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

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

Agespan, Inc. (NPI 1619007630)

Field	Value
Entity Type	Organization
Organization	Agespan, Inc.
Address	280 Merrimack St
City	Lawrence
State	MA
ZIP	01843
Taxonomy	Case Management Agency
NPI Enumerated	March 7, 2007

Payer Source	Total Paid
Medicaid	$163.5M
Medicare	$0

Key Findings

This provider is effectively a single-payer Medicaid operator: no Medicare billing is on file while lifetime Medicaid revenue is $163.5M. That imbalance indicates AGESPAN, INC. is focused on state Medicaid-funded long-term services and supports rather than traditional Medicare-covered medical services, and its NPI has been active since 2007-03-07 (~19 years ago), supporting an established market presence.

Revenue is highly concentrated: the top 3 Medicaid codes by revenue account for 62.6% of total Medicaid revenue. Those codes are G0156 ($51.7M, 31.6%), T1019 ($27.6M, 16.9%), and S5130 ($23.2M, 14.2%), so a small set of home- and personal-care services drive the majority of dollars.

The code mix and volumes indicate a workforce- and encounter-intensive home- and community-based services operation. High claim counts for per-15-minute and per-meal codes — G0156 with 66.8K claims, T1019 with 205.8K claims, and S5130 with 251.8K claims — point to large-scale personal care, homemaker, and home-aide delivery rather than episodic clinical care.

Competitive standing is strong in several in-state service lines: S5130 ranks #5 of 162 and is in the 98th percentile (notably above typical state volume), S5135 ranks #3 of 74 at the 97th percentile (notably above typical state volume), and S5165 ranks #2 of 35 at the 97th percentile (notably above typical state volume). By contrast, G0156 ranks #30 of 193 at the 85th percentile (labeled typical, unremarkable volume) and therefore AGESPAN is a market leader for homemaker/companion/home-modification services while being a more typical participant in home-health-aide billing.

The provider combines high-claim-volume, lower-unit payments with some higher-unit services, indicating a mixed reimbursement structure that affects margin and staffing needs. Examples: S5130 averages $92 paid/claim across 251.8K claims, T1019 averages $134 paid/claim across 205.8K claims, and G0156 averages $773 paid/claim across 66.8K claims — this mix suggests operational emphasis on both high-frequency direct-care shifts and some higher-paid skilled or aide services.

Beyond the top three, AGESPAN bills across a broad set of Medicaid HCBS and support codes, reflecting integrated community service offerings. Notable additional lines include S5102 day care services ($14.9M, 9.1%), T2022 case management ($5.8M, 3.6%) and S5170 home delivered meals ($7.7M, 4.7%), plus transportation (T2003) and emergency-response services (S5161), which together indicate capability to deliver multi-modal long-term supports.

Despite the large overall Medicaid footprint ($163.5M), some ancillary services remain modest in revenue but are comparatively high relative to peers, which could be strategic niches. For example, S5165 home modifications is $1.3M but ranks #2 of 35 (97th percentile; notably above typical state volume), and S5135 companion care is $7.6M and ranks #3 of 74 (97th percentile; notably above typical state volume), suggesting focused strength in selected supplemental services.

Medicaid: Complete Services Breakdown

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

28 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0156	Services of home health/hospice aide in home health or hospice settings, each 15 minutes	66,850	$770	$51.7M
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…	205,770	$130	$27.6M
S5130	Homemaker service, nos; per 15 minutes	251,760	$90	$23.2M
S5102	Day care services, adult; per diem	68,230	$220	$14.9M
S5125	Attendant care services; per 15 minutes	17,170	$670	$11.5M
S5170	Home delivered meals, including preparation; per meal	296,250	$30	$7.7M
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	110,850	$70	$7.6M
T2003	Non-emergency transportation; encounter/trip	61,690	$120	$7.1M
T2022	Case management, per month	107,960	$50	$5.8M
S5161	Emergency response system; service fee, per month (excludes installation and testing)	95,280	$30	$2.5M

Showing 1–10 of 28

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

Agespan, Inc. — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

28 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…	10	140	7,990	$90	$61.6M
S5125	Attendant care services; per 15 minutes	10	40	3,390	$300	$4.7M
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…	28	50	11,820	$40	$4.4M
S5102	Day care services, adult; per diem	65	340	25,780	$110	$4.1M
S5130	Homemaker service, nos; per 15 minutes	5	160	7,330	$90	$3.8M
G0156	Services of home health/hospice aide in home health or hospice settings, each 15 minutes	30	190	14,240	$110	$3.7M
T2022	Case management, per month	8	80	7,230	$50	$2.6M
S5170	Home delivered meals, including preparation; per meal	7	60	50,010	$20	$2.5M
T2003	Non-emergency transportation; encounter/trip	99	250	40,490	$30	$2.2M
S5161	Emergency response system; service fee, per month (excludes installation and testing)	4	60	19,060	$20	$2.1M

Showing 1–10 of 28

Nearby Providers

Other providers in the same ZIP code as Agespan, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Commonwealth Of Massachusetts	MA	Case Management Agency	$0	$444M
Elder Services Of The Merrimack Valley, Inc.	MA	Home Health Agency	$0	$86.8M
Maestro-connections Health Systems, LLC	MA	Home Health Agency	$0	$52.7M
Column Health, LLC	MA	Clinic/Center	$72.6K	$32.7M
Fidelity House, Inc	MA	Foster Care Agency	$0	$26.3M
Fcp, Inc	MA	Community/Behavioral Health Agency	$0	$21.2M
Royal Comfort Home Care Inc	MA	Home Health Agency	$0	$20.5M
Gentle Home Care Services Inc	MA	Home Health Agency	$0	$17M
Northeast Independent Living Program Inc	MA	Counselor	$0	$15.8M
New England Family Dentistry, PC	MA	General Practice Dentistry	$0	$12.5M

Agespan, Inc. — Billing Profile & Reimbursement Data

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Agespan, 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