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.

Consumer Direct Care Network Virginia (NPI 1538649983)

Field	Value
Entity Type	Organization
Organization	Consumer Direct Care Network Virginia
Address	100 Consumer Direct Way
City	Missoula
State	MT
ZIP	59808
Taxonomy	Home Health Agency
NPI Enumerated	August 15, 2018

Payer Source	Total Paid
Medicaid	$2.1B
Medicare	$0

Key Findings

This provider has no Medicare billing on file and is effectively a single-payer Medicaid operator, with total Medicaid revenue of $2.11B reported in the lifetime file. The absence of Medicare activity combined with a large Medicaid footprint indicates its business is concentrated almost entirely in state Medicaid-managed long-term services and supports.

Revenue is highly concentrated: the precomputed top 3 Medicaid codes account for 99.3% of this provider's total Medicaid revenue, driven primarily by S5126 ($1.77B, 84.0%), followed by S5150 ($229.2M, 10.8%) and S5136 ($94.3M, 4.5%). These three codes together constitute the vast majority of receipts, leaving minimal revenue diversification across other Medicaid codes.

The code mix (S5126 – attendant care services; S5150 – unskilled respite care; S5136 – companion care) indicates the organization operates as a high-volume home- and personal-care agency focused on attendant and aide-based services rather than clinical skilled nursing or therapy. The predominance of per-diem attendant and companion codes suggests day-to-day personal assistance and non-skilled respite are the operational core services.

CONSUMER DIRECT CARE NETWORK VIRGINIA is a dominant statewide provider for its leading service lines: S5126 ranks #1 of 16 providers in-state and is labeled an extreme outlier (100th percentile, far above typical state volume for this code), and S5150 ranks #1 of 5 providers in-state and is notably above typical state volume (100th percentile). S5136 also ranks #1 of 1 providers statewide, though no peer-volume comparison is available; together these ranks signal market leadership and outsized scale in Medicaid personal-care segments.

Claim volume metrics reinforce the operational scale: S5126 shows 17.9M claims associated with the $1.77B revenue pool, and S5150 shows 3.1M claims for $229.2M, indicating very high utilization of attendant and respite units. This pattern—large per-diem and interval-based claim counts—suggests broad enrollment or episode counts rather than small, episodic skilled services.

Smaller, non-core codes contribute negligible revenue relative to the top three: G2021 accounts for $15.6M (0.7% of Medicaid revenue) and 99199 accounts for $5.5K (0.0%). Both of these codes rank #1 of 1 providers in-state with no state peer comparison available, underscoring that the provider’s measurable competitive footprint is concentrated in a few specific Medicaid service codes.

The provider’s Medicaid concentration creates operational sensitivity to state Medicaid policy, rate-setting, and utilization-management changes that target attendant and respite service lines; any regulatory shifts affecting per-diem attendant care reimbursement or eligibility criteria could materially affect revenue given the $2.11B Medicaid base and the 99.3% concentration in three codes. Analysts should prioritize monitoring state policy and program design in these service categories when modeling near-term financial or utilization risk.

Tenure on the NPI file is relatively recent in system terms: the NPI was enumerated on 2018-08-15 (~8 years ago), indicating the organization scaled rapidly to achieve multi-billion-dollar Medicaid revenue within that operating window. That speed-to-scale, coupled with the extreme outlier status on S5126, suggests deliberate growth focused on high-volume personal care lines rather than gradual expansion across a broad mix of clinical services.

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5126	Attendant care services; per diem	17,914,320	$100	$1.8B
S5150	Unskilled respite care, not hospice; per 15 minutes	3,096,640	$70	$229.2M
S5136	Companion care, adult (e.g., iadl/adl); per diem	1,136,420	$80	$94.3M
G2021	Health care practitioners rendering treatment in place (tip)	14,060	$1,110	$15.6M
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	1,100	$10	$5.5K

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

Consumer Direct Care Network Virginia — 2 of 5 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

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5126	Attendant care services; per diem	1	20	5,400	$100	$111M
S5136	Companion care, adult (e.g., iadl/adl); per diem	1	10	1,136,420	$80	$93.9M
S5150	Unskilled respite care, not hospice; per 15 minutes	1	10	3,560	$80	$46.8M
G2021	Health care practitioners rendering treatment in place (tip)	1	10	14,060	$1,110	$15.6M
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	1	10	1,100	$1	$5.5K

Nearby Providers

Other providers in the same ZIP code as Consumer Direct Care Network Virginia, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Consumer Direct Personal Care, LLC	MT	In Home Supportive Care Agency	$0	$49.1M
Hkj Inc	MT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$15.2M
We Care Behavioral Health LLC	MT	Clinic/Center	$0	$14.8M
Partners In Home Care, Inc	MT	Nursing Care Agency	$0	$13M
Hkj Inc	MT	Case Management Agency	$0	$11.6M
Sunburst Health LLC	MT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$6.1M
Providence Health & Services Mt	MT	Family Medicine Physician	$0	$4.9M
Welltower Tenant Group LLC	MT	Assisted Living Facility	$0	$3.8M
Norco, Inc	MT	Durable Medical Equipment & Medical Supplies	$0	$3.8M
County Of Missoula School Dist 4	MT	Local Education Agency (LEA)	$0	$3.4M

Consumer Direct Care Network Virginia — Billing Profile & Reimbursement Data

Sign up for Consumer Direct Care Network Virginia — Billing Profile & Reimbursement Data policy alerts

Consumer Direct Care Network Virginia — Billing Profile & Reimbursement Data

Sign up for Consumer Direct Care Network Virginia — 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