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

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

Springwell (NPI 1184758310)

Field	Value
Entity Type	Organization
Organization	Springwell
Address	125 Walnut St
City	Watertown
State	MA
ZIP	02472
Taxonomy	Case Management Agency
NPI Enumerated	March 16, 2007

Payer Source	Total Paid
Medicaid	$153.9M
Medicare	$0

Key Findings

This provider is effectively single‑payer: there is no Medicare billing on file while lifetime Medicaid revenue is $153.9M, indicating that Medicaid is the dominant — effectively sole — source of claims-based revenue reported for SPRINGWELL in WATERTOWN, MA. Analysts should treat Medicaid trends as the primary lens for commercial or population-health contracting assessments.

Revenue is highly concentrated in a few service lines: the precomputed top 3 Medicaid codes by revenue account for 87.9% of the provider's total Medicaid revenue. The three drivers are T1019 ($52.1M, 33.8%), G0156 ($43.3M, 28.1%), and S5130 ($39.9M, 25.9%), so financial performance and utilization patterns will be driven almost entirely by these codes rather than the long tail of ancillary services.

The code mix points to a home- and community‑based care model focused on direct personal support and homemaker services rather than skilled clinical care. Top codes T1019 (Personal care services), G0156 (home health/hospice aide services), and S5130 (Homemaker service) together suggest operations centered on in‑home personal assistance, ADL/IADL support, and household maintenance rather than high volumes of skilled nursing or therapy.

Competitive standing within the state is uneven across those top codes: SPRINGWELL ranks #25 of 137 for T1019 (82th percentile) and #20 of 162 for S5130 (88th percentile), indicating a strong in‑state presence for personal care and homemaker services, while G0156 ranks #87 of 193 (55th percentile), a more typical mid‑market position. In short, the provider is a leading statewide competitor for several HCBS personal care codes but not uniformly dominant across all related home‑health aide lines.

Operational throughput and unit economics differ materially across the top codes: T1019 shows 91.5K claims at $569 avg paid/claim, G0156 shows 17.4K claims at $2488 avg paid/claim, and S5130 shows 124.3K claims at $321 avg paid/claim. These figures reflect a mix of very high‑volume, lower‑unit services (S5130), high‑volume/moderate‑unit personal care (T1019), and lower‑volume/higher‑unit payments (G0156), which has implications for staffing models, billing cadence, and cash flow.

Beyond the top three, SPRINGWELL bills a range of complementary HCBS services that support an integrated non‑clinical offering: S5102 (Day care services, adult) generated $6.4M (35K claims, $184 avg), S5170 (Home delivered meals) generated $4.1M (141.5K claims, $29 avg), and T2003 (Non‑emergency transportation) generated $3.2M (31.9K claims, $101 avg). These mid‑ and lower‑revenue lines indicate service breadth across meals, transportation, and adult day programs that likely operate as adjuncts to the core personal‑care business, even though they represent a much smaller share than the three revenue leaders.

The provider's NPI tenure (enumerated 2007-03-16 (~19 years ago)) together with $153.9M in lifetime Medicaid revenue signals an established operator in the Massachusetts HCBS market. For payers evaluating network stability or contracting, the longevity plus concentration in core personal‑care codes suggests institutional experience in delivering Medicaid community‑based supports.

There is limited activity in more clinically intensive home‑health nursing codes: for example G0299 (Direct skilled nursing services) accounts for $80.4K and ranks #246 of 307 providers in‑state (20th percentile). That lower rank and revenue for skilled nursing reinforces the interpretation that SPRINGWELL is structured around non‑skilled personal and homemaker support rather than being a major provider of skilled home nursing services.

Medicaid: Complete Services Breakdown

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

24 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…	91,540	$570	$52.1M
G0156	Services of home health/hospice aide in home health or hospice settings, each 15 minutes	17,390	$2,490	$43.3M
S5130	Homemaker service, nos; per 15 minutes	124,260	$320	$39.9M
S5102	Day care services, adult; per diem	34,980	$180	$6.4M
S5170	Home delivered meals, including preparation; per meal	141,490	$30	$4.1M
T2003	Non-emergency transportation; encounter/trip	31,920	$100	$3.2M
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	5,660	$320	$1.8M
S5175	Laundry service, external, professional; per order	22,500	$40	$967.6K
S5120	Chore services; per 15 minutes	5,850	$120	$708K
S5161	Emergency response system; service fee, per month (excludes installation and testing)	22,010	$30	$550.1K

Showing 1–10 of 24

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

Springwell — 0 of 24 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

24 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	25	140	7,990	$90	$61.6M
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…	42	50	11,820	$40	$4.4M
S5102	Day care services, adult; per diem	130	340	25,780	$110	$4.1M
S5130	Homemaker service, nos; per 15 minutes	20	160	7,330	$90	$3.8M
G0156	Services of home health/hospice aide in home health or hospice settings, each 15 minutes	87	190	14,240	$110	$3.7M
T2022	Case management, per month	58	80	7,230	$50	$2.6M
S5170	Home delivered meals, including preparation; per meal	15	60	50,010	$20	$2.5M
T2003	Non-emergency transportation; encounter/trip	137	250	40,490	$30	$2.2M
S5161	Emergency response system; service fee, per month (excludes installation and testing)	27	60	19,060	$20	$2.1M
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	246	310	8,710	$40	$1.6M

Showing 1–10 of 24

Nearby Providers

Other providers in the same ZIP code as Springwell, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Steward Medical Group, Inc	MA	Specialist	$0	$50.2M
Springwell, Inc	MA	Case Management Agency	$0	$38.9M
Square Medical Group LLC	MA	Adult Mental Health Clinic/Center	$0	$12.6M
2nd Home Adult Day Health Care Ii, LLC	MA	Adult Day Care Clinic/Center	$0	$11.7M
Toward Independent Living & Learning, Inc.	MA	Developmentally Disabled Services Day Training Agency	$0	$8.2M
2nd Home Adhc, LLC Dba Arevik Adhc	MA	Adult Day Care Clinic/Center	$0	$8.2M
Town Of Watertown	MA	Ambulance	$325K	$724.2K
Daniel Slater	MA	Pediatrics Physician	$421.9K	$88K
George Stamatopoulos	MA	Physical Therapist	$263.6K	$41.3K
Henry Mitcheson	MA	Urology Physician	$139.1K	$0

Springwell — Billing Profile & Reimbursement Data

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Springwell — 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