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

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

North West Home Care Inc. (NPI 1245490713)

Field	Value
Entity Type	Organization
Organization	North West Home Care Inc.
Address	913 Sw Higgins Ave
City	Missoula
State	MT
ZIP	59803
Taxonomy	Nursing Care Agency
NPI Enumerated	June 9, 2008

Payer Source	Total Paid
Medicaid	$16M
Medicare	$0

Key Findings

This provider is effectively a single‑payer Medicaid operator: lifetime Medicaid revenue is $16M while there is none — no Medicare billing on file. The absence of Medicare activity means analysis and contracting considerations should focus almost entirely on Medicaid program dynamics and rates.

Revenue is highly concentrated: the top three Medicaid codes (T1002, T1019, T1003) together account for 95.6% of this provider's total Medicaid revenue. Those three codes individually generate $7.6M (T1002, 47.2%), $4.4M (T1019, 27.5%), and $3.3M (T1003, 20.9%), indicating very heavy reliance on a narrow set of services.

The service mix indicates a combined skilled nursing and personal care model: T1002 (Rn services, up to 15 minutes) and T1003 (Lpn/lvn services, up to 15 minutes) together imply in‑home skilled nursing visits, while T1019 (personal care services, per 15 minutes) represents non‑clinical personal assistance. Claim volumes and average paid amounts — e.g., T1002 at 7.5K claims with $1002 avg paid/claim and T1019 at 21.7K claims with $203 avg paid/claim — support a business that pairs higher‑paid intermittent skilled nursing with high‑volume personal care episodes.

Despite generating most revenue from those three codes, the provider is not an extreme outlier in statewide competition: T1002 ranks #2 of 7 providers in‑state (83th percentile) and is described as typical, unremarkable volume for this code, while T1019 ranks #10 of 38 (76th percentile) and T1003 ranks #3 of 9 (75th percentile), both likewise characterized as typical, unremarkable volumes. These ranks suggest a solid but not dominant market position for RN services and a modestly strong standing for personal care and LPN services within Montana.

The provider has an established tenure in the national registry, with its NPI enumerated on 2008-06-09 (~18 years ago), indicating long‑running enrollment with state Medicaid programs and likely operational experience delivering home‑ and community‑based services. That longevity combined with heavy Medicaid concentration suggests institutional familiarity with state billing rules and care pathways.

Smaller service lines contribute minimally to overall revenue: H2019 (Therapeutic behavioral services) produces $320.4K (2.0%), S5126 (Attendant care services; per diem) $149.9K (0.9%), and other codes such as T2001, S5130, S0215, and A0080 each account for less than 1% of revenue. Each of these codes is described in the data as typical, unremarkable volume for the code and their state percentiles (range from roughly the 31th to 71th percentiles) indicate no pronounced specialization outside the top three lines.

The extreme revenue concentration in three Medicaid codes presents both operational risk and opportunity: dependence on T1002, T1019, and T1003 for 95.6% of revenue makes the provider sensitive to rate or utilization changes for those codes, but it also signals clear competency areas where payers might negotiate bundled rates, value‑based arrangements, or targeted quality programs. Given there is no Medicare exposure, any payer strategy to diversify this provider's business would need to come through additional Medicaid service lines, state plan amendments, or managed‑care contracting rather than Medicare expansion.

Medicaid: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1002	Rn services, up to 15 minutes	7,540	$1,000	$7.6M
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…	21,690	$200	$4.4M
T1003	Lpn/lvn services, up to 15 minutes	5,720	$580	$3.3M
H2019	Therapeutic behavioral services, per 15 minutes	1,050	$310	$320.4K
S5126	Attendant care services; per diem	3,950	$40	$149.9K
T2001	Non-emergency transportation; patient attendant/escort	1,500	$60	$96.1K
S5130	Homemaker service, nos; per 15 minutes	1,440	$60	$90.5K
S0215	Non-emergency transportation; mileage, per mile	2,920	$10	$26.3K
A0080	Non-emergency transportation, per mile - vehicle provided by volunteer (individual or organization), with no vested interest	3,420	$10	$17.1K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Montana Distribution

North West Home Care Inc. — 0 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. Montana median

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5126	Attendant care services; per diem	10	20	5,400	$100	$111M
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…	10	40	6,240	$130	$14.6M
T1002	Rn services, up to 15 minutes	2	10	3,840	$420	$2.2M
T1003	Lpn/lvn services, up to 15 minutes	3	10	1,570	$170	$823K
H2019	Therapeutic behavioral services, per 15 minutes	25	40	3,280	$50	$759.9K
T2001	Non-emergency transportation; patient attendant/escort	8	10	1,730	$50	$264.4K
S5130	Homemaker service, nos; per 15 minutes	6	10	1,560	$30	$143.8K
A0080	Non-emergency transportation, per mile - vehicle provided by volunteer (individual or organization), with no vested interest	5	10	2,890	$10	$70.6K
S0215	Non-emergency transportation; mileage, per mile	7	20	1,250	$10	$41.3K

Nearby Providers

Other providers in the same ZIP code as North West Home Care Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mountain Home Montana Inc	MT	Clinical Social Worker	$0	$1.7M
Functional Performance Therapy, Inc.	MT	Pediatric Occupational Therapist	$0	$773.4K
Sage Hill Therapy Services PC	MT	Pediatric Occupational Therapist	$0	$602.3K
Little Sunflower Counseling, LLC	MT	Mental Health Counselor	$0	$570.3K
Dennehy & Jerde Orthodontics PLLC	MT	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$408.3K
Marie Pettit	MT	Professional Counselor	$0	$341.9K
Christian Kenworthy	MT	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$326.1K
Dana Boylan	MT	Clinical Social Worker	$0	$318.8K
Cody Bryant	MT	Professional Counselor	$0	$308.2K
Nathan Hoyme	MT	Clinical Social Worker	$0	$263.6K

North West Home Care Inc. — Billing Profile & Reimbursement Data

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North West Home Care 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