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

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

Tms Vt, LLC (NPI 1629141262)

Field	Value
Entity Type	Organization
Organization	Tms Vt, LLC
Address	1225 Airport Pkwy Ste A
City	South Burlington
State	VT
ZIP	05403
Taxonomy	Durable Medical Equipment & Medical Supplies
NPI Enumerated	November 15, 2006

Payer Source	Total Paid
Medicaid	$2.9M
Medicare	$0

Key Findings

TMS VT, LLC is effectively a single-payer Medicaid supplier: there is no Medicare billing on file and lifetime Medicaid revenue totals $2.9M, so the provider’s operating footprint and reimbursement exposure appear concentrated in Vermont Medicaid programs rather than a mixed Medicare/Medicaid book of business. This single-payer orientation will shape contracting, compliance focus, and financial sensitivity to state-level policy changes.

The provider’s claim mix is heavily concentrated in positive airway pressure (PAP) and respiratory durable medical equipment and supplies: top codes include A7030 (Full face mask) with 6.6K claims and $542.2K revenue, E0601 (CPAP device) with 8.8K claims and $421K revenue, and A7031 (Face mask interface) with 6.7K claims and $370.7K revenue. Across other high-volume lines the provider also reports large volumes of tubing, humidifiers, filters and headgear (A4604, E0562, A7038, A7035), indicating an operational focus on sleep-disordered breathing therapy and recurring consumable supply.

Revenue concentration is high: the three largest Medicaid codes (A7030, E0601, A7031) together account for 46.2% of this provider’s total Medicaid revenue, showing that nearly half of Medicaid dollars flow from a narrow set of PAP-related products. That concentration increases sensitivity to reimbursement or utilization changes specific to these codes.

TMS VT shows a dominant competitive standing in-state for many PAP accessories and interfaces: A7030 ranks #1 of 14 providers in-state (100th percentile; notably above typical state volume) and A7031 also ranks #1 of 14 providers (100th percentile; notably above typical state volume), while E0601 ranks #2 of 15 providers (93th percentile; notably above typical state volume). Multiple accessory codes (A4604, A7034, A7038, E0562, A7035, A7032, A7046) likewise rank at the 100th percentile in-state, signaling that this supplier is a major distributor of CPAP masks, tubing, humidification parts, and disposable filters in Vermont.

Despite dominance in PAP supplies, volumes are more typical for non-PAP respiratory equipment and other DME: E1390 (oxygen concentrator) posts 2.7K claims and $167.5K revenue and ranks #9 of 16 providers in-state (47th percentile; typical, unremarkable volume), and E0570 (nebulizer) with 4K claims and $31.6K revenue ranks #4 of 20 providers (84th percentile; typical, unremarkable volume). These patterns suggest the provider’s core market strength is PAP therapy supplies rather than broader oxygen or home respiratory rental services.

Operational volume indicators show a high-frequency, consumables-heavy model: very large claim counts for accessory items — A7038 has 11K claims ($132.5K revenue), E0601 has 8.8K claims ($421K revenue), A4604 has 8.6K claims ($265.8K revenue) — consistent with recurring replacement-parts supply to a stable PAP patient base rather than one-time durable deliveries. That claim profile implies logistics, inventory, and customer service operations optimized for repeat shipments and consumable fulfillment.

The NPI was enumerated on 2006-11-15 (~20 years ago), indicating an established presence in the market; paired with top-in-state rankings on multiple PAP codes, this tenure supports the view that TMS VT has built durable relationships and distribution capacity within Vermont Medicaid. Established tenure plus concentrated code dominance increases the provider’s strategic importance to payers managing PAP therapy utilization and supply chains.

Because nearly half of Medicaid revenue is tied to three PAP-related codes (46.2%) and many accessory codes are at the 100th percentile in-state, the provider’s financial performance appears highly sensitive to state reimbursement policy and utilization management for PAP therapy. Payers should treat changes to coverage criteria, prior-authorization rules, or reimbursement levels for A7030, E0601, and A7031 as likely to have outsized budgetary and network-impact consequences.

Medicaid: Complete Services Breakdown

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

40 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
A7030	Full face mask used with positive airway pressure device, each	6,610	$80	$542.2K
E0601	Continuous positive airway pressure (CPAP) device	8,770	$50	$421K
A7031	Face mask interface, replacement for full face mask, each	6,740	$60	$370.7K
A4604	Tubing with integrated heating element for use with positive airway pressure device	8,580	$30	$265.8K
E1390	Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate	2,660	$60	$167.5K
A7034	Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap	3,110	$50	$155.6K
A7038	Filter, disposable, used with positive airway pressure device	11,040	$10	$132.5K
E0562	Humidifier, heated, used with positive airway pressure device	6,130	$20	$128.6K
A7035	Headgear used with positive airway pressure device	5,920	$20	$118.4K
A7032	Cushion for use on nasal mask interface, replacement only, each	1,710	$70	$114.6K

Showing 1–10 of 40

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Vermont Distribution

Tms Vt, LLC — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Vermont

Full comparison — all codes billed, vs. Vermont median

40 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
E1390	Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate	9	20	2,660	$50	$197.6K
A7030	Full face mask used with positive airway pressure device, each	1	10	510	$90	$115.7K
E0601	Continuous positive airway pressure (CPAP) device	2	20	590	$50	$100.2K
A7031	Face mask interface, replacement for full face mask, each	1	10	960	$50	$80.1K
E0470	Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive…	2	10	750	$90	$59K
A4604	Tubing with integrated heating element for use with positive airway pressure device	1	10	420	$30	$57.5K
K0108	Wheelchair component or accessory, not otherwise specified	2	10	230	$70	$55.1K
A7034	Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap	1	10	280	$60	$46K
E0562	Humidifier, heated, used with positive airway pressure device	1	10	900	$20	$44.4K
K0739	Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes	3	10	390	$50	$41.8K

Showing 1–10 of 40

Nearby Providers

Other providers in the same ZIP code as Tms Vt, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nfi Vermont, Inc	VT	Clinic/Center	$0	$33.6M
Bla Partners, LLC	VT	Clinical Medical Laboratory	$0	$15.2M
Timberlane Dental Group	VT	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$7.5M
Michelle Young	VT	Ophthalmology Physician	$2.1M	$0
Howard Center Inc	VT	Psychiatry Physician	$0	$2M
Vermont Eye Surgery & Laser Center	VT	Ambulatory Surgical Clinic/Center	$1.8M	$2.7K
David Weissgold	VT	Ophthalmology Physician	$1.7M	$0
Surgi-care Inc	VT	Prosthetic/Orthotic Supplier	$0	$1.7M
City Of So Burlington	VT	Ambulance	$400.9K	$1M
Green Mountain Pediatric Dentistry, PLLC	VT	Pediatric Dentistry	$0	$1.3M

Tms Vt, LLC — Billing Profile & Reimbursement Data

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Tms Vt, 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