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

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

Legacy Home Health Agency, Inc. (NPI 1689652166)

Field	Value
Entity Type	Organization
Organization	Legacy Home Health Agency, Inc.
Address	5277 Old Brownsville Rd Ste 205
City	Corpus Christi
State	TX
ZIP	78405
Taxonomy	Home Health Agency
NPI Enumerated	January 5, 2006

Payer Source	Total Paid
Medicaid	$244M
Medicare	$0

Key Findings

LEGACY HOME HEALTH AGENCY, INC. is effectively a Medicaid-focused provider: it has no Medicare billing on file and reports $244M in total Medicaid revenue, indicating a single-payer concentration in Medicaid rather than a mixed Medicare/Medicaid payer mix. This profile should be treated as a Medicaid-centric operation for competitive and utilization analyses.

The provider’s service mix is dominated by community-based attendant and personal care: the top code is S5125 (Attendant care services; per 15 minutes), and the other top codes are T1019 (Personal care services, per 15 minutes) and T1005 (Respite care services, up to 15 minutes), which together reflect an operational focus on hands-on personal/attendant care and short-interval respite visits. This code mix is consistent with a home health agency organized around high-frequency, direct-care personal assistance rather than episodic skilled nursing or therapy bundles.

Revenue is extremely concentrated in a single service line: the precomputed top-3 Medicaid codes account for 100.0% of the provider’s total Medicaid revenue, with S5125 representing $238.5M or 97.7% of that total. This level of concentration means nearly all Medicaid dollars flow from attendant care billing rather than a diversified set of Medicaid service types.

S5125 shows exceptional market dominance in-state: the provider reported 4.2M claims and $238.5M revenue for S5125, ranks #3 of 1678 providers in Texas, is at the 100th percentile, and is labeled an "extreme outlier, far above typical state volume for this code." That combination of rank, percentile, and the "extreme outlier" designation signals a scale and share for attendant care that is materially larger than almost all peers.

By contrast, the other top Medicaid codes are modest contributors and competitive positions are more typical: T1019 generated 97.9K claims and $3.5M (1.4% of total Medicaid revenue), ranking #170 of 1050 providers (84th percentile), described as typical and unremarkable; T1005 generated 38.2K claims and $2M (0.8% of total Medicaid revenue), ranking #57 of 564 (90th percentile) and likewise described as typical. These codes contribute operational breadth but not meaningful revenue diversification relative to S5125.

Payment and utilization dynamics reinforce the operational picture: S5125 paid at $57 avg paid/claim across 4.2M claims, while T1019 paid $36 avg/claim across 97.9K claims and T1005 paid $53 avg/claim across 38.2K claims. The very high claim count for S5125 combined with its per-claim payment level suggests large-scale, high-frequency delivery workflows and billing volume concentrated in short-interval attendant-care units.

The provider has a long-standing enrollment history: the NPI was enumerated 2006-01-05 (~20 years ago), indicating sustained market presence and operational longevity in the Texas home- and personal-care market. That tenure may reflect established payer relationships and operational capacity to handle large Medicaid volumes.

From an operational and payer-risk perspective, the business is highly exposed to changes affecting attendant care reimbursement or authorization: with 97.7% of Medicaid revenue coming from S5125 and the top three codes together accounting for 100.0% of Medicaid revenue, any policy, rate, or utilization change for attendant, personal, or respite care could materially impact overall revenue. Analysts should flag revenue concentration as a key sensitivity when modeling this provider’s financial or contracting scenarios.

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5125	Attendant care services; per 15 minutes	4,184,140	$60	$238.5M
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…	97,850	$40	$3.5M
T1005	Respite care services, up to 15 minutes	38,170	$50	$2M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Texas Distribution

Legacy Home Health Agency, Inc. — 1 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. Texas median

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5125	Attendant care services; per 15 minutes	3	1,680	50,290	$60	$9.5M
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…	170	1,050	23,280	$30	$1.8M
T1005	Respite care services, up to 15 minutes	57	560	8,490	$50	$842.3K

Nearby Providers

Other providers in the same ZIP code as Legacy Home Health Agency, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Restorative Health Services LLC	TX	Home Health Agency	$0	$56.3M
Jim Hsiang	TX	Radiation Oncology Physician	$1.1M	$0
Jude Aririguzo	TX	Internal Medicine Physician	$491.9K	$0
David White	TX	Family Medicine Physician	$433.6K	$0
Jerrod King	TX	Emergency Medicine Physician	$130.4K	$0
Kathryn Kortzendorf	TX	Family Nurse Practitioner	$123K	$0
Timothy Reyes	TX	Certified Registered Nurse Anesthetist	$65.6K	$0
Felicia Daniels	TX	Anesthesiology Physician	$21.4K	$0

Legacy Home Health Agency, Inc. — Billing Profile & Reimbursement Data

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Legacy Home Health Agency, Inc. — 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