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 District of Columbia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to District of Columbia 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. District of Columbia (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.

Specialty Home Care LLC (NPI 1619400058)

Field	Value
Entity Type	Organization
Organization	Specialty Home Care LLC
Address	6856 Eastern Ave Nw Ste 376
City	Washington
State	DC
ZIP	20012
Taxonomy	Respite Care
NPI Enumerated	April 4, 2017

Payer Source	Total Paid
Medicaid	$85.1M
Medicare	$0

Key Findings

SPECIALTY HOME CARE LLC shows no Medicare billing on file and instead operates effectively as a single-payer Medicaid provider, reporting $85.1M in lifetime Medicaid revenue. This concentration in Medicaid suggests the organization’s business model and contracts are primarily anchored in state programs rather than federal Medicare reimbursement streams.

Revenue is highly concentrated in a tiny set of codes: the top three Medicaid codes (T1019, T1000, and G0299) account for 99.2% of total Medicaid revenue. Specifically, T1019 represents 52.0% of Medicaid revenue, T1000 represents 44.7%, and G0299 represents 2.5%, indicating nearly all dollars flow through a small set of services.

The code mix indicates the provider’s core operations are personal care and private-duty nursing rather than traditional Medicare home health services: T1019 is personal care services per 15 minutes and T1000 is private duty/independent nursing service(s) up to 15 minutes. The presence of G0299 and G0300 shows a smaller component of direct skilled nursing (RN/LPN) in home or hospice settings, but these skilled-nursing codes are minor contributors to overall revenue.

Operationally, volume and unit rates diverge across the top codes: T1019 generated 289.2K claims at $153 avg paid/claim for $44.2M in revenue, while T1000 produced 59.5K claims at $638 avg paid/claim for $38M in revenue. G0299 produced 11.7K claims at $181 avg paid/claim for $2.1M, and G0300 is a small-volume, high-unit-rate line with 900 claims at $803 avg paid/claim for $722.7K—together these patterns suggest a high-volume personal-care engine supported by higher-paid private-duty nursing.

Competitive standing is strong for private-duty nursing: T1000 ranks #1 of 5 providers in-state and is labeled "notably above typical state volume," signaling a dominant in-state position for licensed private-duty nursing services relative to peers. This ranking suggests SPECIALTY HOME CARE LLC has carved out a leading role in that specific service line within the state market.

For personal care and skilled-nursing lines the provider is more modest: T1019 ranks #18 of 29 providers in-state and is described as "typical, unremarkable volume," while G0299 ranks #19 of 32 providers and is also tagged as "typical, unremarkable volume." G0300 sits near the middle of its peer group (rank #6 of 12) with a typical volume label, indicating limited competitive differentiation on these codes.

The extreme concentration in two revenue drivers is a strategic operational risk and opportunity: T1019 and T1000 together account for the lion’s share of Medicaid receipts (52.0% and 44.7% respectively), meaning changes in utilization, policy, or reimbursement for either code would materially affect overall revenue. From a payer oversight and contract-management perspective, this concentration focuses where audit, care-management, or rate-negotiation efforts would have the greatest impact.

The provider has an established enrollment history with NPI enumerated 2017-04-04 (~9 years ago), giving it multiple years to build Medicaid relationships and operational capacity in the DC market. That tenure, combined with the dominant T1000 position, suggests an entrenched niche in private-duty nursing within the state Medicaid ecosystem.

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…	289,190	$150	$44.2M
T1000	Private duty / independent nursing service(s) - licensed, up to 15 minutes	59,550	$640	$38M
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	11,730	$180	$2.1M
G0300	Direct skilled nursing services of a licensed practical nurse (LPN) in the home health or hospice setting, each 15 minutes	900	$800	$722.7K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. District of Columbia Distribution

Specialty Home Care LLC — 1 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — District of Columbia

Full comparison — all codes billed, vs. District of Columbia 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…	18	30	405,140	$140	$47.5M
T1000	Private duty / independent nursing service(s) - licensed, up to 15 minutes	1	10	15,550	$370	$7.9M
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	19	30	13,380	$80	$1.3M
G0300	Direct skilled nursing services of a licensed practical nurse (LPN) in the home health or hospice setting, each 15 minutes	6	10	610	$130	$1.2M

Nearby Providers

Other providers in the same ZIP code as Specialty Home Care LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kbc Nursing Agency Hm Health Inc	DC	Home Health Agency	$0	$82.4M
Berhan Home Health Care Agency Inc	DC	Home Health Agency	$0	$76.6M
Kinara Health And Home Care Services LLC	DC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$48.5M
Ward & Ward Association, Inc.	DC	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$38.7M
Alliance Home Healthcare & Equipment Services Inc	DC	Respite Care	$0	$37.5M
Premier Health Services Inc.	DC	Home Health Agency	$0	$36.8M
Affordable Health Care Services LLC	DC	Developmental Disabilities Clinic/Center	$0	$25.8M
Direct Care Home Health Services LLC	DC	Home Health Agency	$0	$14.3M
Kahak, Inc.	DC	Home Health Agency	$0	$13.8M
Dedicated Care Health Services, Inc.	DC	Community/Behavioral Health Agency	$0	$11.2M

Specialty Home Care LLC — Billing Profile & Reimbursement Data

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Specialty Home Care LLC — 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