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

Why is the Medicaid comparison limited to New Mexico 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. New Mexico (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.

Professional Home Health Care De Santa Fe Y Los Alamos (NPI 1316940216)

Field	Value
Entity Type	Organization
Organization	Professional Home Health Care De Santa Fe Y Los Alamos
Address	10 Calle Medico
City	Santa Fe
State	NM
ZIP	87505
Taxonomy	Home Health Agency
NPI Enumerated	May 24, 2005

Payer Source	Total Paid
Medicaid	$32.5M
Medicare	$0

Key Findings

This provider is effectively single-payer in the available data: there is no Medicare billing on file while Medicaid revenue totals $32.5M, so Medicaid drives the entirety of reported public-payer activity. Analysts should treat Medicaid policy and enrollment changes as the primary external risk factors for this entity.

Revenue is highly concentrated in three codes: T1019 drives $15.1M (46.6% of Medicaid revenue), S5125 drives $9.5M (29.1%), and 99509 drives $6.9M (21.1%); these top three codes together account for 96.8% of the provider's total Medicaid revenue. This concentration indicates that changes in reimbursement, prior-authorization, or utilization for these specific service lines would materially affect overall revenue.

The code mix (T1019, S5125, 99509) and their descriptions point to a business model focused on home-based personal/attendant care and assistance with activities of daily living rather than high volumes of skilled nursing procedures. Frequent use of time-based personal care and attendant-care codes suggests operational emphasis on prolonged in-home support and caregiver visits rather than episodic clinical interventions.

Competitive standing by code is mixed but generally within typical statewide ranges: T1019 ranks #24 of 89 (74th percentile) and is described as "typical, unremarkable volume," S5125 ranks #9 of 45 (82th percentile) and likewise is "typical, unremarkable volume," and 99509 ranks #30 of 82 (64th percentile) with the same characterization. In plain terms, the provider has a relatively strong position in attendant care statewide, a solid but not dominant presence in personal care, and a more moderate presence for ADL-focused visits.

Skilled nursing and care-coordination codes are much smaller contributors: G9006 contributes $904.1K (2.8% of Medicaid revenue) and S9123 contributes $104K (0.3%), with other nursing-hour codes each at negligible shares. This indicates the provider captures little Medicaid revenue from home-based nursing or coordinated-monitoring services relative to its personal/attendant-care business.

The provider's NPI was enumerated on 2005-05-24 (~21 years ago), indicating longstanding participation in Medicaid programs and suggesting an established operational footprint in the Santa Fe area. That tenure can be relevant when evaluating referral relationships, local market knowledge, and potential contract histories.

From a risk-management and contracting perspective, the heavy dependence on a small set of time-based personal/attendant-care codes creates both negotiating leverage and vulnerability: the organization likely has operational scale in those services but would face material revenue disruption if utilization or reimbursement for T1019, S5125, or 99509 changed. Payors and network managers should prioritize review of authorizations, utilization patterns, and service mix for these three codes when assessing provider performance.

Across the listed high-volume codes, none are labeled as statistical outliers in the source data; each top code is described as "typical, unremarkable volume." That suggests the provider's utilization patterns are within normal statewide variation rather than exhibiting extreme deviations that would warrant immediate anomaly-focused investigation.

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	189,230	$80	$15.1M
S5125	Attendant care services; per 15 minutes	78,890	$120	$9.5M
99509	A home health provider, such as a registered nurse, or a non nursing practitioner, visits a patient to provide help with activities of daily living, or ADLs, and self care.	38,340	$180	$6.9M
G9006	Coordinated care fee, home monitoring	4,210	$220	$904.1K
S9123	Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)	790	$130	$104K
S9122	Home health aide or certified nurse assistant, providing care in the home; per hour	170	$110	$19.5K
T1002	Rn services, up to 15 minutes	310	$50	$16.8K
S9124	Nursing care, in the home; by licensed practical nurse, per hour	50	$120	$5.7K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Mexico Distribution

Professional Home Health Care De Santa Fe Y Los Alamos — 0 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Mexico

Full comparison — all codes billed, vs. New Mexico median

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99509	A home health provider, such as a registered nurse, or a non nursing practitioner, visits a patient to provide help with activities of daily living, or ADLs, and self care.	30	80	20,990	$310	$16.4M
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…	24	90	92,900	$70	$13.3M
S5125	Attendant care services; per 15 minutes	9	50	10,600	$100	$4.3M
G9006	Coordinated care fee, home monitoring	39	80	3,840	$190	$2M
S9122	Home health aide or certified nurse assistant, providing care in the home; per hour	7	10	18,020	$130	$2M
S9123	Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)	5	20	450	$260	$400.2K
T1002	Rn services, up to 15 minutes	25	40	1,350	$150	$368.7K
S9124	Nursing care, in the home; by licensed practical nurse, per hour	5	10	150	$200	$140.3K

Nearby Providers

Other providers in the same ZIP code as Professional Home Health Care De Santa Fe Y Los Alamos, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Vincent Hospital	NM	General Acute Care Hospital	$0	$46.5M
New Mexico Treatment Services LLC	NM	Community/Behavioral Health Agency	$291.6K	$35.3M
State Of New Mexico	NM	Public Health or Welfare Agency	$0	$15.9M
Whole Child Dental, LLC	NM	Pediatric Dentistry	$0	$13.6M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$13.3M
Santa Fe Indian Hospital	NM	Federal Public Health Clinic/Center	$0	$12.5M
Noesis Integrative Health Inc	NM	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$12.3M
Healthfront PC	NM	Emergency Medicine Physician	$0	$8.9M
Hero Dental Of Santa Fe PC	NM	General Practice Dentistry	$0	$8.3M
The Life Link	NM	Community/Behavioral Health Agency	$0	$8.1M

Professional Home Health Care De Santa Fe Y Los Alamos — Billing Profile & Reimbursement Data

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Professional Home Health Care De Santa Fe Y Los Alamos — Billing Profile & Reimbursement Data

Sign up for Professional Home Health Care De Santa Fe Y Los Alamos — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References