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

Why is the Medicaid comparison limited to Rhode Island 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. Rhode Island (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.

Elmwood Home Care, Inc. (NPI 1184073058)

Field	Value
Entity Type	Organization
Organization	Elmwood Home Care, Inc.
Address	120 Dudley Street
City	Providence
State	RI
ZIP	02905
Taxonomy	Home Health Agency
NPI Enumerated	June 10, 2016

Payer Source	Total Paid
Medicaid	$38.6M
Medicare	$0

Key Findings

ELMWOOD HOME CARE, INC. is effectively a single-payer Medicaid provider: there is no Medicare billing on file and its lifetime Medicaid revenue on record is $38.6M. This payer concentration means all observed claims and revenue patterns reflect Medicaid program utilization and state-level competitive dynamics rather than Medicare home health markets.

Revenue is highly concentrated in a few service lines: the precomputed top three codes (S5125, S5130, S9131) together account for 86.6% of the provider's total Medicaid revenue. In dollar terms those top contributors include S5125 at $26M (67.2% of Medicaid revenue), S5130 at $5.8M (15.1%), and S9131 at $1.7M (4.3%), indicating a small number of codes drive the vast majority of reported Medicaid receipts.

The top code mix signals an operational emphasis on personal care and home-based support rather than hospital-level skilled Medicare home health. S5125 (attendant care services; per 15 minutes) and S5130 (homemaker service, nos; per 15 minutes) together represent over 80% of the revenue picture, while S9131 (physical therapy; in the home, per diem) shows the presence of in-home therapy services as a meaningful tertiary line.

Competitive standing is mixed across codes: ELMWOOD ranks #1 in the state for S5130 and S9131 (both described as notably above typical state volume), showing clear dominance in homemaker services and in-home physical therapy per diem billing. By contrast, the provider's S5125 volume ranks #6 of 83 providers (94th percentile) and is labeled a typical, unremarkable volume for that code, so while attendant care is the largest revenue line it is not an extreme outlier versus in-state peers.

The broader clinical mix includes smaller but visible nursing and therapy lines: T1030 (nursing care, in the home, RN per diem) accounts for $1.1M and ranks in the 64th percentile, S9129 (occupational therapy, in the home, per diem) contributes $897.4K and ranks #1 in-state (notably above typical), and X0043 (no description available) contributes $784.5K and ranks #2 of 7. These mid-tier codes indicate the organization supplements its personal care focus with licensed clinical services rather than operating solely as a non-skilled aide vendor.

Operationally, the dominant codes are billed on time- or per-diem-based units (S5125 and S5130 per 15 minutes; S9131 per diem), which implies a staffing model oriented to recurring, scheduled home visits and hourly personal-care delivery. That configuration typically requires a labor pool of aides and therapists capable of high-volume, decentralized visits and can drive predictable utilization patterns tied to patient hours rather than episodic skilled care.

The heavy reliance on a narrow set of Medicaid codes creates both opportunity and vulnerability: ELMWOOD's #1 statewide positions in homemaker services and in-home PT suggest market strength that could be leveraged for growth or contracting, but the 86.6% concentration in three codes also makes revenue materially sensitive to state policy, rate changes, or utilization-management actions affecting those specific code lines.

The provider has been enumerated since 2016-06-10 (~10 years ago), which indicates roughly a decade of Medicaid billing history captured on file. That tenure supports the observed established service mix and state rankings rather than reflecting a very new entrant or a short-lived billing pattern.

Medicaid: Complete Services Breakdown

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

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5125	Attendant care services; per 15 minutes	209,340	$120	$26M
S5130	Homemaker service, nos; per 15 minutes	76,590	$80	$5.8M
S9131	Physical therapy; in the home, per diem	17,620	$100	$1.7M
T1030	Nursing care, in the home, by registered nurse, per diem	8,680	$120	$1.1M
S9129	Occupational therapy, in the home, per diem	9,450	$100	$897.4K
X0043	N/A	2,020	$390	$784.5K
S9122	Home health aide or certified nurse assistant, providing care in the home; per hour	6,650	$100	$671.8K
S9097	Home visit for wound care	4,930	$100	$488.2K
T1031	Nursing care, in the home, by licensed practical nurse, per diem	4,590	$100	$459K
T1001	Nursing assessment / evaluation	3,670	$110	$403.1K

Showing 1–10 of 17

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Rhode Island Distribution

Elmwood Home Care, Inc. — 3 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Rhode Island

Full comparison — all codes billed, vs. Rhode Island median

17 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5125	Attendant care services; per 15 minutes	6	80	13,620	$120	$7.8M
S9124	Nursing care, in the home; by licensed practical nurse, per hour	4	10	670	$320	$3M
S5130	Homemaker service, nos; per 15 minutes	1	30	10,010	$100	$1.9M
S9123	Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)	5	20	750	$300	$1.6M
S9122	Home health aide or certified nurse assistant, providing care in the home; per hour	6	10	2,650	$130	$1M
T1030	Nursing care, in the home, by registered nurse, per diem	6	20	4,630	$120	$916.9K
S9131	Physical therapy; in the home, per diem	1	20	1,950	$100	$426K
S9097	Home visit for wound care	2	10	4,470	$100	$350.1K
T1031	Nursing care, in the home, by licensed practical nurse, per diem	3	10	1,020	$100	$283.2K
X0043	N/A	2	10	80	$260	$279.7K

Showing 1–10 of 17

Nearby Providers

Other providers in the same ZIP code as Elmwood Home Care, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Women & Infants Hospital Of Rhode Island	RI	General Acute Care Hospital	$0	$132.1M
H&t Medicals, Inc	RI	Home Health Agency	$0	$14.8M
R.i.s.a.t., LLC	RI	Methadone Clinic	$321.1K	$14M
Meeting Street Center	RI	Early Intervention Provider Agency	$0	$13.8M
The Providence Community Health Centers, Inc.	RI	Federally Qualified Health Center (FQHC)	$0	$13.4M
Rhode Island Hospital	RI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$13.2M
Women And Infants Hospital	RI	General Acute Care Hospital	$0	$12.6M
The Providence Community Health Centers, Inc.	RI	Federally Qualified Health Center (FQHC)	$0	$8.3M
Renaissance Adhc, LLC	RI	Adult Day Care Clinic/Center	$0	$7.4M
Catherine Allen	RI	Mental Health Counselor	$0	$7.4M

Elmwood Home Care, Inc. — Billing Profile & Reimbursement Data

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Elmwood Home Care, 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