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

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

Home-care Pca, Inc. — Billing Profile & Reimbursement Data

NPI 1407993033 · Thibodaux, LA · Community Based Hospice Care Agency

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Home-care Pca, Inc. is a community based hospice care agency provider located in Thibodaux, Louisiana. This profile covers 0 Medicare and 1 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

(source: NPPES NPI Registry)

Home-care Pca, Inc. — Billing Profile & Reimbursement Data

NPI 1407993033 · Thibodaux, LA · Community Based Hospice Care Agency

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(source: NPPES NPI Registry)

Field	Value
Entity Type	Organization
Organization	Home-care Pca, Inc.
Address	353 W. Main St.
City	Thibodaux
State	LA
ZIP	70302
Taxonomy	Community Based Hospice Care Agency
NPI Enumerated	January 31, 2007

Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

Payer Source	Total Paid
Medicaid	$28.2M
Medicare	$0

This provider is effectively a single-payer Medicaid operator: there is no Medicare billing on file and the provider reports Total Medicaid revenue of $28.2M. The absence of Medicare activity means all recorded public-payor volume and financial exposure is concentrated in the Medicaid program.

Revenue concentration is extreme: the precomputed top 3 Medicaid codes account for 100.0% of this provider's total Medicaid revenue, and that concentration is entirely captured by a single code, S5125, which the dataset lists as generating $28.2M in revenue (100.0% of this provider's total Medicaid revenue). This indicates virtually no revenue diversification across Medicaid procedure lines.

S5125 (Attendant care services; per 15 minutes) dominates the operational footprint: the file shows 204.2K claims and a $138 avg paid/claim associated with S5125. Billing dominated by a per-15-minute attendant-care code points to a service model focused on high-frequency, time-based personal care or attendant services rather than episodic procedural care.

The provider is a high-volume in-state participant for S5125: it ranks #7 of 486 providers in-state and sits at the 99th percentile, described as notably above typical state volume for this code. That ranking signals a major market position in Louisiana for attendant-care services under Medicaid, making the organization a significant competitor among community-based personal care agencies.

From an operational scale perspective, 204.2K claims at a $138 avg paid/claim producing $28.2M in Medicaid revenue reflects sustained, heavy utilization of short-interval attendant-care units. This claim and payment profile suggests staffing and scheduling models built around frequent, time-based care events and robust claims-processing capacity to support that throughput.

The combination of a Community Based Hospice Care Agency taxonomy and exclusive Medicaid billing for attendant-care (S5125) suggests the provider’s day-to-day business is oriented toward delivering home-based personal/attendant care services under Medicaid rather than reimbursed Medicare hospice or procedural lines. The taxonomy plus billing mix should be interpreted as consistent with a community-focused home care operator whose revenue base is driven by time-based attendant services.

Concentration risk is material: with 100.0% of Medicaid revenue tied to S5125 and no Medicare revenue to diversify payer exposure, the provider is vulnerable to Medicaid rate changes, policy edits to attendant-care reimbursement, or utilization-management initiatives targeting S5125. Analysts should monitor state-level policy and reimbursement developments for attendant-care services as potential drivers of near-term revenue variability.

The NPI was enumerated 2007-01-31 (~19 years ago), indicating a long-tenured presence in the market. That tenure, combined with the provider’s top-tier in-state ranking for S5125, is consistent with an established operational footprint and relationships within the state Medicaid ecosystem.

Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

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

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5125	Attendant care services; per 15 minutes	204,160	$140	$28.2M

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

Full comparison — all codes billed, vs. Louisiana median

Home-care Pca, 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

Frequently Asked Questions

References