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

Why is the Medicaid comparison limited to West Virginia 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. West Virginia (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.

Hometown Care (NPI 1679891659)

Field	Value
Entity Type	Organization
Organization	Hometown Care
Address	66 S. Crim Ave
City	Belington
State	WV
ZIP	26250
Taxonomy	Homemaker
NPI Enumerated	May 14, 2010

Payer Source	Total Paid
Medicaid	$22.1M
Medicare	$0

Key Findings

HOMETOWN CARE is effectively a Medicaid-only operator: the profile shows no Medicare billing on file and $22.1M in lifetime Medicaid revenue, indicating the organization’s billing footprint is concentrated entirely in state Medicaid programs rather than Medicare. This payer mix suggests the provider’s services and reimbursement strategy are oriented to Medicaid policy and eligibility rather than dual-eligible or fee-for-service Medicare populations.

Revenue concentration is very high: the top 3 Medicaid codes by revenue account for 99.1% of this provider’s total Medicaid revenue, and a single code, S5130, accounts for $21.4M and 96.7% of Medicaid revenue. This level of concentration implies that the business model is overwhelmingly dependent on one service line and that fluctuations in reimbursement or authorization for that code would materially affect overall revenue.

The code mix signals a core homemaker and home- and community-based services (HCBS) operation: S5130 (Homemaker service, per 15 minutes) is the dominant billed service, while A0160 (non-emergency transportation), T1002 (RN services, up to 15 minutes), S5161 (emergency response system monthly service fee), and T1001 (nursing assessment) appear as supporting services. Taken together, these codes indicate the provider delivers hands-on homemaker supports plus ancillary nursing and transportation resources typical of community-based long-term services and supports.

Competitive standing on the state Medicaid stage is concentrated but not singularly dominant: S5130 ranks #7 of 72 providers in-state (92th percentile) and is labeled in the data as "typical, unremarkable volume," which denotes a strong but not exceptional statewide presence for that primary service. Other high-volume codes also sit in upper percentiles—A0160 at #13 of 112 (89th percentile) and T1002 at #14 of 151 (91th percentile)—and are similarly described as "typical, unremarkable volume," indicating consistent, peer-level activity across complementary services.

Operational implications from the ancillary codes: the presence of 15.2K claims for A0160 ($349.6K) and 10.8K claims for T1002 ($194.6K) indicates routine provision of transportation and short-interval nursing visits that support in-home homemaker care. S5161’s 2.4K claims and $116.7K revenue for monthly emergency response system fees suggest recurring subscription-style billing that complements personal care services and may stabilize cashflow independent of episodic homemaker visits.

Service portfolio gaps and low-use items are visible: G9002 (coordinated care fee) generates only $8.9K and ranks #114 of 123 providers in-state (7th percentile), labeled as "typical, unremarkable volume," which suggests limited participation in or low reimbursement capture from coordinated-care maintenance fees relative to peers. T1001 (nursing assessment) is modest at $63.2K and ranks #17 of 60 providers (73th percentile), implying assessments are performed but are a small share of revenue compared with homemaker services.

Tenure and regulatory footprint: the provider’s NPI was enumerated on 2010-05-14 (approximately 16 years ago), indicating a long-standing Medicaid billing presence in the state market. That longevity, combined with concentrated revenue from S5130, suggests established operational processes for delivering and billing homemaker services within the state Medicaid program.

Risk and strategic considerations for payers and analysts: because S5130 drives the vast majority of revenue, any Medicaid policy changes, prior authorization adjustments, or audit focus on homemaker services could disproportionately affect HOMETOWN CARE’s financial performance. Analysts should flag this concentration for monitoring and consider reviewing utilization patterns and authorization practices for S5130 alongside the modest but recurring revenue streams from transportation (A0160), nursing visits (T1002/T1001), and emergency response subscriptions (S5161).

Medicaid: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5130	Homemaker service, nos; per 15 minutes	49,900	$430	$21.4M
A0160	Non-emergency transportation: per mile - case worker or social worker	15,200	$20	$349.6K
T1002	Rn services, up to 15 minutes	10,810	$20	$194.6K
S5161	Emergency response system; service fee, per month (excludes installation and testing)	2,430	$50	$116.7K
T1001	Nursing assessment / evaluation	550	$120	$63.2K
G9002	Coordinated care fee, maintenance rate	90	$100	$8.9K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. West Virginia Distribution

Hometown Care — 0 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — West Virginia

Full comparison — all codes billed, vs. West Virginia median

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5130	Homemaker service, nos; per 15 minutes	7	70	6,710	$330	$6.6M
G9002	Coordinated care fee, maintenance rate	114	120	2,950	$150	$901.9K
A0160	Non-emergency transportation: per mile - case worker or social worker	13	110	2,030	$50	$278.8K
T1002	Rn services, up to 15 minutes	14	150	1,980	$40	$232.6K
T1001	Nursing assessment / evaluation	17	60	200	$110	$90.3K
S5161	Emergency response system; service fee, per month (excludes installation and testing)	4	50	460	$50	$63.1K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Belington Community Medical Services Association	WV	Federally Qualified Health Center (FQHC)	$0	$5M
Hometown Care LLC	WV	Child Intellectual and/or Developmental Disabilities Respite Care	$0	$4.6M
Hometown Care	WV	Case Manager/Care Coordinator	$0	$1.9M
Hometown Care LLC	WV	Personal Care Attendant	$0	$1.9M
Belington Emergency Squad Inc	WV	Ambulance	$134K	$1.1M
Mariah Jennings	WV	Audiologist	$2.9K	$0

Hometown Care — Billing Profile & Reimbursement Data

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Hometown Care — 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