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

Why is the Medicaid comparison limited to South Dakota 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. South Dakota (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.

South Dakota Home Care, Inc. (NPI 1568899425)

Field	Value
Entity Type	Organization
Organization	South Dakota Home Care, Inc.
Address	1400 W Russell St
City	Sioux Falls
State	SD
ZIP	57104
Taxonomy	Respite Care
NPI Enumerated	October 8, 2013

Payer Source	Total Paid
Medicaid	$8.6M
Medicare	$0

Key Findings

This provider effectively operates as a Medicaid-only biller: there is no Medicare billing on file while total Medicaid revenue is $8.6M, indicating that Medicaid is the dominant and near-exclusive payer for its services. The absence of Medicare activity implies the organization's revenue and growth considerations are driven almost entirely by state-managed long-term services and supports programs rather than fee-for-service Medicare channels.

Revenue is highly concentrated in a small set of service codes: the precomputed top 3 Medicaid codes (T1019, T1000, S5130) account for 85.2% of the provider's Medicaid revenue. Those three codes individually account for $3.4M (39.3%), $2.2M (25.8%), and $1.7M (20.1%) respectively, showing reliance on a narrow mix of per-15-minute personal care, private duty nursing, and homemaker services for the vast majority of cash flow.

The code mix and descriptions point to a hands-on home- and community-based services operation: T1019 (personal care services, per 15 minutes), T1000 (private duty / independent nursing service(s), up to 15 minutes), and S5130 (homemaker service, per 15 minutes) together suggest the organization provides both personal care aides and licensed private-duty nursing as core offerings. This mix indicates capacity to deliver long-duration, minute-level billed supports rather than episodic medical procedures, aligning with a Respite Care taxonomy and in-home support model.

For the largest code, T1019, the provider bills at scale (31.6K claims, $107 avg paid/claim, $3.4M revenue) and ranks #4 of 33 providers in-state (91th percentile; typical, unremarkable volume for this code). That ranking places the organization among the higher-volume state providers for personal care, but the supplied label (“typical, unremarkable volume”) suggests this scale is consistent with other established providers rather than an extreme outlier.

Private-duty nursing represented by T1000 (10.4K claims, $213 avg paid/claim, $2.2M revenue) also shows substantial activity and a meaningful revenue contribution; it ranks #5 of 28 providers in-state (85th percentile; typical, unremarkable volume for this code). Together with T1019, this indicates a two-pronged service approach of aide-level personal care and licensed nursing services that together drive most of the business.

Homemaker and companion services are additional high-volume lines: S5130 (29.8K claims, $58 avg paid/claim, $1.7M revenue) ranks #4 of 48 providers in-state (94th percentile; notably above typical state volume for this code), and S5135 (14.8K claims, $86 avg paid/claim, $1.3M revenue; 14.8% of total Medicaid revenue) ranks #2 of 21 providers in-state (95th percentile; notably above typical). These percentiles and ranks indicate the provider is a regional leader on homemaker and companion services, with volumes that exceed typical peers in South Dakota.

Ancillary services appear minimal: S5161 (emergency response system; 134 claims, $36 avg paid/claim, $4.8K revenue; 0.1% of total Medicaid revenue) contributes a vanishing share of revenue and ranks #8 of 8 providers in-state (0th percentile; typical, unremarkable volume for this code). The provider’s product mix is therefore concentrated in labor-intensive personal and nursing care rather than technology-enabled monitoring or emergency-response subscriptions.

The NPI was enumerated on 2013-10-08 (~13 years ago), signaling a decade-plus operating history; combined with $8.6M in Medicaid lifetime revenue and the concentration in recurring, minute-level service codes, this suggests an established, Medicaid-focused home-care operator with sustained delivery of in-home personal, homemaker, companion, and private-duty nursing 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
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…	31,590	$110	$3.4M
T1000	Private duty / independent nursing service(s) - licensed, up to 15 minutes	10,430	$210	$2.2M
S5130	Homemaker service, nos; per 15 minutes	29,820	$60	$1.7M
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	14,800	$90	$1.3M
S5161	Emergency response system; service fee, per month (excludes installation and testing)	130	$40	$4.8K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Dakota Distribution

South Dakota Home Care, Inc. — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. South Dakota median

5 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…	4	30	6,050	$80	$894.1K
T1000	Private duty / independent nursing service(s) - licensed, up to 15 minutes	5	30	2,790	$120	$627.7K
S5130	Homemaker service, nos; per 15 minutes	4	50	5,130	$70	$607.5K
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	2	20	2,520	$110	$518.5K
S5161	Emergency response system; service fee, per month (excludes installation and testing)	8	10	870	$40	$120.2K

Nearby Providers

Other providers in the same ZIP code as South Dakota Home Care, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sanford Medical Center	SD	Clinical Medical Laboratory	$1.8M	$18M
Lutheran Social Services Of Sd	SD	Psychiatric Residential Treatment Facility	$0	$15.7M
Iwe Inc.	SD	In Home Supportive Care Agency	$0	$15M
City Of Sioux Falls	SD	Federally Qualified Health Center (FQHC)	$0	$8.6M
Sanford Clinic	SD	Diagnostic Radiology Physician	$0	$6M
Paramedics Logistics South Dakota LLC	SD	Land Ambulance	$1.9M	$3.6M
Sanford Healthcare Accessories, LLC	SD	Durable Medical Equipment & Medical Supplies	$0	$3.1M
Behavior Care Specialists, Inc	SD	Behavior Analyst	$0	$2.9M
Asana Integrated Medical Group PC	SD	Psychiatry Physician	$0	$2.5M
Rehabilitation Medical Supply	SD	Durable Medical Equipment & Medical Supplies	$0	$2.1M

South Dakota Home Care, Inc. — Billing Profile & Reimbursement Data

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South Dakota Home Care, 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