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

Why is the Medicaid comparison limited to New Mexico 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. New Mexico (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.

Silver Lining Services, LLC (NPI 1477645612)

Field	Value
Entity Type	Organization
Organization	Silver Lining Services, LLC
Address	110b E Santa Fe Ave
City	Grants
State	NM
ZIP	87020
Taxonomy	Home Health Agency
NPI Enumerated	September 28, 2006

Payer Source	Total Paid
Medicaid	$31.9M
Medicare	$0

Key Findings

This provider is effectively single-payer: SILVER LINING SERVICES, LLC reports no Medicare billing on file and $31.9M in lifetime Medicaid revenue, indicating its entire recorded federal payer footprint is Medicaid-driven rather than split between Medicare and Medicaid. That concentration means payer-specific policy or rate changes in New Mexico Medicaid would have outsized impact on its revenue base.

Revenue is highly concentrated in three Medicaid codes: 99509 ($14.9M, 46.7% of Medicaid revenue), T1019 ($14.9M, 46.6% of Medicaid revenue), and G9006 ($1.9M, 5.9% of Medicaid revenue); together these top three codes account for 99.3% of the provider's Medicaid revenue. This extreme concentration implies that the business is organized around a very narrow set of service lines rather than a diversified Medicaid service mix.

The service mix suggested by the top codes points to a home-based personal care and ADL support model: 99509 (home visits for ADLs) and T1019 (personal care services, per 15 minutes) together drive the vast majority of revenue, while G9006 (coordinated care fee, home monitoring) represents a smaller but material telemonitoring/care coordination component. The claim volumes and average paid/claim — 99509: 52.2K claims at $286 avg paid/claim; T1019: 248.2K claims at $60 avg paid/claim; G9006: 8.7K claims at $217 avg paid/claim — are consistent with an aide-heavy, high-frequency, time-based billing operation supplemented by remote monitoring fees.

On statewide competitive standing for core codes, SILVER LINING is a modest but not dominant participant: 99509 ranks #22 of 82 providers in-state (74th percentile; typical, unremarkable volume for this code), T1019 ranks #18 of 89 providers in-state (81th percentile; typical, unremarkable volume for this code), and G9006 ranks #25 of 79 providers in-state (69th percentile; typical, unremarkable volume for this code). These rankings indicate above-median scale for its primary personal-care offerings but stop short of market leadership in New Mexico.

Operational scale is reflected in very large claim counts for time-based personal care: 248.2K T1019 claims and 52.2K 99509 claims on file, which, combined with the per-claim averages, produce the largest shares of the $31.9M Medicaid revenue total. The high-frequency, lower-dollar-per-claim profile of T1019 versus the higher per-claim average for 99509 suggests a cost structure and workforce heavily weighted toward frequent, short-interval personal care visits.

The provider has a long tenure in the NPI registry, enumerated on 2006-09-28 (~20 years ago), indicating an established presence in its local market. That longevity, paired with concentrated Medicaid revenue, suggests operational continuity but also a persistent dependency on Medicaid volume and reimbursement for ongoing sustainability.

Smaller ancillary codes generate only marginal revenue: S5110 accounts for $168.6K (0.5% of Medicaid revenue) and ranks #14 of 36 in-state (63th percentile; typical, unremarkable volume for this code), S9999 accounts for $50.1K (0.2% of Medicaid revenue) and ranks #45 of 163 in-state (73th percentile; typical, unremarkable volume for this code), and G9012 contributes $14.6K (0.0% of Medicaid revenue) and ranks #4 of 10 in-state (67th percentile; typical, unremarkable volume for this code). These line items indicate limited non-core revenue streams for family training, tax billing, and niche case management services relative to the provider's dominant personal-care billing.

Medicaid: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99509	A home health provider, such as a registered nurse, or a non nursing practitioner, visits a patient to provide help with activities of daily living, or ADLs, and self care.	52,170	$290	$14.9M
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…	248,200	$60	$14.9M
G9006	Coordinated care fee, home monitoring	8,660	$220	$1.9M
S5110	Home care training, family; per 15 minutes	490	$340	$168.6K
S9999	Sales tax	1,930	$30	$50.1K
G9012	Other specified case management service not elsewhere classified	290	$50	$14.6K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Mexico Distribution

Silver Lining Services, LLC — 0 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Mexico

Full comparison — all codes billed, vs. New Mexico median

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99509	A home health provider, such as a registered nurse, or a non nursing practitioner, visits a patient to provide help with activities of daily living, or ADLs, and self care.	22	80	20,990	$310	$16.4M
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…	18	90	92,900	$70	$13.3M
G9006	Coordinated care fee, home monitoring	25	80	3,840	$190	$2M
S5110	Home care training, family; per 15 minutes	14	40	340	$200	$202.4K
S9999	Sales tax	45	160	800	$10	$25.2K
G9012	Other specified case management service not elsewhere classified	4	10	160	$60	$20.1K

Nearby Providers

Other providers in the same ZIP code as Silver Lining Services, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cibola General Hospital Corporation	NM	Critical Access Hospital	$0	$26.5M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$10.3M
Fedko Emergency Physicians New Mexico LLC	NM	Emergency Medicine Physician	$0	$7.2M
Cibola General Hospital Corporation	NM	Rural Health Clinic/Center	$0	$6.4M
Las Brisas Enterprises, LLC	NM	Dental Clinic/Center	$0	$4.6M
Dialysis Clinic Inc.	NM	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.7M
Michael Rohde	NM	Physical Therapist	$135.1K	$0
Amy Yates	NM	Occupational Therapist	$23.7K	$0

Silver Lining Services, LLC — Billing Profile & Reimbursement Data

Sign up for Silver Lining Services, LLC — Billing Profile & Reimbursement Data policy alerts

Silver Lining Services, LLC — Billing Profile & Reimbursement Data

Sign up for Silver Lining Services, LLC — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References