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

Why is the Medicaid comparison limited to Colorado 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. Colorado (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 Physicians Home Care (NPI 1417486531)

Field	Value
Entity Type	Organization
Organization	A Physicians Home Care
Address	905 Garden Of The Gods Rd Ste F
City	Colorado Springs
State	CO
ZIP	80907
Taxonomy	In Home Supportive Care Agency
NPI Enumerated	June 12, 2017

Payer Source	Total Paid
Medicaid	$247.9M
Medicare	$0

Key Findings

A PHYSICIANS HOME CARE is an In Home Supportive Care Agency based in COLORADO SPRINGS, CO with an NPI enumerated on 2017-06-12 (~9 years ago). The provider reports no Medicare billing on file and is effectively a Medicaid-focused operator, with total Medicaid revenue of $247.9M driving its entire reported lifetime revenue.

Revenue is extremely concentrated in a narrow set of Medicaid codes: the precomputed top three Medicaid codes account for 100.0% of this provider's total Medicaid revenue. Those codes break down as H0038 — $234.4M (94.5% of Medicaid revenue), T1019 — $12.2M (4.9%), and S5130 — $1.4M (0.6%), per the supplied figures.

The code mix and taxonomy indicate a service model centered on in-home supportive services and peer/self-help supports rather than traditional skilled home health care. H0038 (Self-help/peer services, per 15 minutes), T1019 (Personal care services, per 15 minutes), and S5130 (Homemaker service, per 15 minutes) together point to an operational focus on frequent, unit-based personal and peer-support visits delivered in community or home settings.

H0038 is the dominant revenue driver: 789.1K claims and $234.4M in revenue (94.5% of the provider's Medicaid total) and it ranks #2 of 276 providers in-state (100th percentile; extreme outlier). This placement and volume signal that the provider is a major statewide participant for H0038 services and operates at a scale far above typical state volume for that code.

T1019 represents a secondary but meaningful service line with 169.5K claims and $12.2M in revenue (4.9% of Medicaid revenue); the provider ranks #12 of 475 in-state (98th percentile; notably above typical state volume). While much smaller than H0038 in revenue share, the rank shows the provider is a significant regional player in personal care services.

S5130 is a minor revenue contributor at 30.3K claims and $1.4M (0.6% of Medicaid revenue) and ranks #28 of 342 in-state (92th percentile; typical, unremarkable volume). This suggests homemaker services are offered at customary scale relative to peers and are not the core business.

Unit-level reimbursement patterns reinforce the operational emphasis on peer/self-help services: H0038 pays an average of $297 per claim, compared with $72 avg paid/claim for T1019 and $45 avg paid/claim for S5130. The combination of very high H0038 claim volume and a substantially higher average paid/claim for that code explains why a single code dominates total Medicaid revenue.

The lack of any Medicare billing on file combined with $247.9M in Medicaid revenue makes the provider effectively single-payer dependent on Medicaid; this concentration could limit revenue diversification and makes the entity's financial exposure sensitive to Medicaid policy changes, utilization management, or rate adjustments for H0038. Given the extreme outlier status on H0038, analysts should treat changes in Medicaid program rules or scrutiny of peer/self-help reimbursement as material to this provider's revenue outlook.

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0038	Self‑help/peer services, per 15 minutes	789,150	$300	$234.4M
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…	169,540	$70	$12.2M
S5130	Homemaker service, nos; per 15 minutes	30,310	$50	$1.4M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

A Physicians Home Care — 2 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0038	Self‑help/peer services, per 15 minutes	2	280	2,330	$210	$4.8M
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…	12	480	5,200	$150	$3.5M
S5130	Homemaker service, nos; per 15 minutes	28	340	3,530	$80	$1.2M

Nearby Providers

Other providers in the same ZIP code as A Physicians Home Care, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
A Circle Of Care Colorado, LLC.	CO	In Home Supportive Care Agency	$0	$101.8M
Goodwill Of Colorado	CO	Home Health Agency	$0	$33.3M
Stellar Care And Services, LLC	CO	Child Intellectual and/or Developmental Disabilities Respite Care	$0	$31M
Catholic Health Initiatives Colorado	CO	General Acute Care Hospital	$0	$25.2M
American Medical Response Of Colorado Inc	CO	Ambulance	$3.4M	$21.6M
Special Kids Special Families	CO	Developmentally Disabled Services Day Training Agency	$0	$24.8M
Lucas Inc	CO	Respite Care	$0	$23.6M
Achieve Whole Recovery, PC	CO	Specialist	$0	$22.7M
Loving Care Agency, Inc.	CO	In Home Supportive Care Agency	$0	$18.2M
United Seating And Mobility LLC	CO	Durable Medical Equipment & Medical Supplies	$0	$15.4M

A Physicians Home Care — Billing Profile & Reimbursement Data

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A Physicians Home Care — 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