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.

Caregiver Homes Of Massachusetts, Inc (NPI 1245414721)

Field	Value
Entity Type	Organization
Organization	Caregiver Homes Of Massachusetts, Inc
Address	11 Midstate Dr Ste 22
City	Auburn
State	MA
ZIP	01501
Taxonomy	Case Management Agency
NPI Enumerated	December 20, 2007

Payer Source	Total Paid
Medicaid	$597.8M
Medicare	$0

Key Findings

This provider is effectively single-payer in its billing profile: there is no Medicare billing on file and all reported lifetime government revenue is Medicaid-based totaling $597.8M. The absence of Medicare activity means payer exposure, revenue forecasting, and competitive comparisons should be framed almost entirely within the Medicaid market.

Revenue is extremely concentrated by code: the precomputed top 3 Medicaid codes account for 100.0% of the provider's total Medicaid revenue, and a single code, S5140, represents $596.8M or 99.8% of that revenue. That concentration indicates the business is overwhelmingly dependent on one service line for its Medicaid receipts.

The top revenue-driving code S5140 (Foster care, adult; per diem) dominates operational activity: it accounts for 7.5M claims with an average paid amount of $80 per claim and $596.8M in revenue. Coupled with the provider taxonomy listed as Case Management Agency, this pattern strongly indicates the organization operates extensive adult foster-care or residential per-diem placements as its core service offering.

A secondary Medicaid code, T1028 (assessment of home, physical and family environment), shows 3.9K claims at $251 average paid/claim for $985.4K in revenue (0.2% of total Medicaid revenue). Although material to service mix—suggesting in-home or placement suitability assessments—T1028 is a minor contributor to overall revenue relative to S5140.

Competitive standing for S5140 is dominant in-state: the provider ranks #1 of 158 providers (100th percentile) and is labeled an extreme outlier, meaning its S5140 volume is far above typical state providers. This ranking positions the organization as a statewide leader for adult foster-care per-diem billing and likely a major capacity holder in that market.

T1028 also ranks #1 of 32 providers in-state (100th percentile; extreme outlier), indicating the provider is a top performer for home-assessment activity among a smaller pool of billers. However, because T1028 represents only 0.2% of Medicaid revenue, the competitive advantage in assessment services contributes little to overall financial scale.

The provider has an established operational tenure, with its NPI enumerated on 2007-12-20 (~19 years ago), which aligns with the large lifetime Medicaid revenue and may reflect long-standing contracts or infrastructure to support high-volume per-diem foster care operations. Given the heavy reliance on S5140, analysts should monitor policy, rate, and utilization changes affecting foster-care per-diem reimbursement as key risks to the provider's revenue stability.

Medicaid: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5140	Foster care, adult; per diem	7,460,330	$80	$596.8M
T1028	Assessment of home, physical and family environment, to determine suitability to meet patient's medical needs	3,930	$250	$985.4K

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

Caregiver Homes Of Massachusetts, Inc — 2 of 2 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

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5140	Foster care, adult; per diem	1	160	48,640	$110	$19.5M
T1028	Assessment of home, physical and family environment, to determine suitability to meet patient's medical needs	1	30	50	$220	$87.4K

Nearby Providers

Other providers in the same ZIP code as Caregiver Homes Of Massachusetts, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
T&n Reliable Nursing Care, LLC Ma	MA	Home Health Agency	$0	$29.9M
Life Choice Hospice Of Western Massachusetts LLC	MA	Community Based Hospice Care Agency	$0	$7.8M
Reema Dhingra Dmd PC	MA	Pediatric Dentistry	$0	$6M
Reliant Medical Group The Endoscopy Center, LLC	MA	Endoscopy Clinic/Center	$530.3K	$1.5M
Town Of Auburn	MA	Land Ambulance	$361.9K	$964.4K
Dennis Murphy	MA	Internal Medicine Physician	$158K	$0
David Weinstock	MA	Internal Medicine Physician	$113.4K	$0
Jonathan Taylor	MA	Gastroenterology Physician	$94.8K	$0
Wassim Assaf	MA	Sleep Medicine (Internal Medicine) Physician	$79.4K	$0
Georgios Poniros	MA	Podiatrist	$65.6K	$10.1K

Caregiver Homes Of Massachusetts, Inc — Billing Profile & Reimbursement Data

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Caregiver Homes Of Massachusetts, 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