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

Why is the Medicaid comparison limited to Rhode Island 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. Rhode Island (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.

A Caring Experience Nursing Services, Inc. (NPI 1326250572)

Field	Value
Entity Type	Organization
Organization	A Caring Experience Nursing Services, Inc.
Address	21 Douglas Ave
City	Providence
State	RI
ZIP	02908
Taxonomy	Home Health Agency
NPI Enumerated	May 3, 2007

Payer Source	Total Paid
Medicaid	$78.5M
Medicare	$0

Key Findings

A CARING EXPERIENCE NURSING SERVICES, INC. is effectively a Medicaid-focused home health agency: it has no Medicare billing on file and reports $78.5M in lifetime Medicaid revenue, indicating the organization operates almost exclusively within the Medicaid market rather than serving Medicare beneficiaries. This payer concentration means analyses of its business lines and competitive position should focus on Medicaid program dynamics.

Revenue is highly concentrated in a very small set of services: the top three Medicaid codes account for 99.3% of this provider’s total Medicaid revenue, with S5125 alone representing $69.8M (89.0% of Medicaid revenue). This concentration implies the provider’s financial performance and utilization profile are driven overwhelmingly by attendant care and related personal care services.

Clinical/service-line implications: the dominant use of S5125 (attendant care services; per 15 minutes) and S9122 (home health aide/CNA per hour) indicates the organization primarily delivers personal care and attendant services in the home rather than skilled nursing or therapy-dominated home health. The presence of S5130 (homemaker services) and T1001 (nursing assessment/evaluation) as much smaller contributors suggests some ancillary homemaker and assessment activity, but these are secondary to direct attendant and aide hours.

Competitive standing in-state is pronounced for core personal-care codes: the provider ranks #2 of 83 in Rhode Island for S5125 (99th percentile, labeled an extreme outlier) and ranks #1 of 13 for S9122 (100th percentile, extreme outlier). Those rankings characterize the provider as a dominant state-level participant for attendant and aide services, operating at volumes far above typical peers for these codes.

Operational emphasis and scale implications: the combination of very high claim counts for S5125 (652.6K claims) and S9122 (49.3K claims) with average paid/claim levels ($107 and $128 respectively) is consistent with a high-volume, labor-intensive care model that bills frequent short-interval attendant-care units. This pattern suggests staffing, scheduling, and payroll are likely the core operational drivers of cost and capacity.

Tenure: the NPI was enumerated on 2007-05-03 (about 19 years ago), indicating long-standing participation in Medicaid markets. This extended tenure supports the likelihood of established referral relationships and operational infrastructure within the state.

Relative role of other service codes: S5130 (homemaker service) contributes $1.8M (2.3% of Medicaid revenue) and ranks #9 of 34 in-state (76th percentile), which is consistent with a typical, unremarkable provider-level presence for homemaker services compared with peers. T1001 (nursing assessment/evaluation) is a notable but small revenue contributor ($557.1K, 0.7% of Medicaid revenue) and ranks #3 of 42 in-state (95th percentile), indicating above-typical activity in assessments despite being a minor share of revenue.

Concentration risk and payer exposure: because Medicare activity is absent and 99.3% of Medicaid revenue derives from three codes, the provider is exposed to changes in Medicaid coverage, rate-setting, or utilization management specifically targeting attendant and aide services. Any policy, reimbursement, or oversight changes affecting S5125 or S9122 would disproportionately impact this provider’s revenue base.

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5125	Attendant care services; per 15 minutes	652,580	$110	$69.8M
S9122	Home health aide or certified nurse assistant, providing care in the home; per hour	49,320	$130	$6.3M
S5130	Homemaker service, nos; per 15 minutes	28,120	$60	$1.8M
T1001	Nursing assessment / evaluation	5,930	$90	$557.1K
T1004	Services of a qualified nursing aide, up to 15 minutes	1,060	$10	$14.9K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Rhode Island Distribution

A Caring Experience Nursing Services, Inc. — 3 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Rhode Island

Full comparison — all codes billed, vs. Rhode Island median

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5125	Attendant care services; per 15 minutes	2	80	13,620	$120	$7.8M
S5130	Homemaker service, nos; per 15 minutes	9	30	10,010	$100	$1.9M
S9122	Home health aide or certified nurse assistant, providing care in the home; per hour	1	10	2,650	$130	$1M
T1001	Nursing assessment / evaluation	3	40	460	$100	$164.4K
T1004	Services of a qualified nursing aide, up to 15 minutes	2	10	1,060	$10	$11.8K

Nearby Providers

Other providers in the same ZIP code as A Caring Experience Nursing Services, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Prospect Chartercare Rwmc, LLC	RI	General Acute Care Hospital	$0	$57.1M
Caregiver Homes Of Rhode Island Inc.	RI	Case Management Agency	$0	$43.4M
Roger Williams Medical Center	RI	Surgical Oncology Physician	$0	$5.4M
John Ricci	RI	Dentist	$0	$4.3M
Meals On Wheels Of Ri, Inc.	RI	Case Manager/Care Coordinator	$0	$4.1M
Professional Ambulance LLC	RI	Ambulance	$1.7M	$1.4M
University Pathologists, LLC	RI	Anatomic Pathology Physician	$0	$2.9M
Prospect Chartercare Rwmc, LLC	RI	Internal Medicine Physician	$0	$2.4M
Antonio Barajas	RI	Emergency Medical Services (Emergency Medicine) Physician	$0	$2.1M
Nakitta Noel	RI	Emergency Medicine Physician	$32.3K	$1.5M

A Caring Experience Nursing Services, Inc. — Billing Profile & Reimbursement Data

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A Caring Experience Nursing Services, 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