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.

Wec Health, LLC (NPI 1639574635)

Field	Value
Entity Type	Organization
Organization	Wec Health, LLC
Address	855 Worcester Rd Ste 12
City	Framingham
State	MA
ZIP	01701
Taxonomy	Foster Care Agency
NPI Enumerated	November 3, 2014

Payer Source	Total Paid
Medicaid	$126.4M
Medicare	$0

Key Findings

WEC HEALTH, LLC is effectively a single-payer Medicaid provider: there is no Medicare billing on file and the provider reports $126.4M in lifetime Medicaid revenue, indicating operations are concentrated in the Medicaid program rather than serving a dual Medicare/Medicaid mix. The absence of Medicare claims means payer-mix analysis should treat this entity as a Medicaid-focused foster care agency.

Revenue concentration is extreme: the top 3 Medicaid codes account for 100.0% of WEC HEALTH’s reported Medicaid revenue, with S5140 alone representing $126M (99.7% of total Medicaid revenue). This indicates the organization’s revenue stream is overwhelmingly driven by per-diem foster care placements rather than a diversified set of clinical or ancillary services.

Service-line implications from the top codes point to a core business of foster care placement and related assessments. S5140 (Foster care, adult; per diem) being the dominant code implies the provider primarily offers room-and-board and supervision services under Medicaid foster care payment structures, while T1028 (home and family environment assessment) appearing among the small-revenue codes suggests they also bill for intake or suitability assessments tied to placements.

Competitive standing in-state for the lead code is strong but not singular: S5140 ranks #3 of 158 providers in Massachusetts and sits in the 99th percentile, which positions WEC HEALTH as a major regional participant for foster care per-diem services. The 99th percentile ranking qualifies the organization as a top-tier Medicaid provider for that specific service within the state, though the narrative notes this is “typical, unremarkable volume for this code,” suggesting its volumes align with other large, established foster care agencies.

Smaller ancillary billing is present but immaterial to overall revenue: T1028 accounts for $404.8K (0.3% of Medicaid revenue) with 1.6K claims and ranks #4 of 32 providers in-state (90th percentile). These assessment-related services are billed at far lower aggregate value and appear to support the primary foster-care placement business rather than represent a separate revenue center.

Operational tenure is substantial: the provider’s NPI was enumerated on 2014-11-03 (~12 years ago), indicating more than a decade of enrollment and continuity in Medicaid billing, which is consistent with the large cumulative Medicaid revenue reported. This tenure supports interpretation of the provider as an established foster care operator rather than a recent entrant.

Given the extreme revenue concentration in one per-diem code, financial or utilization analyses should treat WEC HEALTH as high exposure to policy or rate changes affecting S5140 reimbursements; any shifts in foster care per-diem rates, eligibility, or placement volumes would likely have an outsized impact on the provider’s Medicaid revenue. Monitoring of S5140 utilization trends and state rate-setting activity is therefore critical for payers and analysts assessing financial risk.

Medicaid: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5140	Foster care, adult; per diem	1,049,870	$120	$126M
T1028	Assessment of home, physical and family environment, to determine suitability to meet patient's medical needs	1,570	$260	$404.8K

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

Wec Health, LLC — 1 of 2 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

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5140	Foster care, adult; per diem	3	160	48,640	$110	$19.5M
T1028	Assessment of home, physical and family environment, to determine suitability to meet patient's medical needs	4	30	50	$220	$87.4K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Advocates, Inc.	MA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$83.5M
Wayside Youth And Family Support Network	MA	Mental Health Counselor	$0	$38.5M
Advocates, Inc.	MA	Adult Care Home Facility	$0	$22.5M
Elderly Home Care	MA	Home Health Agency	$0	$16.9M
Variantyx Inc	MA	Clinical Medical Laboratory	$0	$8.6M
Shields Mri Of Framingham, LLC	MA	Magnetic Resonance Imaging (MRI) Clinic/Center	$570.3K	$814.1K
Pet-ct Services By Tufts Medical Center And Shields LLC	MA	Mobile Radiology Clinic/Center	$775.6K	$12.2K
Petronela Iorga	MA	Anatomic Pathology & Clinical Pathology Physician	$633K	$0
Stanley Kraus	MA	Urology Physician	$449.4K	$0
Jill Becker	MA	General Practice Physician	$147.7K	$272.7K

Wec Health, LLC — Billing Profile & Reimbursement Data

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Wec Health, 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