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

Why is the Medicaid comparison limited to New Mexico 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. New Mexico (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.

New Mexico Consumer Direct Personal Care, LLC (NPI 1740376292)

Field	Value
Entity Type	Organization
Organization	New Mexico Consumer Direct Personal Care, LLC
Address	8220 San Pedro Dr Ne Ste 400
City	Albuquerque
State	NM
ZIP	87113
Taxonomy	Home Health Agency
NPI Enumerated	October 4, 2006

Payer Source	Total Paid
Medicaid	$149.8M
Medicare	$0

Key Findings

This provider is effectively single-payer: there is no Medicare billing on file while Medicaid billing totals $149.8M, indicating that Medicaid is the dominant — and essentially sole — public-payer revenue source on record. Analysts should treat this profile as Medicaid-centric when evaluating revenue risk, access-to-care, and contract leverage.

Revenue is extremely concentrated in a very small set of Medicaid codes: the precomputed top 3 codes account for 99.8% of this provider's total Medicaid revenue, signaling material dependence on a narrow service mix and corresponding payment policies for financial performance. Such concentration heightens exposure to any state-level reimbursement changes or utilization reviews that target these specific codes.

The largest single revenue driver is 99509 (home health/ADL visits): 367.9K claims, $347 avg paid/claim, $127.7M revenue, which is 85.2% of this provider's total Medicaid revenue. The provider ranks #2 of 82 in-state and is described as an "extreme outlier," indicating exceptionally high volume and a business model built predominantly around in-home ADL/self-care visits.

G9006 (coordinated care fee, home monitoring) is a secondary but significant line: 89.3K claims, $196 avg paid/claim, $17.5M revenue (11.7% of Medicaid revenue). The #2 rank of 79 and "extreme outlier" designation suggest the provider operates a large coordinated care/home monitoring program in tandem with ADL services rather than relying solely on episodic skilled home health.

T1019 (personal care services, per 15 minutes) represents a modest share by comparison: 70.7K claims, $62 avg paid/claim, $4.4M revenue (2.9% of Medicaid revenue) and ranks #55 of 89 (39th percentile). That middling rank and lower revenue share suggest the provider bills fewer time-based personal-care units relative to peers and instead concentrates reimbursement under 99509 and G9006.

Despite dominance on its top codes, several ancillary codes show limited impact: S9999 (sales tax) produced $232.7K (0.2% of revenue) with a #6 of 163 rank (97th percentile; characterized as typical), and T2025 shows 5.4K claims but $0 revenue (0.0% of Medicaid revenue) and ranks #6 of 35 (85th percentile). These items are immaterial to total revenue but indicate a broader claim mix for administrative or waiver-related elements.

Competitive standing in-state is strong and specialized: occupying #2 positions and 99th-percentile volume for both 99509 and G9006 marks the provider as a major, high-volume operator in home ADL services and coordinated care/home monitoring across New Mexico. However, the lack of Medicare billing means this competitive strength is concentrated entirely within the Medicaid market and may not translate to other payer segments.

The provider has long tenure in the NPI registry, enumerated on 2006-10-04 (~20 years ago), which combined with $149.8M in Medicaid lifetime revenue and extremely high-volume coding for 99509 and G9006 suggests an established, large-scale home personal care operation that is institutionally embedded in the state's Medicaid delivery network.

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99509	A home health provider, such as a registered nurse, or a non nursing practitioner, visits a patient to provide help with activities of daily living, or ADLs, and self care.	367,920	$350	$127.7M
G9006	Coordinated care fee, home monitoring	89,320	$200	$17.5M
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…	70,670	$60	$4.4M
S9999	Sales tax	8,950	$30	$232.7K
T2025	Waiver services; not otherwise specified (nos)	5,440	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Mexico Distribution

New Mexico Consumer Direct Personal Care, LLC — 3 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Mexico

Full comparison — all codes billed, vs. New Mexico median

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99509	A home health provider, such as a registered nurse, or a non nursing practitioner, visits a patient to provide help with activities of daily living, or ADLs, and self care.	2	80	20,990	$310	$16.4M
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…	55	90	92,900	$70	$13.3M
G9006	Coordinated care fee, home monitoring	2	80	3,840	$190	$2M
T2025	Waiver services; not otherwise specified (nos)	6	40	1,010	$360	$1.6M
S9999	Sales tax	6	160	800	$10	$25.2K

Nearby Providers

Other providers in the same ZIP code as New Mexico Consumer Direct Personal Care, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ambercare Hospice, Inc.	NM	Community Based Hospice Care Agency	$0	$28.7M
Advantage Home Care, Inc.	NM	Primary Care Nurse Practitioner	$0	$13.7M
Home Modification Solutions, LLC	NM	In Home Supportive Care Agency	$0	$9.9M
A Childs Voice	NM	Community/Behavioral Health Agency	$0	$5.3M
Allergy Partners, PLLC	NM	Allergy & Immunology Physician	$0	$5M
Christopher Roybal	NM	Ophthalmology Physician	$3.8M	$0
Armada Skilled Homecare Of New Mexico LLC	NM	Home Health Agency	$0	$3.2M
Anne K. Hempstead D.d.s., P.C.	NM	Pediatric Dentistry	$0	$3M
Autism Specialists LLC	NM	Speech-Language Pathologist	$0	$2.1M
Dr Puneet Rastogi & Associates LLC	NM	Optometrist	$0	$2M

New Mexico Consumer Direct Personal Care, LLC — Billing Profile & Reimbursement Data

Sign up for New Mexico Consumer Direct Personal Care, LLC — Billing Profile & Reimbursement Data policy alerts

New Mexico Consumer Direct Personal Care, LLC — Billing Profile & Reimbursement Data

Sign up for New Mexico Consumer Direct Personal Care, LLC — 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