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

Why is the Medicaid comparison limited to Montana 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. Montana (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 Plus Health Care Inc (NPI 1528088853)

Field	Value
Entity Type	Organization
Organization	A Plus Health Care Inc
Address	1310 S Main St
City	Kalispell
State	MT
ZIP	59901
Taxonomy	In Home Supportive Care Agency
NPI Enumerated	July 20, 2006

Payer Source	Total Paid
Medicaid	$28.2M
Medicare	$0

Key Findings

A PLUS HEALTH CARE INC is effectively a Medicaid-focused provider: lifetime Medicare revenue is reported as none while total Medicaid revenue is $28.2M, so its commercial/Medicare exposure is negligible and its financial footprint is concentrated in state Medicaid programs. This payer mix makes the organization highly sensitive to Montana Medicaid policy and reimbursement changes.

Revenue concentration is extremely high: the precomputed top 3 Medicaid codes account for 84.0% of this provider's total Medicaid revenue, indicating most dollars flow through a small set of service lines rather than a broad array of codes. Those top codes are dominated by personal-care and skilled nursing services.

The single largest Medicaid revenue source is T1019 (Personal care services), which generated $17.6M or 62.2% of the provider’s Medicaid revenue. Despite this large dollar share, T1019 is characterized in the state as a typical volume position (ranks #4 of 38 providers in-state, 92th percentile; typical, unremarkable volume for this code), suggesting A PLUS’s dominance in dollars comes from high unit volume rather than outlier per-unit payments.

A PLUS is a statewide leader on multiple skilled-nursing and supportive-care codes: T1002 (RN services) produced $4.4M (15.4% of Medicaid revenue) and ranks #1 of 7 providers in-state (100th percentile; notably above typical state volume), while T1003 (LPN/LVN services) and S5135 (Companion care) also rank #1 in their peer groups (T1003: $1.6M, 5.7% of revenue; S5135: $1.8M, 6.3% of revenue), indicating the provider is a dominant player for nursing and companion-service lines in Montana.

The mix of high-volume per-15-minute codes (T1019, T1002, T1003, S5135) and per-diem attendant care (S5126) points to an operational model built around frequent in-home visits and per-diem attendant services rather than episodic facility-based care. High claim counts—e.g., T1019 with 358.6K claims and T1002 with 18.2K claims—underscore a labor-intensive service delivery model that likely depends on scalable caregiver staffing and scheduling.

Transportation and mileage services are a material secondary line: A0080 (18K claims, $143.6K revenue) and S0215 (12.2K claims, $85.5K revenue) are both present and rank above typical state volumes (A0080 ranks #3 of 13, 83th percentile; S0215 ranks #3 of 22, 90th percentile; notably above typical state volume), suggesting A PLUS operates or coordinates substantial non-emergency transport and mileage reimbursement activity in addition to direct care.

Operationally, the provider shows a contrast between dominance in several specialty supportive-care categories and a more typical position on the single largest personal-care code: it is a major state player for RN, LPN, and companion care (multiple #1 ranks) while its biggest revenue driver T1019 is high in absolute dollars but described as typical in state volume. That pattern suggests strategic strength in clinical and companion offerings even as personal-care services remain broadly competitive in the market.

The organization has been established for a sustained period: NPI enumerated on 2006-07-20 (~20 years ago), indicating long tenure in the market which can support experienced operations, caregiver networks, and payer relationships that align with the provider’s demonstrated Medicaid-focused service mix.

Medicaid: Complete Services Breakdown

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	358,590	$50	$17.6M
T1002	Rn services, up to 15 minutes	18,230	$240	$4.4M
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	8,500	$210	$1.8M
T1003	Lpn/lvn services, up to 15 minutes	16,280	$100	$1.6M
S5126	Attendant care services; per diem	30,570	$30	$1M
T2001	Non-emergency transportation; patient attendant/escort	17,220	$40	$671.5K
S5150	Unskilled respite care, not hospice; per 15 minutes	3,560	$160	$558.9K
H2019	Therapeutic behavioral services, per 15 minutes	2,960	$80	$222.3K
A0080	Non-emergency transportation, per mile - vehicle provided by volunteer (individual or organization), with no vested interest	17,950	$10	$143.6K
T2021	Day habilitation, waiver; per 15 minutes	1,860	$80	$141.3K

Showing 1–10 of 16

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Montana Distribution

A Plus Health Care Inc — 4 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. Montana median

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5126	Attendant care services; per diem	4	20	5,400	$100	$111M
S5150	Unskilled respite care, not hospice; per 15 minutes	3	10	3,560	$80	$46.8M
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…	4	40	6,240	$130	$14.6M
T2021	Day habilitation, waiver; per 15 minutes	22	50	1,630	$1,010	$2.6M
T1002	Rn services, up to 15 minutes	1	10	3,840	$420	$2.2M
T2033	Residential care, not otherwise specified (nos), waiver; per diem	4	10	680	$1,190	$1.5M
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	1	10	1,900	$450	$1.4M
T1003	Lpn/lvn services, up to 15 minutes	1	10	1,570	$170	$823K
H2019	Therapeutic behavioral services, per 15 minutes	20	40	3,280	$50	$759.9K
T2001	Non-emergency transportation; patient attendant/escort	1	10	1,730	$50	$264.4K

Showing 1–10 of 16

Nearby Providers

Other providers in the same ZIP code as A Plus Health Care Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Flathead Industries	MT	Community/Behavioral Health Agency	$0	$40.7M
Gabriel Dawson	MT	Pediatric Dentistry	$0	$10.7M
Kalispell Regional Medical Center Inc	MT	General Acute Care Hospital	$0	$8.8M
Benefis Community Care, Inc.	MT	Case Management Agency	$0	$6.8M
Kiddsteeth PLLC	MT	Pediatric Dentistry	$0	$6.7M
Kalispell Regional Medical Center, Inc	MT	Clinic/Center	$0	$6.2M
Kalispell Public Schools	MT	Local Education Agency (LEA)	$0	$6M
Kalispell Regional Medical Center Inc	MT	Psychiatry Physician	$0	$5.9M
Kalispell Regional Medical Center Inc	MT	Emergency Medicine Physician	$0	$5.4M
Sunburst Community Service Foundation, Inc	MT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$5.3M

A Plus Health Care Inc — Billing Profile & Reimbursement Data

Sign up for A Plus Health Care Inc — Billing Profile & Reimbursement Data policy alerts

A Plus Health Care Inc — Billing Profile & Reimbursement Data

Sign up for A Plus Health Care Inc — 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