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

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

Visiting Nurse Group, Inc (NPI 1639176522)

Field	Value
Entity Type	Organization
Organization	Visiting Nurse Group, Inc
Address	128 W Girard Ave
City	Philadelphia
State	PA
ZIP	19123
Taxonomy	Home Health Agency
NPI Enumerated	July 7, 2005

Payer Source	Total Paid
Medicaid	$66.4M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-only operator: there is no Medicare billing on file while total Medicaid revenue is $66.4M, signaling a single-payer footprint concentrated on state Medicaid programs rather than Medicare fee-for-service. The NPI was enumerated on 2005-07-07 (~21 years ago), indicating an established presence in the market.

Revenue is highly concentrated in a very small set of codes: the top three Medicaid codes (T2025, S9124, T1002) together account for 95.7% of this provider's total Medicaid revenue. Individually these codes generate $34.2M (T2025, 51.5%), $23.1M (S9124, 34.8%) and $6.3M (T1002, 9.5%), which underscores a narrow service mix driving nearly all receipts.

The code mix indicates a home-focused, waiver-and-skilled-nursing operation. T2025 (Waiver services; nos) is the single largest revenue driver with 41.6K claims and $821 avg paid/claim, while S9124 (nursing care in the home by LPN, per hour) accounts for 37.7K claims at $612 avg paid/claim and T1002 (RN services, up to 15 minutes) shows 10.8K claims at $585 avg paid/claim. These volumes and payment levels point to labor-intensive, in-home care dominated by LPN hours and short RN visits under waiver arrangements.

Competitive standing is mixed across top codes. For T2025 the provider ranks #5 of 24 in-state (83th percentile) with a labeled status of typical/unremarkable volume, indicating a mid-to-upper position in the narrower universe of waiver providers; for S9124 it ranks #8 of 92 (92th percentile) and for T1002 #11 of 90 (89th percentile), both labeled typical/unremarkable and reflecting a strong statewide presence in in-home nursing services but not an extreme outlier. The fourth-ranking code, S9123 (RN hourly), is smaller at $2.8M (4.3%) and ranks #29 of 73 (61th percentile), which is a more modest standing.

Operationally, the sheer claim counts (41.6K T2025 claims and 37.7K S9124 claims) indicate a high-volume, labor-delivered business model focused on recurring hourly visits and waiver-authorized services rather than episodic procedures. The combination of high claim volumes and relatively high avg paid/claim amounts (e.g., $821 for T2025) suggests staffing and scheduling are central operational levers and key cost drivers for the organization.

The provider’s revenue concentration creates sensitivity to Medicaid program policy and rate changes for a handful of codes: because T2025, S9124 and T1002 together make up 95.7% of Medicaid revenue, reimbursement adjustments or utilization shifts for waiver services or in-home nursing could materially affect financial performance. Analysts should prioritize monitoring state waiver program rules and hourly nursing reimbursement trends when evaluating this entity.

Although the provider ranks in high percentiles for several of its highest-revenue codes, the descriptive labels attached to those rankings are consistently "typical, unremarkable volume for this code," which indicates that while the provider is an important local supplier—especially for LPN home care—it does not appear as an extreme statistical outlier in the available state data. This suggests competitive significance without unusual deviation from peer behavior.

The combination of long tenure (~21 years since NPI enumeration), concentrated Medicaid dependency ($66.4M with no Medicare billing), and a code mix dominated by waiver and in-home nursing services positions this entity as an established, Medicaid-focused home health agency whose health depends primarily on state-managed waiver and home-care reimbursement streams.

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
T2025	Waiver services; not otherwise specified (nos)	41,600	$820	$34.2M
S9124	Nursing care, in the home; by licensed practical nurse, per hour	37,720	$610	$23.1M
T1002	Rn services, up to 15 minutes	10,770	$590	$6.3M
S9123	Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)	5,390	$520	$2.8M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Pennsylvania Distribution

Visiting Nurse Group, Inc — 0 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2025	Waiver services; not otherwise specified (nos)	5	20	10,570	$680	$14M
S9124	Nursing care, in the home; by licensed practical nurse, per hour	8	90	12,800	$580	$9.1M
S9123	Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)	29	70	4,620	$530	$4M
T1002	Rn services, up to 15 minutes	11	90	1,850	$400	$1.5M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
City Of Philadelphia	PA	Land Ambulance	$8.3M	$108.1M
Ameribest Home Care, LLC	PA	Home Health Agency	$0	$55.3M
Northeast Treatment Centers, Inc.	PA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$39.8M
Pmhcc Ctt Inc	PA	Case Management Agency	$0	$27.5M
Greater Philadelphia Health Action Inc.	PA	Federally Qualified Health Center (FQHC)	$0	$21M
St. John's Community Services	PA	Developmentally Disabled Services Day Training Agency	$0	$18.2M
Northeast Treatment Centers. Inc.	PA	Community/Behavioral Health Agency	$0	$15.3M
Family Practice & Counseling Services Network, Inc.	PA	Federally Qualified Health Center (FQHC)	$0	$13.3M
Gaudenzia Inc	PA	Community/Behavioral Health Agency	$0	$13.2M
Public Health Management Corporation	PA	Federally Qualified Health Center (FQHC)	$0	$11.8M

Visiting Nurse Group, Inc — Billing Profile & Reimbursement Data

Sign up for Visiting Nurse Group, Inc — Billing Profile & Reimbursement Data policy alerts

Visiting Nurse Group, Inc — Billing Profile & Reimbursement Data

Sign up for Visiting Nurse Group, Inc — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References