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.

Horizon Home Care Services, Inc. (NPI 1619363678)

Field	Value
Entity Type	Organization
Organization	Horizon Home Care Services, Inc.
Address	600 E Fordham Rd
City	Bronx
State	NY
ZIP	10458
Taxonomy	Home Health Agency
NPI Enumerated	April 7, 2015

Payer Source	Total Paid
Medicaid	$329.6M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and reported Total Medicaid revenue of $329.6M, indicating an effectively single‑payer operation concentrated in New York Medicaid rather than a mixed Medicare/Medicaid provider. The absence of Medicare activity means comparative national Medicare benchmarking is not applicable for this entity.

Revenue is extremely concentrated: the precomputed top‑3 Medicaid codes account for 100.0% of this provider’s Medicaid revenue, with a single code, T1019, representing $319.2M or 96.9% of the total. This concentration implies that the provider’s financial performance is largely driven by one service type.

The code mix (T1019 and T1020 as the principal drivers) identifies HORIZON HOME CARE SERVICES, INC. as a provider of personal care services rather than skilled home health: T1019 is billed per 15 minutes and T1020 per diem, consistent with routine personal care/home‑aid delivery rather than medically skilled nursing or therapy. The presence of T1022 (contracted home health agency services) in the dataset, though small, indicates some contracted arrangements but not a major revenue stream.

T1019 shows very large absolute volume at 2.5M claims with an average paid/claim of $126 and $319.2M in revenue; it ranks #46 of 912 in-state (95th percentile) and is described as "typical, unremarkable volume." In plain terms, the provider is a high-volume biller of T1019 relative to peers but that level sits within expected patterns for in-state home care agencies.

T1020 contributes $10.1M across 36.8K claims with an average paid/claim of $275, ranking #115 of 354 in-state (68th percentile) and characterized as "typical, unremarkable volume." This positions the provider as a mid‑tier biller of per‑diem personal care services among comparable in‑state agencies rather than a dominant supplier of per‑diem care.

Smaller codes (99199: 781 claims, $193 avg paid/claim, $150.7K revenue, ranks #15 of 167, 92th percentile; and T1022: 472 claims, $188 avg paid/claim, $88.7K revenue, ranks #166 of 334, 50th percentile) form a minimal revenue tail. These lines are not material to total revenue but indicate occasional reporting of miscellaneous medicine services and contracted home health days.

With an NPI enumerated on 2015-04-07 (~11 years ago), the provider has an established presence in the market, which aligns with the sustained, high-volume billing pattern for a single personal‑care code over time. The tenure supports interpretation of the concentration as an operational strategy rather than a transient reporting artifact.

The extreme concentration in T1019 (96.9% of Medicaid dollars) creates exposure to any policy, eligibility, or rate changes affecting personal care per‑15‑minute billing; conversely, it suggests operational specialization and potential scale advantages in delivering personal care services to Medicaid beneficiaries. Given the provider’s percentile ranks on its leading codes, these advantages appear to be realized within normal in‑state competitive dynamics rather than as outlier behavior.

Medicaid: Complete Services Breakdown

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

4 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…	2,533,620	$130	$319.2M
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…	36,780	$280	$10.1M
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	780	$190	$150.7K
T1022	Contracted home health agency services, all services provided under contract, per day	470	$190	$88.7K

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

Horizon Home Care Services, Inc. — 1 of 4 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

4 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…	46	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…	115	350	12,660	$310	$13.1M
T1022	Contracted home health agency services, all services provided under contract, per day	166	330	470	$170	$231.1K
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	15	170	80	$20	$68.2K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cooperative Home Care Associates, Inc	NY	Home Health Agency	$0	$269.4M
Union Community Health Center, Inc.	NY	Clinic/Center	$0	$88.7M
Cooperative Home Care Associates, Inc	NY	Home Health Agency	$0	$38.9M
Medalliance Medical Health Services Inc	NY	Clinic/Center	$0	$32.5M
Mark Fromer, LLC	NY	Ambulatory Surgical Clinic/Center	$409.1K	$1.9M
Mitchell Butin	NY	Psychiatry Physician	$423.7K	$0
Medassure LLC	NY	Community/Retail Pharmacy	$86.5K	$87.8K
Darren Esposito	NY	Internal Medicine Physician	$121.5K	$10.7K
Rachel Spiers	NY	Occupational Therapist	$7.8K	$0

Horizon Home Care Services, Inc. — Billing Profile & Reimbursement Data

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Horizon Home Care Services, 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