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.

Positive Outcomes, Inc. (NPI 1770624348)

Field	Value
Entity Type	Organization
Organization	Positive Outcomes, Inc.
Address	1115 N California St
City	Socorro
State	NM
ZIP	87801
Taxonomy	Personal Care Attendant
NPI Enumerated	February 8, 2007

Payer Source	Total Paid
Medicaid	$46.3M
Medicare	$0

Key Findings

This provider is effectively single-payer: there is no Medicare billing on file and lifetime Medicaid revenue is $46.3M, so the organization operates almost entirely in the Medicaid space rather than as a dual-payer provider. Analysts should treat Medicaid policy and state-level reimbursement as the primary drivers of its financial performance and competitive dynamics.

Revenue is highly concentrated in a narrow set of service lines: the precomputed top three Medicaid codes account for 94.3% of the provider's total Medicaid revenue, with 99509 alone contributing $34.1M (73.7%), T1019 contributing $5.1M (11.1%), and G9006 contributing $4.4M (9.4%). This concentration indicates that a very small number of service categories produce the overwhelming share of income.

The code mix signals a home- and community-based personal care operation: 99509 (home health/ADL visits), T1019 (personal care services per 15 minutes), and G9006 (coordinated care fee, home monitoring) together dominate billing, suggesting core capabilities in in-home assistance, personal care aides, and remote care coordination rather than facility-based or specialty procedural services. The presence of family training (T1027) and targeted case management (T2023) as smaller contributors further supports a community-oriented service model.

Competitive standing is mixed across those top codes: for 99509 the provider ranks #16 of 82 in-state (81th percentile; typical, unremarkable volume for this code), which indicates a solid but not dominant position in the high-revenue ADL/home-visit space. That placement, combined with the large share of revenue tied to 99509, makes this code a key driver of its market visibility within New Mexico.

G9006 (coordinated care fee, home monitoring) is a relative strength: the provider ranks #11 of 79 (87th percentile; typical, unremarkable volume for this code), reflecting above-average statewide activity in remote monitoring and coordinated-care payments. By contrast, T1019 (personal care services) sits at #54 of 89 (40th percentile; typical, unremarkable volume for this code), indicating modest participation among in-state peers despite contributing 11.1% of revenue.

The provider shows long tenure in the NPI registry: the NPI was enumerated on 2007-02-08 (~19 years ago), indicating sustained enrollment and an established operating history that underpins the multi-million-dollar Medicaid footprint. This longevity supports interpretation of observed billing patterns as stable operational choices rather than short-term anomalies.

Services beyond the top three account for only a small slice of revenue and reflect complementary capabilities: T1027 generated $1.7M (3.6%), T2023 generated $739.7K (1.6%), and S5110 generated $148.1K (0.3%), while therapy codes (e.g., 97110 at $81.1K) and manual therapy (97140 at $8.2K) are minor. That distribution confirms limited diversification into rehabilitative or higher-volume ancillary services and underscores reliance on core personal-care and care-coordination billing.

The heavy dependence on a few Medicaid codes creates both operational exposure and an opportunity lens for payers and analysts: with 73.7% of revenue tied to 99509 and the top three codes making up 94.3% of revenue, the provider’s financials are sensitive to reimbursement changes, policy edits, or audit focus affecting home health/ADL visits and coordinated care fees; at the same time, its above-average rank on G9006 suggests an existing favorable position to expand coordinated-care offerings if market or policy incentives develop.

Medicaid: Complete Services Breakdown

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

11 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.	84,640	$400	$34.1M
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…	72,440	$70	$5.1M
G9006	Coordinated care fee, home monitoring	20,330	$220	$4.4M
T1027	Family training and counseling for child development, per 15 minutes	16,230	$100	$1.7M
T2023	Targeted case management; per month	3,910	$190	$739.7K
S5110	Home care training, family; per 15 minutes	790	$190	$148.1K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	1,400	$60	$81.1K
H2000	Comprehensive multidisciplinary evaluation	20	$780	$11.6K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	280	$30	$8.2K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	50	$60	$2.9K

Showing 1–10 of 11

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

Positive Outcomes, Inc. — 0 of 11 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

11 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.	16	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…	54	90	92,900	$70	$13.3M
T1027	Family training and counseling for child development, per 15 minutes	26	40	25,180	$110	$5.7M
T2023	Targeted case management; per month	23	30	7,450	$200	$2.4M
G9006	Coordinated care fee, home monitoring	11	80	3,840	$190	$2M
H2000	Comprehensive multidisciplinary evaluation	45	50	170	$690	$380.3K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	206	220	1,570	$70	$340.6K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	184	290	2,790	$50	$325.7K
S5110	Home care training, family; per 15 minutes	9	40	340	$200	$202.4K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	117	150	1,710	$30	$149.9K

Showing 1–10 of 11

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Presbyterian Healthcare Services	NM	Critical Access Hospital	$0	$20.6M
Socorro Taxi Inc	NM	Non-emergency Medical Transport (VAN)	$0	$10.8M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$8.2M
Promises Kept Home Healthcare LLC	NM	Personal Care Attendant	$0	$3M
Bhasker Medical Clinic PC	NM	Family Medicine Physician	$0	$1.6M
City Of Socorro	NM	Ambulance	$202.3K	$1.2M
Ravi Bhasker	NM	Family Medicine Physician	$165.7K	$0
Kelby Stephens	NM	Physical Therapist	$122.3K	$0
Lisa Daniels	NM	Family Nurse Practitioner	$27.1K	$0
Steven Woodard	NM	Optometrist	$18.4K	$0

Positive Outcomes, Inc. — Billing Profile & Reimbursement Data

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Positive Outcomes, 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