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

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

Home Health Specialists, LLC (NPI 1811226772)

Field	Value
Entity Type	Organization
Organization	Home Health Specialists, LLC
Address	11 E 200 N
City	Orem
State	UT
ZIP	84057
Taxonomy	Home Health Agency
NPI Enumerated	December 23, 2009

Payer Source	Total Paid
Medicaid	$16.1M
Medicare	$0

Key Findings

This provider is effectively single‑payer: HOME HEALTH SPECIALISTS, LLC has no Medicare billing on file and $16.1M in lifetime Medicaid revenue, so Medicaid is the sole recorded federal payer contributing material revenue for this NPI. Analysts should treat any Medicare comparators as inapplicable for this entity and focus competitive analysis on the Medicaid market.

Revenue is extremely concentrated in a very small set of services: the precomputed top three Medicaid codes account for 99.7% of the provider's total Medicaid revenue. That concentration exposes the provider’s financial profile to changes in reimbursement or utilization for those specific codes.

Operationally, the code mix indicates a private‑duty/respite nursing business model rather than traditional episodic skilled home health: T1000 (Private duty / independent nursing service(s) - licensed, up to 15 minutes) generated $12.9M (80.2% of Medicaid revenue) and T1005 (Respite care services, up to 15 minutes) generated $3M (18.9%). The dominance of short‑interval, per‑visit codes suggests staffing and scheduling optimized for high‑frequency, in‑home nursing visits and respite care rather than bundled home health episodes.

Volume and payment characteristics reinforce a high‑throughput, lower‑paid‑per‑claim operation: T1000 shows 47.1K claims at $274 avg paid/claim and T1005 shows 20K claims at $152 avg paid/claim. Those claim counts combined with the relatively modest avg paid/claim are consistent with delivering many brief, recurring in‑home nursing encounters.

Competitive standing within the state is notable but described as routine: T1000 ranks #2 of 7 providers in‑state (83th percentile) and T1005 ranks #2 of 9 providers in‑state (88th percentile), and both are labeled in the source as "typical, unremarkable volume for this code." In other words, HOME HEALTH SPECIALISTS is a leading biller on these lines in Utah but its volumes are not flagged as atypical in the dataset.

Participation on secondary Medicaid codes is modest to minimal: T1001 (Nursing assessment / evaluation) produced $109.3K and ranks #35 of 65 providers in‑state (47th percentile), G0299 produced $31K and ranks #32 of 45 providers (30th percentile), and T1030 produced $12.2K and ranks #14 of 14 providers (0th percentile). These smaller lines do not materially diversify the provider's revenue base and reflect limited engagement in other home‑health skill categories.

The revenue profile creates concentrated operational risk tied to two primary service lines: $12.9M from T1000 and $3M from T1005 together represent the vast bulk of revenue, so utilization or policy shifts affecting private duty nursing or respite reimbursement would disproportionately impact the practice. Analysts should monitor state Medicaid rate changes, prior‑authorization rules, and audit focus for these specific service codes.

The provider has an established presence in the market, with NPI enumeration dated 2009-12-23 (~17 years ago), which indicates longevity and an entrenched operational footprint in Utah’s Medicaid home‑care market; tenure may support stable referral relationships even as revenue remains concentrated in a narrow set of service codes.

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
T1000	Private duty / independent nursing service(s) - licensed, up to 15 minutes	47,110	$270	$12.9M
T1005	Respite care services, up to 15 minutes	20,020	$150	$3M
T1001	Nursing assessment / evaluation	650	$170	$109.3K
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	360	$90	$31K
T1030	Nursing care, in the home, by registered nurse, per diem	60	$200	$12.2K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Utah Distribution

Home Health Specialists, LLC — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Utah

Full comparison — all codes billed, vs. Utah median

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1000	Private duty / independent nursing service(s) - licensed, up to 15 minutes	2	10	25,500	$350	$11.1M
T1005	Respite care services, up to 15 minutes	2	10	3,930	$150	$1.7M
T1030	Nursing care, in the home, by registered nurse, per diem	14	10	960	$320	$857.8K
T1001	Nursing assessment / evaluation	35	70	700	$80	$603.4K
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	32	50	2,960	$20	$130.6K

Nearby Providers

Other providers in the same ZIP code as Home Health Specialists, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Timpanogos Regional Medical Services, Inc.	UT	General Acute Care Hospital	$0	$7.8M
Kids On The Move, Inc.	UT	Developmentally Disabled Services Day Training Agency	$0	$6.7M
Papilion Integrated Recovery Centers	UT	Substance Use Disorder Rehabilitation Clinic/Center	$0	$6.2M
Chrysalis Utah, LLC	UT	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$4.6M
Kids On The Move, Inc	UT	Developmentally Disabled Services Day Training Agency	$0	$4.4M
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$4.2M
City Of Orem Corporation	UT	Land Ambulance	$235.5K	$3.1M
Central Utah Surgicenter, LLC	UT	Ambulatory Surgical Clinic/Center	$2.1M	$28K
Hautoa Enterprises LLC	UT	Substance Abuse Rehabilitation Facility	$49.8K	$1.9M
Joshua Martin	UT	General Practice Dentistry	$0	$1.6M

Home Health Specialists, LLC — Billing Profile & Reimbursement Data

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Home Health Specialists, 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