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

Why is the Medicaid comparison limited to Connecticut 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. Connecticut (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 Connecticut, Inc (NPI 1265867394)

Field	Value
Entity Type	Organization
Organization	Caregiver Homes Of Connecticut, Inc
Address	912 Silas Dean Highway - Suite 101
City	Weathersfield
State	CT
ZIP	06109
Taxonomy	Case Management Agency
NPI Enumerated	September 9, 2013

Payer Source	Total Paid
Medicaid	$112.5M
Medicare	$0

Key Findings

This provider reports no Medicare billing on file and $112.5M in lifetime Medicaid revenue, indicating it operates effectively as a single-payer (Medicaid-focused) entity at scale rather than a mixed Medicare/Medicaid provider. The absence of Medicare activity should shape peer comparisons and risk assessments primarily against Medicaid-era benchmarks.

Revenue is extremely concentrated: the top three Medicaid codes (5140Z, 5140Y, 5140X) together account for 98.8% of this provider's total Medicaid revenue. Individually those codes generate $80.3M (71.4%) for 5140Z, $22.5M (20.0%) for 5140Y, and $8.4M (7.4%) for 5140X, so changes to reimbursement or utilization for any of these codes would materially affect overall revenue.

The provider’s taxonomy is Case Management Agency and the dataset lists S5140 as S5140 – Foster care, adult; per diem, which combined with the dominant 5140Z/5140Y/5140X billing pattern (no descriptions available in the file) is consistent with a business model focused on high-volume case management and per‑diem foster/adult residential services. While the three 5140* codes lack descriptions in the supplied table, their claim counts and the presence of S5140 support inference of recurring, per‑client service delivery rather than episodic acute care.

Claim volumes are very large and suggest recurring, per‑diem operations: 5140Z shows 757.9K claims at an average $106 paid/claim, 5140Y shows 292.5K claims at $77 avg paid/claim, and 5140X shows 132.6K claims at $63 avg paid/claim. These high claim counts, paired with relatively modest per‑claim payments, are consistent with ongoing care or day‑rate billing rather than one‑time procedures.

Competitive standing in Connecticut is dominant for the top codes: 5140Z ranks #1 of 18 providers and is described as an "extreme outlier, far above typical state volume for this code," 5140Y ranks #1 of 12 providers and is also an "extreme outlier, far above typical state volume for this code," and 5140X ranks #1 of 6 providers and is "notably above typical state volume for this code." These rankings place the provider at the top of the state market for its core billed services.

S5140 (Foster care, adult; per diem) accounts for $1.3M (1.2% of Medicaid revenue) with 33.5K claims at an average $40 paid/claim and ranks #1 of 2 providers; this volume is described as "typical, unremarkable" for that code. The small share of revenue from S5140 indicates it is a secondary revenue line compared with the three dominant 5140* codes.

The provider was enumerated on 2013-09-09 (~13 years ago), indicating an established operating history in the state Medicaid market; that tenure, combined with its dominant rank positions, suggests sustained specialization in the services tied to the 5140* codes.

Because $112.5M of lifetime revenue is concentrated in a narrow code mix (top three codes = 98.8%), the provider carries concentrated reimbursement exposure: policy, eligibility, or rate changes affecting 5140Z/5140Y/5140X would likely have outsized impact on financials and operational planning. Analysts should prioritize monitoring reimbursement rules and utilization trends specific to those codes when assessing risk and future performance.

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
5140Z	N/A	757,860	$110	$80.3M
5140Y	N/A	292,480	$80	$22.5M
5140X	N/A	132,640	$60	$8.4M
S5140	Foster care, adult; per diem	33,460	$40	$1.3M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Connecticut Distribution

Caregiver Homes Of Connecticut, Inc — 4 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Connecticut

Full comparison — all codes billed, vs. Connecticut median

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
5140Z	N/A	1	20	3,940	$150	$7.5M
5140Y	N/A	1	10	3,140	$120	$3.3M
5140X	N/A	1	10	2,990	$80	$2M
S5140	Foster care, adult; per diem	1	10	17,110	$40	$741.5K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hartford Healthcare Medical Group, Inc	CT	Surgery Physician	$0	$22.4M
Medical Management Plus	CT	Home Health Agency	$0	$21.5M
Hartford Healthcare At Home, Inc	CT	Home Health Agency	$0	$19.2M
Connecticut Imaging Partners, LLC	CT	Diagnostic Radiology Physician	$0	$4.6M
Prime Healthcare, PC	CT	Internal Medicine Physician	$0	$4.3M
1271972 LLC	CT	Urgent Care Clinic/Center	$0	$4M
Dr. James Hai T. Nguyen, LLC	CT	General Practice Dentistry	$0	$1.5M
Dr. Nguyen Associates LLC	CT	Optometrist	$0	$1.4M
Minds Cornerstone LLC	CT	Community/Behavioral Health Agency	$0	$1.3M
Laura Miner	CT	Pediatric Dentistry	$0	$1.3M

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

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Caregiver Homes Of Connecticut, 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