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

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

A Plus Personal Care Provider LLC (NPI 1740651322)

Field	Value
Entity Type	Organization
Organization	A Plus Personal Care Provider LLC
Address	6825 E Tennessee Ave Ste 421
City	Denver
State	CO
ZIP	80224
Taxonomy	In Home Supportive Care Agency
NPI Enumerated	October 8, 2015

Payer Source	Total Paid
Medicaid	$33.7M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and is effectively single‑payer: lifetime Medicare revenue is none while total Medicaid revenue is $33.7M, indicating the organization operates almost entirely within the Medicaid program. Analysts should treat Medicaid as the primary market when evaluating this entity's scale and contracting footprint.

Revenue is highly concentrated in three task‑level service codes: the top 3 Medicaid codes account for 100.0% of this provider's total Medicaid revenue, driven predominantly by T1019 (68.1% of Medicaid revenue), with S5130 (18.4%) and H0038 (13.5%) making up the remainder. This concentration means performance and reimbursement changes to any of these codes will have outsized effects on total revenue.

Code mix and descriptions point to an in‑home supportive care model focused on hands‑on personal assistance and nonclinical peer support. T1019 (Personal care services, per 15 minutes) and S5130 (Homemaker service, per 15 minutes) together represent routine personal care and household assistance delivered in short time increments, while H0038 (Self-help/peer services, per 15 minutes) indicates an added behavioral/peer support component to the service mix.

Volume and payment metrics show how the revenue is generated: T1019 produced $22.9M from 14.5K claims at $1583 avg paid/claim; S5130 produced $6.2M from 5.4K claims at $1145 avg paid/claim; and H0038 produced $4.5M from 5.1K claims at $894 avg paid/claim. These per‑claim payment levels combined with multi‑thousand claim counts drive the $33.7M Medicaid total.

State competitive standing is modest and near‑typical for each major code rather than dominant: T1019 ranks #147 of 475 providers in‑state (69th percentile; typical, unremarkable volume), S5130 ranks #144 of 342 (58th percentile; typical, unremarkable volume), and H0038 ranks #101 of 276 (64th percentile; typical, unremarkable volume). In each case the provider sits around the mid‑to‑upper percentiles in Colorado but does not appear to be a statewide leader for these services.

Across the three leading codes there are no statistical outliers reported; each is described as having "typical, unremarkable volume," which indicates utilization patterns comparable to many in‑state peers rather than extreme deviation. For payers and auditors, this pattern suggests normal operational scale for a Medicaid personal‑care/home‑help provider rather than anomalous billing behavior.

The provider has an established presence in the Medicaid market, with its NPI enumerated on 2015‑10‑08 (~11 years ago). That tenure supports a multi‑year operational history and likely longstanding relationships with Medicaid payers or managed care plans in the state.

Because T1019 alone contributes $22.9M (68.1% of Medicaid revenue), the business is materially dependent on per‑15‑minute personal care billing; strategic or policy changes that affect reimbursement or allowable units for T1019 would disproportionately affect overall revenue. Stakeholders should prioritize review of authorizations, documentation practices, and contract terms related to these dominant per‑15‑minute service lines.

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
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…	14,500	$1,580	$22.9M
S5130	Homemaker service, nos; per 15 minutes	5,410	$1,150	$6.2M
H0038	Self‑help/peer services, per 15 minutes	5,070	$890	$4.5M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

A Plus Personal Care Provider LLC — 0 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0038	Self‑help/peer services, per 15 minutes	101	280	2,330	$210	$4.8M
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…	147	480	5,200	$150	$3.5M
S5130	Homemaker service, nos; per 15 minutes	144	340	3,530	$80	$1.2M

Nearby Providers

Other providers in the same ZIP code as A Plus Personal Care Provider LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Supreme Health Care,llc	CO	Homemaker	$0	$62.2M
Irn International Corp.	CO	Home Health Agency	$0	$51M
Temure Inc	CO	Home Health Agency	$0	$46.7M
Monaco Adult Day Care	CO	Adult Day Care Clinic/Center	$0	$29.7M
Respect Home Health, Inc.	CO	Home Health Agency	$0	$22.2M
G&b Homecare Services, Inc.	CO	In Home Supportive Care Agency	$0	$18.8M
Four Star Home Care Inc	CO	In Home Supportive Care Agency	$0	$13.9M
Goldin Pharmacy And Medical Supply Inc.	CO	Community/Retail Pharmacy	$0	$11.6M
Prima Adult Day Care	CO	Developmentally Disabled Services Day Training Agency	$0	$11.5M
Medstuff Inc	CO	Pharmacy	$0	$9.6M

A Plus Personal Care Provider LLC — Billing Profile & Reimbursement Data

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A Plus Personal Care Provider 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