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

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

Children's Nursing Specialties, Inc. (NPI 1467544833)

Field	Value
Entity Type	Organization
Organization	Children's Nursing Specialties, Inc.
Address	9900 Sw Greenburg Rd
City	Portland
State	OR
ZIP	97223
Taxonomy	Nursing Care Agency
NPI Enumerated	September 29, 2006

Payer Source	Total Paid
Medicaid	$18.9M
Medicare	$0

Key Findings

CHILDREN'S NURSING SPECIALTIES, INC. is effectively a Medicaid-focused provider: there is no Medicare billing on file while lifetime Medicaid revenue is $18.9M. The practice has long tenure, with its NPI enumerated 2006-09-29 (~20 years ago), indicating established operations in Oregon.

Revenue is highly concentrated in a very small set of Medicaid codes: the top three Medicaid codes account for 99.4% of the provider's total Medicaid revenue, with T1002 alone representing $16.7M (88.2% of Medicaid revenue). This concentration means changes to reimbursement or utilization for those codes would disproportionately affect overall revenue.

The code mix and descriptions point to a skilled, time-based home nursing operation: T1002 (Rn services, up to 15 minutes) and T1003 (Lpn/lvn services, up to 15 minutes) together drive the vast majority of revenue, suggesting the provider delivers frequent, short-interval skilled nursing visits. The high average paid amounts per claim—T1002 at $6864 avg paid/claim and T1003 at $3278 avg paid/claim—underscore that these services are the principal revenue drivers.

Competitive standing for the top codes is mixed within Oregon: for T1002 the provider ranks #8 of 54 (87th percentile) which places it as a solid statewide participant but not a market leader for that code. For T1003 it ranks #1 of 2 (100th percentile), indicating top placement among a very small in-state peer group; this leadership is notable but occurs in a narrow competitive set.

Volume metrics show significant operational activity in time-based and training services: T1002 has 2.4K claims, T1003 has 556 claims, S5115 (home care training, non-family; per 15 minutes) has 3.3K claims, and T1016 (case management, each 15 minutes) has 2.5K claims. The presence of many claims billed by 15-minute increments suggests a business model built around frequent, short-duration patient encounters and caregiver training.

Ancillary and non-skilled services contribute only a small share of revenue: S5115 accounts for $296.7K (1.6% of Medicaid revenue) and T1016 accounts for $121K (0.6% of Medicaid revenue), so training and case management are present but not major revenue diversifiers. This indicates limited revenue diversification beyond core RN/LPN home nursing.

Statistically, the provider’s code-level volumes are described as typical and unremarkable within their peer groups rather than extreme outliers; each listed code is labeled as "typical, unremarkable volume" and percentile positions fall in middle-to-high ranges rather than extreme tails. From a monitoring perspective, there are no built-in statistical red flags in the supplied rankings, but the overall Medicaid dependence increases sensitivity to policy or reimbursement shifts.

For payer and provider analysts, the key operational and financial risk to track is T1002-driven exposure: because T1002 represents $16.7M (88.2% of Medicaid revenue) and the top three codes represent 99.4% of Medicaid revenue, any utilization, authorization, or rate changes for these codes would materially affect revenue. Given the lack of Medicare billing on file, any strategic or regulatory movement in Medicaid programs in Oregon should be prioritized when assessing financial stability and network impact.

Medicaid: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1002	Rn services, up to 15 minutes	2,430	$6,860	$16.7M
T1003	Lpn/lvn services, up to 15 minutes	560	$3,280	$1.8M
S5115	Home care training, non-family; per 15 minutes	3,300	$90	$296.7K
T1016	Case management, each 15 minutes	2,520	$50	$121K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Oregon Distribution

Children's Nursing Specialties, Inc. — 1 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oregon

Full comparison — all codes billed, vs. Oregon median

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1003	Lpn/lvn services, up to 15 minutes	1	10	450	$3,200	$1.5M
T1002	Rn services, up to 15 minutes	8	50	660	$560	$678.1K
S5115	Home care training, non-family; per 15 minutes	2	20	420	$120	$158.8K
T1016	Case management, each 15 minutes	46	210	410	$50	$126.4K

Nearby Providers

Other providers in the same ZIP code as Children's Nursing Specialties, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
New Narrative	OR	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$46.9M
Crc Health Oregon, LLC	OR	Methadone Clinic	$125.2K	$14.5M
Recovery Works Nw LLC	OR	Multi-Specialty Clinic/Center	$0	$12.1M
Neighborhood Health Center	OR	Federally Qualified Health Center (FQHC)	$0	$11.3M
Maxim Healthcare Services, Inc.	OR	Home Health Agency	$0	$10.8M
Sound Health Medical Supply	OR	Durable Medical Equipment & Medical Supplies	$0	$9.5M
Aiden Healthcare LLC	OR	Community Based Hospice Care Agency	$0	$5.9M
Women's Healthcare Associates, LLC	OR	Specialist	$0	$5.6M
Pacific Footwear Company, Inc.	OR	Customized Equipment (DME)	$0	$4.3M
Cynthia Gulick, PC	OR	Family Medicine Physician	$0	$3.9M

Children's Nursing Specialties, Inc. — Billing Profile & Reimbursement Data

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Children's Nursing Specialties, 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