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.

Morning Star Home Care LLC (NPI 1205053048)

Field	Value
Entity Type	Organization
Organization	Morning Star Home Care LLC
Address	349 Centerville Road Bldg 6
City	Warwick
State	RI
ZIP	02886
Taxonomy	Nursing Care Agency
NPI Enumerated	April 20, 2007

Payer Source	Total Paid
Medicaid	$16.5M
Medicare	$0

Key Findings

This provider effectively operates as a Medicaid-only home care agency: Total Medicare revenue is listed as none (no Medicare billing on file) while total Medicaid revenue is $16.5M, indicating the organization’s entire reported lifetime billing is driven by Medicaid. Analysts should treat payer mix risk as concentrated in state Medicaid policy and rate changes rather than Medicare dynamics.

Revenue concentration is extreme at the code level: the precomputed top three Medicaid codes account for 100.0% of the provider’s Medicaid revenue, with S5125 contributing $14M (84.6%), S5130 contributing $2.5M (15.2%), and T1001 contributing $33.2K (0.2%). This concentration means changes to coverage or unit rates for these specific codes would disproportionately affect overall revenue.

The code mix and descriptions indicate a labor- and time-intensive personal care operation: S5125 (Attendant care services; per 15 minutes) and S5130 (Homemaker service, nos; per 15 minutes) dominate revenue and are billed on a per-15-minute basis, which implies the business model relies on high-volume, shift-based direct care staff and scheduling capacity. Average paid amounts align with that model: S5125 averages $164 paid/claim, S5130 averages $132 paid/claim, and the smaller nursing assessment code T1001 averages $74 paid/claim.

S5125 is the single largest revenue driver and a core competency but is not a statewide dominant position: S5125 generated 85.3K claims and $14M in revenue (84.6% of Medicaid revenue) and the provider ranks #18 of 83 in-state (79th percentile; typical, unremarkable volume). That rank indicates a meaningful presence in attendant care statewide but not market leadership.

S5130 provides a meaningful secondary service line: with 19K claims and $2.5M revenue (15.2% of Medicaid revenue) the provider ranks #14 of 34 in-state (61th percentile; typical, unremarkable volume). This suggests the agency supplements attendant care with homemaker services at mid-range volumes among in-state peers, representing a notable but smaller revenue stream.

Nursing assessment activity is minimal relative to personal care: T1001 produced 448 claims and $33.2K (0.2% of Medicaid revenue) and the provider ranks #22 of 42 in-state (49th percentile; typical, unremarkable volume). This pattern implies clinical assessment is performed but is not a major revenue driver or distinguishing capability for the organization.

Operational and cost implications flow from the time-based billing mix: high claim counts for S5125 (85.3K claims) and S5130 (19K claims) point to heavy administrative needs around time capture, visit verification, and workforce scheduling, making labor management and compliance with per-15-minute documentation central operational priorities. Payers and network managers should focus oversight, rate negotiations, and utilization reviews on these high-volume time-based codes.

The provider shows long-term market tenure: NPI enumerated 2007-04-20 (~19 years ago), and combined with $16.5M in Medicaid billing this suggests an established presence in the state Medicaid home care market. Longevity alongside a concentrated code mix signals stability in a focused service niche, but also exposure to state Medicaid policy or unit-rate changes for a small set of codes.

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5125	Attendant care services; per 15 minutes	85,330	$160	$14M
S5130	Homemaker service, nos; per 15 minutes	19,030	$130	$2.5M
T1001	Nursing assessment / evaluation	450	$70	$33.2K

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

Morning Star Home Care LLC — 0 of 3 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

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5125	Attendant care services; per 15 minutes	18	80	13,620	$120	$7.8M
S5130	Homemaker service, nos; per 15 minutes	14	30	10,010	$100	$1.9M
T1001	Nursing assessment / evaluation	22	40	460	$100	$164.4K

Nearby Providers

Other providers in the same ZIP code as Morning Star Home Care LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
West Bay Residential Services Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$145.8M
Kent County Memorial Hospital	RI	General Acute Care Hospital	$0	$90.8M
Avatar Residential, Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$72.9M
Thrive Behavioral Health, Inc.	RI	Community/Behavioral Health Agency	$0	$71.9M
Bayada Home Health Care, Inc.	RI	Home Health Agency	$0	$69.5M
Community Living Of Rhode Island	RI	Developmentally Disabled Services Day Training Agency	$0	$65.7M
J.arthur Trudeau Memorial Center Conversion Waivers	RI	Developmentally Disabled Services Day Training Agency	$0	$57.1M
Gateways To Change, Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$54.5M
Affinity Physicians LLC.	RI	Internal Medicine Physician	$0	$41.8M
J, Arthur Trudeau Memorial Center	RI	Developmentally Disabled Services Day Training Agency	$0	$33.9M

Morning Star Home Care LLC — Billing Profile & Reimbursement Data

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Morning Star Home Care 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