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

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

Five Star Home Health Care Agency (NPI 1528315397)

Field	Value
Entity Type	Organization
Organization	Five Star Home Health Care Agency
Address	1811 Kings Hwy
City	Brooklyn
State	NY
ZIP	11229
Taxonomy	Home Health Agency
NPI Enumerated	August 10, 2012

Payer Source	Total Paid
Medicaid	$739.1M
Medicare	$0

Key Findings

FIVE STAR HOME HEALTH CARE AGENCY is effectively a Medicaid-focused home health agency with Total Medicaid revenue of $739.1M and Total Medicare revenue: none (no Medicare billing on file). Its NPI was enumerated on 2012-08-10 (~14 years ago), indicating more than a decade of active enrollment in the state market.

Revenue is extremely concentrated: the precomputed top 3 Medicaid codes account for 100.0% of this provider's total Medicaid revenue, with T1019 alone representing 96.5% of Medicaid revenue and T1020 representing 3.4%. This concentration implies that the provider’s financial performance is heavily dependent on reimbursement and utilization trends for a very small set of personal/attendant care codes.

The provider’s code mix shows a clear operational focus on personal care services: T1019 (personal care services, per 15 minutes) and T1020 (personal care services, per diem) together drive virtually all revenue, which is consistent with a business model built around high-volume personal/attendant care delivery rather than skilled nursing. Low-revenue nursing codes (T1030 and S9123, each producing $3.3K and $3.2K respectively and listed as 0.0% of total Medicaid revenue) indicate negligible revenue from general nursing visits.

T1019 volume is very large at 4.6M claims with $155 avg paid/claim and $713.2M revenue, and the provider ranks #21 of 912 in-state (98th percentile; notably above typical state volume for this code), signaling a dominant statewide position for this specific personal-care code. By contrast, T1020’s 83.2K claims and $25.2M revenue rank #47 of 354 (87th percentile; typical, unremarkable volume), and S5125’s 2.7K claims and $339.6K revenue rank #36 of 61 (42th percentile; typical, unremarkable volume), which together portray a business that is dominant on the primary per-15-minute personal care code but more modest on other related codes.

Other billed codes outside the top two are economically immaterial: T1022 ($202.9K revenue), 99199 ($132.6K), T1030 ($3.3K), and S9123 ($3.2K) are all shown as 0.0% of total Medicaid revenue and occupy generally low-to-moderate rank percentiles in-state. This limited diversification suggests most operational resources and compliance attention will be concentrated on the high-volume personal-care workflow tied to T1019/T1020.

From a payer-mix and risk perspective, the absence of Medicare billing makes this an effectively single-payer (Medicaid) operation at scale; reliance on Medicaid reimbursement (Total Medicaid revenue $739.1M) creates exposure to state policy changes, rate adjustments, or program oversight that could materially affect revenue. The provider’s heavy dependence on one code (T1019 at 96.5%) amplifies both operational leverage and reimbursement/regulatory sensitivity.

Operational implications are significant: delivering 4.6M T1019 claims suggests a large frontline workforce and scheduling/logistics footprint oriented around short-interval personal care visits, while the $303 avg paid/claim for T1020 indicates different economics for per-diem personal care. Analysts should prioritize utilization trends, state Medicaid policy, and provider-level documentation practices for T1019 when assessing future revenue stability and competitive positioning.

Medicaid: Complete Services Breakdown

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

7 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…	4,601,230	$160	$713.2M
T1020	Personal care services, per diem, 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…	83,200	$300	$25.2M
S5125	Attendant care services; per 15 minutes	2,650	$130	$339.6K
T1022	Contracted home health agency services, all services provided under contract, per day	1,370	$150	$202.9K
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	510	$260	$132.6K
T1030	Nursing care, in the home, by registered nurse, per diem	40	$90	$3.3K
S9123	Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)	40	$90	$3.2K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New York Distribution

Five Star Home Health Care Agency — 1 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New York

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

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	21	910	108,820	$150	$81.8M
T1020	Personal care services, per diem, 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…	47	350	12,660	$310	$13.1M
S5125	Attendant care services; per 15 minutes	36	60	4,640	$100	$5.7M
S9123	Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)	101	110	1,520	$250	$1.5M
T1030	Nursing care, in the home, by registered nurse, per diem	184	210	450	$120	$728.3K
T1022	Contracted home health agency services, all services provided under contract, per day	63	330	470	$170	$231.1K
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	20	170	80	$20	$68.2K

Nearby Providers

Other providers in the same ZIP code as Five Star Home Health Care Agency, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Interborough Developmental And Consultation Center, Inc.	NY	Case Management Agency	$0	$183.9M
All Heart Homecare Agency	NY	Home Health Agency	$0	$169.6M
Carepro Of Ny Inc	NY	Home Health Agency	$0	$158.2M
Five Star Home Health Care Agency	NY	Home Health Agency	$0	$91.9M
Big Heart	NY	In Home Supportive Care Agency	$0	$86.6M
Incare Home Health Care Group LLC	NY	Home Health Agency	$0	$81M
Carepro Of Big Apple, LLC	NY	Home Health Agency	$0	$78.5M
Big Heart Home Care	NY	Home Health Agency	$0	$72.7M
Scharome Cares, Inc.	NY	Home Health Agency	$0	$72.6M
Easy Touch Home Care	NY	Home Health Agency	$0	$65.8M

Five Star Home Health Care Agency — Billing Profile & Reimbursement Data

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Five Star Home Health Care Agency — 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