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 District of Columbia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to District of Columbia 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. District of Columbia (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.

Kbc Nursing Agency Hm Health Inc (NPI 1376694869)

Field	Value
Entity Type	Organization
Organization	Kbc Nursing Agency Hm Health Inc
Address	7506 Georgia Ave Nw
City	Washington
State	DC
ZIP	20012
Taxonomy	Home Health Agency
NPI Enumerated	January 13, 2007

Payer Source	Total Paid
Medicaid	$82.4M
Medicare	$0

Key Findings

KBC NURSING AGENCY HM HEALTH INC reports $82.4M in lifetime Medicaid revenue and has no Medicare billing on file, making it effectively a Medicaid-focused operator. The NPI was enumerated 2007-01-13 (~19 years ago), indicating nearly two decades of enrollment at the current tax ID.

Revenue is extremely concentrated: the provider’s top three Medicaid codes account for 100.0% of its total Medicaid revenue, with T1019 alone representing $80M (97.1% of Medicaid revenue) and G0299 contributing $2.4M (2.9%). S9123 contributes only $736 (0.0% of Medicaid revenue), so nearly all dollars flow through a single personal-care code.

The code mix points to a business model dominated by non-skilled personal care rather than traditional Medicare home health services: T1019 (personal care services, per 15 minutes) drives the vast majority of revenue while G0299 (direct skilled nursing RN in the home, per 15 minutes) represents a small complementary skilled-nursing component. This suggests primary operations are organized around high-volume personal care aide delivery with a limited skilled nursing overlay.

Volume metrics reinforce the service-line view: KBC reported 784.6K claims for T1019 with an average paid per claim of $102, indicating very large-scale delivery of short-interval personal care units. By contrast, G0299 shows 28K claims at $85 average paid/claim and S9123 shows 368 claims at $2 average paid/claim, underscoring how unusually dominant T1019 is in both claims and dollars.

On competitive standing in-state, the provider ranks #2 of 29 for T1019 (96th percentile) and is described as "notably above typical state volume" for that code, signifying it is a major statewide player for personal care services. For skilled nursing code G0299 the provider ranks #4 of 32 (90th percentile), a strong but more typical position, while S9123 is mid-range at #6 of 16 (67th percentile).

Unit-payment patterns are disparate: T1019 pays $102 on average per claim versus $85 for G0299 and only $2 for S9123, and those per-claim differences drive the revenue concentration despite large claim counts. The enormous dollar gap between T1019 ($80M) and the other codes highlights that reimbursement mix is driven more by volume of billed personal-care units than by higher per-unit skilled-nursing rates.

Being effectively single-payer (Medicaid-only billing on file) creates concentration risk: with no Medicare revenue reported, the provider’s entire documented revenue stream depends on Medicaid policy, fee schedules, and state program demand. Any state-level changes to authorization, rate setting, or allowable units for T1019 would disproportionately affect this provider given that T1019 accounts for 97.1% of its Medicaid revenue.

Several codes show activity with little or no recorded payment: S9131 and T1017 have reported claims but $0 average paid/claim, and S9123 produces only $736 in revenue despite 368 claims. These zero- or negligible-payment lines may reflect non-billable adjudications, bundled reimbursement practices, or reporting artifacts, and should be interpreted cautiously when assessing service breadth beyond the dominant T1019 volume.

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
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…	784,560	$100	$80M
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	27,980	$90	$2.4M
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)	370	$1	$740
T1017	Targeted case management, each 15 minutes	30	$0	$0
S9131	Physical therapy; in the home, per diem	150	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. District of Columbia Distribution

Kbc Nursing Agency Hm Health Inc — 1 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — District of Columbia

Full comparison — all codes billed, vs. District of Columbia median

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	2	30	405,140	$140	$47.5M
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	4	30	13,380	$80	$1.3M
T1017	Targeted case management, each 15 minutes	20	20	390	$70	$89.9K
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)	6	20	130	$20	$17.2K
S9131	Physical therapy; in the home, per diem	2	10	100	$1	$20

Nearby Providers

Other providers in the same ZIP code as Kbc Nursing Agency Hm Health Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Specialty Home Care LLC	DC	Respite Care	$0	$85.1M
Berhan Home Health Care Agency Inc	DC	Home Health Agency	$0	$76.6M
Kinara Health And Home Care Services LLC	DC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$48.5M
Ward & Ward Association, Inc.	DC	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$38.7M
Alliance Home Healthcare & Equipment Services Inc	DC	Respite Care	$0	$37.5M
Premier Health Services Inc.	DC	Home Health Agency	$0	$36.8M
Affordable Health Care Services LLC	DC	Developmental Disabilities Clinic/Center	$0	$25.8M
Direct Care Home Health Services LLC	DC	Home Health Agency	$0	$14.3M
Kahak, Inc.	DC	Home Health Agency	$0	$13.8M
Dedicated Care Health Services, Inc.	DC	Community/Behavioral Health Agency	$0	$11.2M

Kbc Nursing Agency Hm Health Inc — Billing Profile & Reimbursement Data

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Kbc Nursing Agency Hm Health 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