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

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

American Health Management, Inc. (NPI 1215076567)

Field	Value
Entity Type	Organization
Organization	American Health Management, Inc.
Address	292 S 2nd St
City	Richmond
State	KY
ZIP	40475
Taxonomy	Adult Day Care Clinic/Center
NPI Enumerated	February 5, 2007

Payer Source	Total Paid
Medicaid	$99.1M
Medicare	$0

Key Findings

This provider is effectively a single-payer Medicaid operation: there is no Medicare billing on file and reported lifetime Medicaid revenue is $99.1M, indicating Medicaid accounts for the entirety of its documented programmatic revenue. The absence of Medicare activity suggests its service mix and contracting are concentrated on Medicaid populations and reimbursement rules.

Revenue is extremely concentrated in a small set of Medicaid service lines: the top 3 Medicaid codes by revenue account for 98.5% of this provider's total Medicaid revenue, driven overwhelmingly by S5108 which alone represents $89.4M (90.2% of total Medicaid revenue). This concentration implies the provider’s financial performance is closely linked to reimbursement and utilization for those specific codes.

The code mix and taxonomy point to an adult day care/home support operational model: the provider is listed as an Adult Day Care Clinic/Center and its largest billing line is S5108 (Home care training to home care client, per 15 minutes) with 616.6K claims at $145 avg paid/claim, consistent with high-frequency, time-based training or coaching services delivered to clients. Secondary services billed include S5100 (Day care services, adult; per 15 minutes) with 50.6K claims and T1016 (Case management, each 15 minutes) with 42.5K claims, supporting a blended day‑program plus case management service mix.

Competitive standing within the state is concentrated and uneven by code: the provider ranks #2 of 101 in the state for S5108 and is described as an "extreme outlier" at the 99th percentile, indicating a dominant statewide position for that specific service. For T1016 it ranks #4 of 63 (95th percentile, "notably above typical"), while S5100 is more modest at #15 of 102 (86th percentile, characterized as typical), so the provider is a major player for some Medicaid services but not uniformly dominant across all adult day care-related codes.

Several ancillary codes add small but meaningful diversification: T1999 (miscellaneous therapeutic items and supplies) appears with 6.4K claims at $206 avg paid/claim for $1.3M (1.3% of revenue) and ranks #3 of 36 providers in-state (94th percentile, "notably above typical"). Other items such as T1005 (respite care) and S5170 (home delivered meals) are present at much smaller revenue levels ($79.6K and $66.9K respectively), indicating limited supplemental service lines.

The operational profile implied by high claim counts and per-claim averages suggests a high-volume, unit‑based billing model: S5108 alone shows 616.6K claims billed at $145 avg paid/claim, which is consistent with frequent, short-interval billing (per 15 minutes) rather than infrequent procedure-based encounters. This pattern has implications for staffing, documentation intensity, and claims-processing workflows required to support sustained per-15-minute billing at scale.

The provider has an established presence in the market: its NPI was enumerated on 2007-02-05 (~19 years ago), which together with $99.1M in Medicaid lifetime revenue and the high-ranking S5108 volume suggests long-standing operations and an entrenched service footprint in the state. Longevity plus concentrated revenue implies institutional experience in delivering the specific Medicaid services driving its income.

Concentration creates material exposure to policy or coverage shifts affecting core codes: because S5108, T1016, and S5100 together constitute 98.5% of Medicaid revenue and S5108 alone is 90.2%, any regulatory, reimbursement, or eligibility changes affecting per-15-minute home care training or related billing rules could materially affect the provider’s financials. Analysts should treat the revenue base as highly sensitive to changes in utilization authorization, documentation standards, or state fee schedules for those dominant codes.

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
S5108	Home care training to home care client, per 15 minutes	616,550	$150	$89.4M
T1016	Case management, each 15 minutes	42,480	$120	$5M
S5100	Day care services, adult; per 15 minutes	50,620	$70	$3.3M
T1999	Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks"	6,410	$210	$1.3M
T1005	Respite care services, up to 15 minutes	2,840	$30	$79.6K
S5170	Home delivered meals, including preparation; per meal	5,570	$10	$66.9K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

American Health Management, Inc. — 2 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5108	Home care training to home care client, per 15 minutes	2	100	43,820	$140	$16.6M
S5100	Day care services, adult; per 15 minutes	15	100	16,270	$70	$1.9M
T1016	Case management, each 15 minutes	4	60	3,410	$120	$970.5K
T1005	Respite care services, up to 15 minutes	42	80	2,880	$70	$799.2K
S5170	Home delivered meals, including preparation; per meal	27	60	5,170	$10	$342.6K
T1999	Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks"	3	40	1,370	$160	$315.4K

Nearby Providers

Other providers in the same ZIP code as American Health Management, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Baptist Healthcare System, Inc.	KY	General Acute Care Hospital	$0	$58.5M
Fm Healing Center, LLC	KY	Addiction Medicine (Family Medicine) Physician	$0	$22M
Quality Care Case Management, LLC.	KY	Case Management Agency	$0	$17.5M
Nathaniel House, Inc.	KY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$14.4M
Ethan Health LLC	KY	Substance Abuse Rehabilitation Facility	$0	$13.1M
Combined Physicians Lab LLC	KY	Clinical Medical Laboratory	$428.1K	$7.4M
Center For Behavioral Health Kentucky LLC	KY	Methadone Clinic	$198.1K	$7.2M
Bluegrass Pediatric Therapies, LLC	KY	Speech-Language Pathologist	$0	$4.5M
Madison Pediatric Assoc	KY	Pediatrics Physician	$0	$3.9M
Rose Bowling, LLC	KY	Rural Health Clinic/Center	$0	$3.9M

American Health Management, Inc. — Billing Profile & Reimbursement Data

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American Health Management, 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