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

Why is the Medicaid comparison limited to 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. 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.

Care Advantage, Inc. (NPI 1710332184)

Field	Value
Entity Type	Organization
Organization	Care Advantage, Inc.
Address	201 N Washington Hwy Ste 206
City	Ashland
State	VA
ZIP	23005
Taxonomy	Home Health Agency
NPI Enumerated	May 4, 2016

Payer Source	Total Paid
Medicaid	$57M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and is effectively a single-payer (Medicaid) operation, reporting $57M in lifetime Medicaid revenue. The absence of Medicare activity means analyses should focus on Medicaid program participation and state-level competitive dynamics rather than dual-payer mix assumptions.

Revenue is extremely concentrated: the top three Medicaid codes (T1019, T1005, S5102) together account for 99.9% of this provider's total Medicaid revenue. Breakdown by code shows T1019 generated $49.3M (86.5% of Medicaid revenue), T1005 generated $7.1M (12.5%), and S5102 generated $545.7K (1.0%), which together dominate the provider's reported receipts.

The code mix indicates the business is operating primarily as a personal care and respite services provider rather than delivering skilled home health visits. T1019 is described as personal care services per 15 minutes and T1005 as respite care per 15 minutes, while S5102 is adult day care per diem; this combination aligns with home- and community-based support services and non-skilled personal assistance.

T1019 and T1005 performance places the provider among the very largest statewide players for those service lines: T1019 ranks #5 of 758 providers in-state and is described as an extreme outlier at the 99th percentile, and T1005 also ranks #5 of 574 providers and is likewise an extreme outlier at the 99th percentile. These rankings and percentiles indicate the provider is a dominant, high-volume supplier of personal care and respite services in Virginia relative to peers.

Other codes show more modest engagement: S5102 (day care services, adult; per diem) produced 8K claims and $545.7K in revenue and ranks #13 of 38 providers in-state (68th percentile; typical, unremarkable volume), indicating a limited but present adult-day capability. G2021 is negligible in scale with 31 claims, $33.5K revenue, and a rank of #198 of 293 providers in-state (31th percentile; typical, unremarkable volume), suggesting little reliance on practitioner tip codes.

Tenure is established but relatively recent: the NPI was enumerated on 2016-05-04 (~10 years ago). Given the $57M Medicaid lifetime revenue reported within that timeframe, the provider has achieved sizable scale in state Medicaid personal care/respite services over its period of operation.

From an analytic perspective, the provider's very high claim volumes for key codes (322.1K claims for T1019 and 90.1K claims for T1005) combined with the extreme-outlier rankings suggest areas for further operational benchmarking. Analysts should prioritize detailed utilization and client-mix comparisons against state peers, review per-claim payment patterns ($153 avg paid/claim for T1019 and $79 avg paid/claim for T1005), and assess network capacity given the concentrated revenue exposure to those two service lines.

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
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…	322,070	$150	$49.3M
T1005	Respite care services, up to 15 minutes	90,090	$80	$7.1M
S5102	Day care services, adult; per diem	8,030	$70	$545.7K
G2021	Health care practitioners rendering treatment in place (tip)	30	$1,080	$33.5K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Virginia Distribution

Care Advantage, Inc. — 2 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	5	760	17,620	$150	$5.5M
S5102	Day care services, adult; per diem	13	40	3,490	$220	$2.3M
T1005	Respite care services, up to 15 minutes	5	570	4,400	$80	$831.8K
G2021	Health care practitioners rendering treatment in place (tip)	198	290	40	$790	$56.7K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hanover County Board Of Supervisors	VA	Mental Health Counselor	$0	$17.1M
Chesapeake Rehab Equipment Inc	VA	Customized Equipment (DME)	$0	$13.7M
Care Advantage, Inc	VA	Home Health Agency	$0	$10M
Care Advantage, Inc.	VA	Home Health Agency	$0	$5.7M
Med-trans Corporation	VA	Air Ambulance	$551.3K	$0
Suzanne Everhart	VA	Ophthalmology Physician	$228.8K	$0
David Haine	VA	Optometrist	$71.4K	$6.7K
Glenna Smith	VA	Psychiatry Physician	$75.6K	$0
Erica Lapp	VA	Speech-Language Pathologist	$49.3K	$0
Daeryl Williamson	VA	Psychiatric/Mental Health Nurse Practitioner	$9.6K	$0

Care Advantage, Inc. — Billing Profile & Reimbursement Data

Sign up for Care Advantage, Inc. — Billing Profile & Reimbursement Data policy alerts

Care Advantage, Inc. — Billing Profile & Reimbursement Data

Sign up for Care Advantage, 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