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

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

Astrocare Class, Inc. (NPI 1396812897)

Field	Value
Entity Type	Organization
Organization	Astrocare Class, Inc.
Address	14950 Heathrow Forest Pkwy Ste 300
City	Houston
State	TX
ZIP	77032
Taxonomy	Home Health Agency
NPI Enumerated	November 29, 2006

Payer Source	Total Paid
Medicaid	$168M
Medicare	$0

Key Findings

This provider is effectively single-payer: ASTROCARE CLASS, INC. shows no Medicare billing on file and $168M in lifetime Medicaid revenue, indicating its business is concentrated in the Medicaid market rather than split between Medicare and Medicaid. The absence of Medicare activity suggests revenue and operational exposure are tied to state Medicaid policy and waiver programs rather than fee-for-service Medicare flows.

Revenue is highly concentrated: the precomputed top three Medicaid codes (T2026, T2016, H2032) account for 67.7% of the provider's total Medicaid revenue. T2026 alone represents $64.5M (38.4% of Medicaid revenue) and T2016 $38.4M (22.9%), so a majority of dollars flow from waiver-based per diem and residential habilitation services.

The code mix implies a business model centered on Medicaid waiver and community-based habilitation services. High-dollar codes such as T2026 (specialized childcare, waiver; per diem) and T2016 (habilitation, residential, waiver; per diem) together with H2032 (activity therapy, per 15 minutes) indicate ASTROCARE operates substantial residential and specialized childcare waiver programs and delivers structured therapeutic activity services.

State-level competitive standing for the main waiver/residential lines is strong: ASTROCARE ranks #3 of 47 providers in-state for T2026 (96th percentile), #5 of 109 for T2016 (96th percentile), and #3 of 46 for H2032 (96th percentile). Those ranks place the provider among the leading statewide participants in these specific Medicaid waiver and activity-therapy service lines.

There are notable statistical outliers in home health therapy codes despite their small share of total revenue: G0151 (qualified physical therapist, home health/hospice) ranks #2 of 159 providers in-state (99th percentile) and G0152 (qualified occupational therapist, home health/hospice) ranks #1 of 22 (100th percentile), labeled as "extreme outlier, far above typical state volume." These outlier rankings suggest an unusually high provision of in-home PT/OT relative to peers, indicating specialized clinical capacity that is disproportionate to their revenue share.

Beyond the top three drivers, the provider offers a broad suite of community and home-based services — examples include 97124 (massage, $9.4M), T1019 (personal care, $5.2M), T1005 (respite care, $4.1M), S5125 (attendant care, $4.5M) and G0176 (activity therapy sessions, $3M). This mix shows ASTROCARE pairs its dominant waiver/residential lines with complementary personal care, respite, and therapeutic services typical of large home- and community-based providers.

The concentration in a few high-value waiver codes creates both risk and leverage: dependence on T2026 and T2016 (together comprising 61.3% of Medicaid revenue by the listed shares) makes the provider sensitive to changes in waiver reimbursement or eligibility, but the provider's high statewide ranks for those codes also give it scale and negotiating visibility with state agencies and managed care plans. That dual dynamic frames ASTROCARE as a high-volume Medicaid-specialty operator with concentrated exposure to waiver program policy.

ASTROCARE has a lengthy tenure: its NPI was enumerated on 2006-11-29 (~20 years ago), which, combined with $168M in Medicaid revenue and the high-ranking positions on key codes, supports characterization as a well-established, long-running participant in Texas Medicaid waiver and community-based habilitation services.

Medicaid: Complete Services Breakdown

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

29 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2026	Specialized childcare, waiver; per diem	395,530	$160	$64.5M
T2016	Habilitation, residential, waiver; per diem	213,250	$180	$38.4M
H2032	Activity therapy, per 15 minutes	51,590	$210	$10.7M
97124	Generally, massage is a technique of applying light or firm pressure, with different movement styles, using palms, fingers, and thumbs, over body muscles and tissues in order to restore better blood…	104,780	$90	$9.4M
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…	67,940	$80	$5.2M
T2015	Habilitation, prevocational, waiver; per hour	3,910	$1,230	$4.8M
S5125	Attendant care services; per 15 minutes	56,590	$80	$4.5M
T1005	Respite care services, up to 15 minutes	47,110	$90	$4.1M
H2015	Comprehensive community support services, per 15 minutes	42,750	$80	$3.6M
S9125	Respite care, in the home, per diem	39,390	$90	$3.4M

Showing 1–10 of 29

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Texas Distribution

Astrocare Class, Inc. — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. Texas median

29 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2026	Specialized childcare, waiver; per diem	3	50	33,380	$180	$17.4M
S5125	Attendant care services; per 15 minutes	804	1,680	50,290	$60	$9.5M
T2016	Habilitation, residential, waiver; per diem	5	110	6,810	$200	$8.1M
S9125	Respite care, in the home, per diem	6	20	18,690	$100	$3.5M
T2015	Habilitation, prevocational, waiver; per hour	3	10	1,450	$200	$3.4M
T2017	Habilitation, residential, waiver; 15 minutes	35	60	19,340	$80	$3M
H2032	Activity therapy, per 15 minutes	3	50	3,520	$170	$2.6M
G0226	N/A	4	10	2,550	$200	$2.5M
T2040	Financial management, self-directed, waiver; per 15 minutes	14	40	4,490	$30	$2.5M
97124	Generally, massage is a technique of applying light or firm pressure, with different movement styles, using palms, fingers, and thumbs, over body muscles and tissues in order to restore better blood…	3	40	3,120	$100	$2.3M

Showing 1–10 of 29

Nearby Providers

Other providers in the same ZIP code as Astrocare Class, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Home Care, LLC	TX	Home Health Agency	$0	$42.6M
Aldine Isd	TX	Local Education Agency (LEA)	$0	$20M
American Medical Response Of Texas Inc	TX	Ambulance	$2.9M	$5.6M
Alphadera Labs,llc	TX	Clinical Medical Laboratory	$4.2M	$1.2M

Astrocare Class, Inc. — Billing Profile & Reimbursement Data

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Astrocare Class, 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