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

Why is the Medicaid comparison limited to New York 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. New York (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.

Concepts Of Independence, Inc. (NPI 1184703415)

Field	Value
Entity Type	Organization
Organization	Concepts Of Independence, Inc.
Address	120 Wall St
City	New York
State	NY
ZIP	10005
Taxonomy	Home Health Agency
NPI Enumerated	November 6, 2006

Payer Source	Total Paid
Medicaid	$1.1B
Medicare	$0

Key Findings

This provider is effectively single‑payer: Medicare activity is absent (none — no Medicare billing on file) while Medicaid is the sole reported source of lifetime Medicare/Medicaid revenue at $1.06B. The absence of Medicare billing on file indicates the organization operates primarily, if not exclusively, within Medicaid-funded personal care and attendant service markets rather than Medicare home health programs.

Revenue concentration is extremely high: the precomputed top three Medicaid codes account for 99.9% of this provider's total Medicaid revenue, with T1019 alone representing $943.8M (89.1%), T1020 $114M (10.8%), and 99199 $827K (0.1%). This concentration signals that the business depends almost entirely on a very narrow set of service lines rather than a diversified set of Medicaid billables.

Operationally, the code mix confirms a workforce‑intensive personal care model rather than skilled clinical home health services: T1019 (personal care services, per 15 minutes) and T1020 (personal care services, per diem) together drive virtually all revenue, implying a high volume of time‑based attendant care delivered in community or home settings. The prominence of per‑15‑minute billing (T1019) versus per‑diem (T1020) suggests heavy reliance on minute‑level staff time tracking and a scheduling/contingent workforce to meet large service demand.

Volume indicators underscore scale and intensity: T1019 shows 4.6M claims at $204 avg paid/claim for $943.8M revenue, while T1020 shows 380K claims at $300 avg paid/claim for $114M revenue. The sheer claim counts for T1019 (millions of units) reflect continuous service provision at scale and operational systems capable of handling very large encounter volumes.

Competitive standing in-state is strong for the top personal care codes: the provider ranks #20 of 912 providers in-state for T1019 (98th percentile; notably above typical state volume for this code) and ranks #3 of 354 providers in-state for T1020 (99th percentile; extreme outlier, far above typical state volume for this code). These rankings indicate the organization is a major, dominant participant in New York’s Medicaid personal care market, particularly for per‑diem and per‑15‑minute personal care services.

Smaller codes and auxiliary services are immaterial to total revenue: 99199 contributes $827K (0.1%) with 1.9K claims and ranks #4 of 167 providers in-state (98th percentile; typical, unremarkable volume for this code), while S5126, S5125 and T1022 together account for negligible shares of revenue. This pattern suggests ancillary attendant care and contracted home health agency services exist but are not strategic revenue drivers.

Tenure is substantial: the provider’s NPI was enumerated on 2006-11-06 (~20 years ago), indicating long-standing presence in the market and likely established payer relationships and operational processes to support high‑volume Medicaid personal care delivery. Long tenure plus concentrated, high-volume billing patterns typically reflect entrenched operational scale rather than recent market entry.

For payer or competitive analysis, the combination of single‑payer Medicaid dependence, extreme concentration in T1019 and T1020, and top‑percentile in‑state rankings implies that any payer contracting, utilization management, or network strategy should treat this entity as a large, high‑volume provider of personal care services in New York; oversight or network decisions should focus on these specific codes and the operational workflows that generate multi‑million claims volumes.

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…	4,626,550	$200	$943.8M
T1020	Personal care services, per diem, 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…	380,040	$300	$114M
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	1,870	$440	$827K
S5126	Attendant care services; per diem	4,330	$160	$670.7K
S5125	Attendant care services; per 15 minutes	1,400	$210	$295.6K
T1022	Contracted home health agency services, all services provided under contract, per day	870	$190	$162.3K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New York Distribution

Concepts Of Independence, Inc. — 3 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New York

Full comparison — all codes billed, vs. New York median

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5126	Attendant care services; per diem	7	20	2,660	$80	$114M
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…	20	910	108,820	$150	$81.8M
T1020	Personal care services, per diem, 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	350	12,660	$310	$13.1M
S5125	Attendant care services; per 15 minutes	45	60	4,640	$100	$5.7M
T1022	Contracted home health agency services, all services provided under contract, per day	98	330	470	$170	$231.1K
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	4	170	80	$20	$68.2K

Nearby Providers

Other providers in the same ZIP code as Concepts Of Independence, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Integra Partners Ipa LLC	NY	Customized Equipment (DME)	$0	$63.7M
Ehsan Abdeshahian	NY	Physical Medicine & Rehabilitation Physician	$554.8K	$0
Vadim Kushnerik	NY	Pain Medicine (Anesthesiology) Physician	$283.3K	$7.9K

Concepts Of Independence, Inc. — Billing Profile & Reimbursement Data

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Concepts Of Independence, 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