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.

St. Anthony's Home Healthcare Service, LLC (NPI 1780728261)

Field	Value
Entity Type	Organization
Organization	St. Anthony's Home Healthcare Service, LLC
Address	8500 Menaul Blvd Ne
City	Albuquerque
State	NM
ZIP	87112
Taxonomy	Home Health Agency
NPI Enumerated	February 16, 2007

Payer Source	Total Paid
Medicaid	$51.4M
Medicare	$0

Key Findings

This provider is effectively single-payer in scope: there is no Medicare billing on file while total Medicaid revenue is $51.4M, indicating the organization’s entire reported lifetime revenue comes from Medicaid contracts and fee-for-service activity. Analysts should treat payer risk and reimbursement exposure as concentrated in state Medicaid arrangements rather than split across Medicare/Medicaid.

Revenue is highly concentrated in a very small set of service codes: the precomputed top three Medicaid codes (99509, S5125, T1019) account for 92.3% of the provider’s Medicaid revenue. In particular, 99509 alone represents $28.8M (56.0% of Medicaid revenue), S5125 contributes $11.1M (21.6%), and T1019 contributes $7.6M (14.7%), so any changes to coverage or rates for these codes would have an outsized impact on overall revenue.

The code mix signals a home-based, labor-intensive service model focused on activities of daily living and minute-based attendant/personal care. 99509 (home health provider visits for ADLs/self care) is the largest revenue driver, while S5125 (attendant care; per 15 minutes) and T1019 (personal care services; per 15 minutes) together indicate heavy reliance on high-volume, time-based personal care delivery with likely supervisory or skilled visits layered on top. This combination suggests the agency operates both hands-on attendant care capacity and clinical visit components.

Competitive standing varies by code: for S5125 the provider ranks #5 of 45 in-state (91th percentile), indicating a strong position among in-state attendant care suppliers, although the dataset characterizes the volume as "typical, unremarkable volume" for that code. For 99509 the provider ranks #15 of 82 (83th percentile) and is likewise labeled "typical, unremarkable volume," indicating above-average statewide presence but not an outlier. Conversely, T1019 ranks #42 of 89 (53th percentile) and is a more modest participant for personal care services.

The presence of G9006 (Coordinated care fee, home monitoring) at $3.9M (7.6% of Medicaid revenue) and ranked #15 of 79 in-state (82th percentile) indicates the provider has invested in care coordination/home monitoring capabilities in addition to hands-on care. That line item suggests the organization participates in value-oriented, coordinated care arrangements or billing for monitoring services that supplement its minute-based personal care offerings.

Operational scale is substantial in claim volumes, reflecting a high-touch service footprint: 99509 shows 86.7K claims, S5125 shows 107.9K claims, and T1019 shows 99.4K claims. These counts are consistent with a large, labor-intensive home health operation that processes very high numbers of short-interval, per-15-minute claims and therefore must manage significant scheduling, payroll, and documentation throughput.

The provider’s heavy dependence on a few Medicaid service codes creates concentration risk: with 56.0% of revenue from 99509 and 92.3% of Medicaid revenue tied to the top three codes, reimbursement policy changes, prior authorization, or rate adjustments for these codes would materially affect financial performance. Combined with the absence of Medicare revenue, this concentration leaves limited diversification of payer revenue streams.

The NPI was enumerated on 2007-02-16 (approximately 19 years ago), indicating long tenure in the market. That longevity, together with large claim volumes and top-tier rank for S5125, suggests an established local operator with capacity to scale minute-based personal and attendant care services within New Mexico.

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.	86,700	$330	$28.8M
S5125	Attendant care services; per 15 minutes	107,920	$100	$11.1M
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…	99,370	$80	$7.6M
G9006	Coordinated care fee, home monitoring	18,190	$210	$3.9M
S5110	Home care training, family; per 15 minutes	230	$340	$77.4K

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

St. Anthony's Home Healthcare Service, LLC — 0 of 5 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.	15	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…	42	90	92,900	$70	$13.3M
S5125	Attendant care services; per 15 minutes	5	50	10,600	$100	$4.3M
G9006	Coordinated care fee, home monitoring	15	80	3,840	$190	$2M
S5110	Home care training, family; per 15 minutes	23	40	340	$200	$202.4K

Nearby Providers

Other providers in the same ZIP code as St. Anthony's Home Healthcare Service, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
El Mirador Incorporated	NM	Home Health Agency	$0	$100.9M
Arca	NM	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$91.7M
Unica	NM	Community/Behavioral Health Agency	$0	$12.5M
Tasker Hatch Rowan LLC	NM	Dentist	$0	$9.8M
Quilted Care Ltd. Co.	NM	Assisted Living Facility	$0	$7.5M
Choice Recovery Path LLC	NM	Substance Use Disorder Rehabilitation Clinic/Center	$0	$3.4M
Bio-medical Applications Of New Mexico, Inc.	NM	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$3.1M
Foust Behavioral Services, LLC	NM	Social Worker	$0	$1.7M
Modern Pain & Spine PC	NM	Interventional Pain Medicine Physician	$0	$1.6M
Trucare Dental Wyoming Blvd LLC	NM	Dentist	$0	$1.4M

St. Anthony's Home Healthcare Service, LLC — Billing Profile & Reimbursement Data

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St. Anthony's Home Healthcare Service, 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