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

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

Advantage In-home Services, LLC (NPI 1194975326)

Field	Value
Entity Type	Organization
Organization	Advantage In-home Services, LLC
Address	11796 Westline Industrial Dr
City	Saint Louis
State	MO
ZIP	63146
Taxonomy	Home Health Agency
NPI Enumerated	September 24, 2008

Payer Source	Total Paid
Medicaid	$99.8M
Medicare	$0

Key Findings

This entity is effectively a Medicaid-focused home health operator: it reports no Medicare billing on file and $99.8M in lifetime Medicaid revenue, indicating Medicaid is the sole material public payer on record for this NPI. The absence of Medicare activity means payer-mix analysis should treat the provider as single-payer (Medicaid) for competitive and financial benchmarking.

Revenue is highly concentrated in a very small set of service codes: the precomputed top three Medicaid codes account for 96.4% of this provider's total Medicaid revenue. The single largest driver is T1019 ($73.6M revenue, 73.7% of this provider's total Medicaid revenue), followed by S5150 ($14.8M, 14.9%) and T1001 ($7.9M, 7.9%).

The code mix (T1019 — personal care services; S5150 — unskilled respite care; T1001 — nursing assessment/evaluation; plus S5130 — homemaker services) signals an operation focused on home- and community-based long-term services and supports (personal care, respite, homemaker assistance and nursing assessments). This pattern is consistent with a provider delivering large-scale non-skilled personal assistance and attendant/respite services rather than medically intensive home health services.

Volume and payment characteristics reinforce the scale of these lines: T1019 shows 1.1M claims with a $67 avg paid/claim, S5150 shows 280K claims with a $53 avg paid/claim, and T1001 shows 154.1K claims with a $51 avg paid/claim. Those claim counts combined with the large per-code revenue totals reflect high operational throughput in time-based personal care and respite services.

State-level competitive standing is dominant for several codes: T1019 ranks #12 of 1332 providers in-state (99th percentile; described as an extreme outlier), S5150 ranks #2 of 216 providers in-state (100th percentile; extreme outlier), and T1001 ranks #3 of 417 providers in-state (100th percentile; extreme outlier). These rankings indicate the provider is a major, outlier-volume participant in Missouri for core personal care and respite services.

Additional codes reinforce the same pattern: S5130 (homemaker service) generated $2.5M (2.5% of total Medicaid revenue) and ranks #1 of 90 providers in-state (100th percentile; extreme outlier), while S5126 (attendant care per diem) produced $1.1M (1.1% of total) and ranks #2 of 4 providers in-state (67th percentile), a more typical volume. Together these supplementary codes confirm specialization in homemaker/attendant/respite lines with a mix of extreme outlier volumes and some routine per-diem activity.

The concentration of nearly all Medicaid revenue in a narrow set of non-skilled and low-acuity codes (top three = 96.4% of Medicaid revenue) creates business sensitivity to Medicaid reimbursement policy, service authorization rules, or utilization-management changes affecting time-based personal care and respite codes. Operational or policy shifts that target these specific codes could materially affect this provider’s revenue profile given the concentration.

This provider has been enumerated since 2008-09-24 (~18 years ago), indicating established tenure in the market. Combined tenure with $99.8M in Medicaid revenue and very high claim volumes suggests an established, high-capacity provider of Medicaid home- and community-based services in Missouri.

Medicaid: Complete Services Breakdown

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

5 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…	1,098,160	$70	$73.6M
S5150	Unskilled respite care, not hospice; per 15 minutes	279,960	$50	$14.8M
T1001	Nursing assessment / evaluation	154,090	$50	$7.9M
S5130	Homemaker service, nos; per 15 minutes	89,170	$30	$2.5M
S5126	Attendant care services; per diem	14,950	$70	$1.1M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Missouri Distribution

Advantage In-home Services, LLC — 4 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. Missouri median

5 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…	12	1,330	6,550	$80	$4.6M
S5126	Attendant care services; per diem	2	10	13,270	$150	$3.5M
S5150	Unskilled respite care, not hospice; per 15 minutes	2	220	3,750	$60	$1.3M
T1001	Nursing assessment / evaluation	3	420	1,610	$50	$378.4K
S5130	Homemaker service, nos; per 15 minutes	1	90	3,300	$30	$317.1K

Nearby Providers

Other providers in the same ZIP code as Advantage In-home Services, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rem Missouri, LLC	MO	Developmental Disabilities Clinic/Center	$0	$240.8M
Advantage Consumer Directed Services, LLC	MO	Home Health Agency	$0	$133.9M
Judevine, Inc.	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$58.4M
St. Louis Arc	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$39.2M
Easter Seals Midwest	MO	Behavior Analyst	$0	$35.2M
Maxim Healthcare Services	MO	Nursing Care Agency	$0	$34.9M
St. Louis Arc	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$33.7M
St. Louis Arc	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$19.9M
Biotab LLC	MO	Durable Medical Equipment & Medical Supplies	$0	$14.1M
The Center For Head Injury Services	MO	Developmentally Disabled Services Day Training Agency	$0	$7.7M

Advantage In-home Services, LLC — Billing Profile & Reimbursement Data

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Advantage In-home Services, LLC — 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