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

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

Vna & Hospice Of The Southwest Region, Inc (NPI 1407856800)

Field	Value
Entity Type	Organization
Organization	Vna & Hospice Of The Southwest Region, Inc
Address	7 Albert Cree Dr
City	Rutland
State	VT
ZIP	05701
Taxonomy	Home Health Agency
NPI Enumerated	July 28, 2005

Payer Source	Total Paid
Medicaid	$4.8M
Medicare	$0

Key Findings

This provider is effectively a single-payer Medicaid operation: there is no Medicare billing on file and all reported lifetime revenue is Medicaid-based totaling $4.8M. The absence of Medicare activity combined with the Medicaid revenue base indicates the organization’s financial footprint is concentrated entirely in state Medicaid programs rather than mixed Medicare/Medicaid care delivery.

Revenue concentration is extreme: the precomputed top three Medicaid codes account for 100.0% of this provider’s total Medicaid revenue, with a single code, T1024, alone representing $4.8M in revenue and 99.6% of Medicaid revenue. That degree of concentration indicates virtually all billed Medicaid dollars flow through a single service line or program tied to T1024.

The code mix and descriptions point to a specialized, multidisciplinary pediatric/complex-care orientation consistent with the Home Health Agency taxonomy: T1024 (evaluation and treatment by an integrated, specialty team for multiple or severely handicapped children) is the dominant activity, supported by smaller volumes of H2000 (Comprehensive multidisciplinary evaluation) and T1023 (screening for program participation). Together these codes suggest the provider operates coordinated, team-based evaluations and treatment planning for children with significant disabilities rather than general home health nursing services.

Despite the heavy revenue concentration in T1024, the provider is not a statewide leader on that code: T1024 ranks #7 of 14 providers in-state (54th percentile), described as typical/unremarkable volume. This ranking implies the organization has meaningful operational scale for this specialty service but is not a dominant statewide market leader for the code.

Several other codes show meaningful claim volumes but report $0 avg paid/claim and $0 revenue (for example, T1017: 8.5K claims, T1027: 2.7K claims, 99199: 476 claims, and H2019: 300 claims). These entries indicate substantial activity or encounter reporting in targeted case management, family training, and other services without associated Medicaid payment amounts in the dataset, a pattern that should be considered when interpreting utilization versus paid-revenue metrics.

Smaller-revenue codes H2000 and T1023 contribute only token amounts to revenue — H2000 produced $14.7K (0.3% of Medicaid revenue) with 27 claims and ranks #13 of 19 in-state (33rd percentile), while T1023 produced $5.3K (0.1% of Medicaid revenue) with 15 claims and ranks #31 of 35 (9th percentile). These positions indicate modest competitive standing for those adjunct evaluation and screening services within Vermont.

There are several codes where the provider ranks very low or at the bottom among in-state peers: H2017 (21 claims) ranks #28 of 28 providers (0th percentile) and thus represents negligible activity relative to peers. In contrast, some zero-paid codes like T1017 still register comparatively high rank (T1017 is #5 of 19, 78th percentile), highlighting a divergence between claim volume and recorded paid revenue that analysts should treat as a distinct utilization signal from revenue signal.

The provider has long tenure in the NPI system, enumerated on 2005-07-28 (~21 years ago), which supports interpretation of these utilization and revenue patterns as established business operations rather than a nascent provider. Given the concentrated revenue stream and the code mix, payer/provider analysts should consider this entity a specialized Medicaid-focused programmatic provider with concentrated financial exposure to the T1024 service line.

Medicaid: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1024	Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter	8,100	$590	$4.8M
H2000	Comprehensive multidisciplinary evaluation	30	$540	$14.7K
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	20	$350	$5.3K
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	480	$0	$0
H2017	Psychosocial rehabilitation services, per 15 minutes	20	$0	$0
H2019	Therapeutic behavioral services, per 15 minutes	300	$0	$0
T1016	Case management, each 15 minutes	70	$0	$0
T1017	Targeted case management, each 15 minutes	8,510	$0	$0
T1027	Family training and counseling for child development, per 15 minutes	2,700	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Vermont Distribution

Vna & Hospice Of The Southwest Region, Inc — 0 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Vermont

Full comparison — all codes billed, vs. Vermont median

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	13	20	6,570	$6,270	$59.7M
T1024	Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter	7	10	7,720	$560	$4.2M
H2017	Psychosocial rehabilitation services, per 15 minutes	28	30	6,730	$110	$4.1M
T1027	Family training and counseling for child development, per 15 minutes	6	10	2,700	$80	$213.5K
T1017	Targeted case management, each 15 minutes	5	20	1,580	$30	$102.9K
H2019	Therapeutic behavioral services, per 15 minutes	4	10	260	$50	$34.1K
T1016	Case management, each 15 minutes	34	40	3,900	$1	$31.1K
H2000	Comprehensive multidisciplinary evaluation	13	20	50	$50	$24.3K
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	31	40	210	$30	$13.7K

Nearby Providers

Other providers in the same ZIP code as Vna & Hospice Of The Southwest Region, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rutland Mental Health Services	VT	Developmental Disabilities Clinic/Center	$0	$122.1M
Community Health Centers Of The Rutland Region Inc	VT	Federally Qualified Health Center (FQHC)	$0	$20.6M
Rutland Mental Health Services, Inc.	VT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$17.7M
Rutland Hospital, Inc.	VT	Psychiatric Hospital Unit	$396.2K	$13.3M
Community Health Centers Of The Rutland Region, Inc.	VT	Pediatrics Physician	$0	$13.6M
Regional Ambulance Service, Inc	VT	Land Ambulance	$1.4M	$5.3M
Bradford Psychiatric Associates. LLC	VT	Addiction Medicine (Internal Medicine) Physician	$0	$4.7M
Community Health Centers Of The Rutland Region, Inc.	VT	Dentist	$0	$4.4M
Community Health Centers Of The Rutland Region, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$4.3M
Community Health Centers Of The Rutland Region Inc	VT	Federally Qualified Health Center (FQHC)	$0	$3.2M

Vna & Hospice Of The Southwest Region, Inc — Billing Profile & Reimbursement Data

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Vna & Hospice Of The Southwest Region, 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