated	September 14, 2009

Payer Source	Total Paid
Medicaid	$3.9M
Medicare	$0

Medicaid: Complete Services Breakdown

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

18 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	22,010	$60	$1.4M
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	17,180	$60	$1.1M
G0152	Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes	10,970	$60	$636.5K
G0300	Direct skilled nursing services of a licensed practical nurse (LPN) in the home health or hospice setting, each 15 minutes	5,950	$40	$243.8K
Q5001	Hospice or home health care provided in patient's home/residence	3,350	$60	$214.7K
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…	1,720	$110	$187.2K
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…	1,590	$50	$79.5K
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…	1,100	$50	$59.2K
G0155	Services of clinical social worker in home health or hospice settings, each 15 minutes	980	$30	$29.5K
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…	260	$60	$14.2K

Showing 1–10 of 18

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 — 5 of 17 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

18 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1030	Nursing care, in the home, by registered nurse, per diem	18	20	530	$1,620	$2.8M
Q5001	Hospice or home health care provided in patient's home/residence	13	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…	150	280	1,920	$40	$262.1K
G0151	Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes	3	60	2,650	$40	$188.7K
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	4	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	4	40	1,070	$70	$135K
G0152	Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes	3	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…	24	150	190	$40	$36.1K
97161	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…	112	190	160	$50	$34.2K
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…	13	50	60	$40	$25K

Showing 1–10 of 18

Related Providers

Other providers that share a Tax Identification Number (TIN) with Providence Health & Services - Washington, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Providence Health & Services - Washington	WA	Community Based Hospice Care Agency	$0	$3.5M

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
Compass Health	WA	Community/Behavioral Health Agency	$0	$61.1M
Northwest Ambulance LLC	WA	Land Ambulance	$2.9M	$19.1M
Sea Mar Community Health Centers	WA	Federally Qualified Health Center (FQHC)	$0	$14.9M
Behavioral Health Northwest	WA	Community/Behavioral Health Agency	$0	$14.6M
Sunrise Services, Inc.	WA	Home Health Agency	$0	$3.5M
American Labworks LLC	WA	Clinical Medical Laboratory	$936.3K	$0
Andrew Sohn	WA	Rheumatology Physician	$176.3K	$0
Brian Fong	WA	Urology Physician	$133.1K	$0
Kimberly Warth	WA	Psychiatric/Mental Health Nurse Practitioner	$97K	$0
Terry Corwin	WA	Urology Physician	$95.5K	$0

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

Related Providers

Nearby Providers

Frequently Asked Questions

References