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

Why is the Medicaid comparison limited to Minnesota 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. Minnesota (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.

Midwest Quality Home Care, Inc. (NPI 1609961747)

Field	Value
Entity Type	Organization
Organization	Midwest Quality Home Care, Inc.
Address	1433 E Franklin Avenue
City	Minneapolis
State	MN
ZIP	55404
Taxonomy	Home Health Agency
NPI Enumerated	October 4, 2006

Payer Source	Total Paid
Medicaid	$66.7M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-only operator: there is no Medicare billing on file while total Medicaid revenue is $66.7M, indicating Medicaid is the sole material payer supporting the business. Analysts should treat this organization as single-payer dependent for revenue analysis and network negotiations.

Revenue is extremely concentrated in a narrow set of service codes: the precomputed top three Medicaid codes account for 100.0% of this provider's Medicaid revenue. In particular, T1019 drives $59.9M (89.8% of Medicaid revenue), S5130 contributes $5.7M (8.5%), and H2015 contributes $1.1M (1.7%), creating a high concentration risk if reimbursement or utilization for these codes changes.

The services billed indicate a labor-intensive, community-based personal care operation: T1019 (personal care services, per 15 minutes) and S5130 (homemaker services, per 15 minutes) together dominate the mix, reflecting frequent, short-interval direct-care visits in home or community settings. The presence of H2015 (comprehensive community support services, per 15 minutes) signals the provider also offers some broader community support/behavioral support services in addition to core personal-care and homemaker offerings.

Operational scale is substantial by claims volume: the provider reported 981.7K claims for T1019, 161.8K claims for S5130, and 13.2K claims for H2015. This throughput profile implies significant staffing, scheduling, and logistics requirements to deliver high-frequency per-15-minute services across its service area.

On competitive standing within the state, the provider is a major player for its top lines: T1019 ranks #4 of 225 providers in-state (99th percentile; extreme outlier), and S5130 ranks #6 of 236 providers in-state (98th percentile; notably above typical). By contrast, H2015 is more typical in scale (rank #20 of 139, 86th percentile; typical, unremarkable volume), so competitive dominance is concentrated in personal-care and homemaker services rather than comprehensive community support.

The provider has an established market presence with an NPI enumeration date of 2006-10-04 (~20 years ago), suggesting long tenure in the market that likely supports existing provider networks, referral relationships, and operational capacity. Long tenure plus high-volume billing patterns are consistent with an entrenched home- and community-based services operator.

Because nearly $59.9M (89.8%) of Medicaid revenue derives from T1019 and the top three codes together represent 100.0% of Medicaid revenue, the organization faces concentrated payer/policy risk: changes to state Medicaid coverage, rates, or per-15-minute billing rules for these codes would have outsized financial impact. Analysts should prioritize scenario modeling of Medicaid rate or rule changes for T1019 and S5130.

The combination of extreme-volume claims (981.7K for T1019) and the “extreme outlier” statistical label suggests payers and plan analysts should monitor utilization patterns, documentation, and workforce capacity as part of oversight and contracting discussions. High-volume, short-interval service models create operational and compliance focus areas distinct from episodic medical care models.

Medicaid: Complete Services Breakdown

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

3 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…	981,680	$60	$59.9M
S5130	Homemaker service, nos; per 15 minutes	161,780	$40	$5.7M
H2015	Comprehensive community support services, per 15 minutes	13,250	$90	$1.1M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Minnesota Distribution

Midwest Quality Home Care, Inc. — 2 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. Minnesota median

3 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	230	37,580	$70	$8.6M
S5130	Homemaker service, nos; per 15 minutes	6	240	7,130	$40	$1M
H2015	Comprehensive community support services, per 15 minutes	20	140	2,300	$110	$700.1K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nu-way House Inc	MN	Substance Abuse Rehabilitation Facility	$0	$200.8M
Childrens Health Care	MN	Children's Hospital	$0	$100M
Midwest Home Health Care, Inc.	MN	Home Health Agency	$0	$73.5M
Regents Of The University Of Minnesota	MN	Federally Qualified Health Center (FQHC)	$0	$55.2M
Minnesota Professional Health Services,inc	MN	Home Health Agency	$0	$51.9M
Park Ave Center Inc	MN	Substance Use Disorder Rehabilitation Clinic/Center	$0	$50.8M
Minnesota Quality Care, Inc.	MN	Home Health Agency	$0	$48.4M
Direct Home Health Care, Inc.	MN	Home Health Agency	$0	$30.7M
Aaa A-z Friendly Languages Inc	MN	Interpreter	$0	$29.4M
Comfort Services LLC	MN	Home Health Agency	$0	$29.1M

Midwest Quality Home Care, Inc. — Billing Profile & Reimbursement Data

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Midwest Quality 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