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

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

Hospice Of The Western Reserve, Inc. (NPI 1255333753)

Field	Value
Entity Type	Organization
Organization	Hospice Of The Western Reserve, Inc.
Address	17876 Saint Clair Ave
City	Cleveland
State	OH
ZIP	44110
Taxonomy	Pediatric Hospice and Palliative Medicine Physician
NPI Enumerated	August 15, 2005

Payer Source	Total Paid
Medicaid	$70.2M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and reports $70.2M in lifetime Medicaid revenue, making its observable commercial/public payer activity effectively single-payer in scope for the available data. The absence of Medicare claims means analysis should focus on Medicaid as the primary revenue source rather than a mixed Medicare/Medicaid footprint.

Revenue is extremely concentrated in a small set of hospice per-diem codes: the precomputed top three Medicaid codes account for 99.9% of this provider's total Medicaid revenue, driven by T2046 ($55.9M, 79.6%), T2042 ($12.4M, 17.7%), and T2045 ($1.8M, 2.6%). This concentration shows most Medicaid dollars flow through standard hospice per-diem reimbursements rather than a broader mix of procedure or ancillary codes.

The code mix and volumes indicate the organization operates primarily as a hospice provider with strong long-term care and home hospice activity. T2046 (Hospice long term care, room and board only; per diem) is the dominant revenue source with 328.6K claims at a $170 avg paid/claim, and T2042 (Hospice routine home care; per diem) is the secondary source with 88.8K claims at a $140 avg paid/claim, together reflecting a business model centered on per-diem hospice services.

Competitive standing within Ohio is strong for the provider's top service lines: T2046 ranks #4 of 134 providers in-state (98th percentile) and is described as notably above typical state volume, and T2042 ranks #2 of 42 providers in-state (98th percentile) and is likewise notably above typical state volume. These rankings position the provider as a major statewide participant for long-term care room-and-board and routine home hospice per-diems.

Higher-intensity inpatient hospice care (T2045) contributes only $1.8M (2.6% of Medicaid revenue) from 2.4K claims at a $750 avg paid/claim and ranks #3 of 7 providers in-state (67th percentile), a pattern consistent with typical, unremarkable inpatient hospice volume. This suggests limited use of general inpatient per-diems relative to facility and home per-diem services.

Direct skilled nursing billing identified by G0299 is minimal: 2.6K claims, $23 avg paid/claim, $60K revenue (0.1% of total) and a rank of #305 of 561 providers in-state (46th percentile), described as typical and unremarkable. The small absolute contribution of G0299 indicates the provider does not generate significant Medicaid revenue from 15-minute RN skilled nursing unit billing compared with its per-diem hospice services.

The provider's NPI was enumerated on 2005-08-15 (~21 years ago), indicating a long tenure in the provider market. This longevity, combined with dominant per-diem volumes, points to an established operational footprint in Ohio hospice services.

Because 99.9% of Medicaid revenue is concentrated in three per-diem hospice codes, the provider's revenue profile is highly sensitive to changes in Medicaid per-diem rates, coding guidance, or utilization patterns for T2046 and T2042. Analysts should prioritize monitoring state policy or reimbursement changes affecting these specific codes when assessing future revenue stability.

Medicaid: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2046	Hospice long term care, room and board only; per diem	328,560	$170	$55.9M
T2042	Hospice routine home care; per diem	88,770	$140	$12.4M
T2045	Hospice general inpatient care; per diem	2,430	$750	$1.8M
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	2,610	$20	$60K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Ohio Distribution

Hospice Of The Western Reserve, Inc. — 2 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. Ohio median

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2046	Hospice long term care, room and board only; per diem	4	130	29,680	$150	$9.8M
T2042	Hospice routine home care; per diem	2	40	10,290	$140	$2.8M
T2045	Hospice general inpatient care; per diem	3	10	710	$720	$1.2M
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	305	560	3,370	$40	$543.8K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Hospice Of The Western Reserve, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Katharine Cirino	OH	Adult Health Nurse Practitioner	$284.4K	$0
Tambert Whetsel	OH	Gerontology Nurse Practitioner	$142K	$0

Nearby Providers

Other providers in the same ZIP code as Hospice Of The Western Reserve, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hospice Of The Western Reserve At University Hospitals, LLC	OH	Community Based Hospice Care Agency	$0	$13.8M

Hospice Of The Western Reserve, Inc. — Billing Profile & Reimbursement Data

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Hospice Of The Western Reserve, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References