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

Why is the Medicaid comparison limited to West Virginia 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. West Virginia (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.

West Virginia's Choice (NPI 1821206228)

Field	Value
Entity Type	Organization
Organization	West Virginia's Choice
Address	1097 Greenbag Rd
City	Morgantown
State	WV
ZIP	26508
Taxonomy	Home Health Agency
NPI Enumerated	May 18, 2007

Payer Source	Total Paid
Medicaid	$72.7M
Medicare	$0

Key Findings

WEST VIRGINIA'S CHOICE operates as a home health agency with a revenue mix that is effectively single-payer: there is no Medicare billing on file and all reported program revenue is Medicaid-based, with total Medicaid revenue of $72.7M. The absence of Medicare claims suggests the organization’s service footprint and payer relationships are concentrated in state Medicaid programs rather than dual-eligible or Medicare-only patient populations.

Revenue concentration is extremely high: the provider’s top three Medicaid codes account for 97.9% of total Medicaid revenue, indicating that a very small set of service lines—primarily homemaker and short-interval nursing and emergency response services—drive nearly all billed Medicaid dollars. This level of concentration implies limited diversification across other billable service types.

The dominant revenue driver is S5130 (Homemaker service, nos; per 15 minutes), which accounts for $69.1M or 95.0% of this provider’s Medicaid revenue. WEST VIRGINIA'S CHOICE ranks #2 of 72 in-state for S5130 and is described as an extreme outlier and in the 99th percentile, indicating the organization is operating at a scale for homemaker services that is far above typical state volumes and positions it as one of the largest providers in that specific service category.

Two secondary codes—T1002 (Rn services, up to 15 minutes) and S5161 (Emergency response system; service fee, per month)—contribute much smaller shares ($1.2M and $906.3K respectively) yet are still notable in competitive context. T1002 is a 99th percentile, extreme outlier (rank #2 of 151), signaling an unusually high volume of short-interval RN visits relative to peers; S5161 is rank #1 of 47 and a 100th percentile extreme outlier, indicating market leadership in providing emergency response system fees at the state level.

The service mix—heavy on S5130 homemaker tasks with supplemental short RN visits (T1002) and monitored emergency response (S5161)—suggests an operational model focused on non-skilled custodial and supportive home-based care, augmented by periodic clinical check-ins and remote safety monitoring. This combination is consistent with agencies that deliver activities of daily living support at scale, with clinical nursing visits provided in small units and subscription-style emergency response billing.

Competitive standing across Medicaid codes is concentrated and top-tier: multiple codes show ranks in the 99th–100th percentiles and are labeled extreme outliers, which together indicate WEST VIRGINIA'S CHOICE is a dominant provider in key in-state service lines rather than a modest participant. At the same time, because there is no Medicare billing on file, its market influence is limited to the Medicaid population and the provider would not be visible in Medicare-based competitive analyses.

The provider has long tenure in federal enrollment, with an NPI enumerated on 2007-05-18 (~19 years ago). This sustained registration aligns with the observed high-volume Medicaid activity and suggests institutional stability and an established operational presence in its market.

Some ancillary codes appear at unremarkable volumes: for example A0160 (Non-emergency transportation: per mile - case worker or social worker) and T1001 (Nursing assessment / evaluation) contribute modest revenue shares ($864.4K and $676.1K) and have ranks that are typical to notably above typical statewide volumes (A0160 at 90th percentile; T1001 at 98th percentile). These suggest the agency also bills for transportation and formal nursing assessments, but these lines are minor relative to homemaker services.

Medicaid: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5130	Homemaker service, nos; per 15 minutes	205,610	$340	$69.1M
T1002	Rn services, up to 15 minutes	58,270	$20	$1.2M
S5161	Emergency response system; service fee, per month (excludes installation and testing)	18,500	$50	$906.3K
A0160	Non-emergency transportation: per mile - case worker or social worker	15,720	$60	$864.4K
T1001	Nursing assessment / evaluation	5,730	$120	$676.1K
S5125	Attendant care services; per 15 minutes	800	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. West Virginia Distribution

West Virginia's Choice — 4 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — West Virginia

Full comparison — all codes billed, vs. West Virginia median

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5125	Attendant care services; per 15 minutes	43	40	14,820	$750	$30.5M
S5130	Homemaker service, nos; per 15 minutes	2	70	6,710	$330	$6.6M
A0160	Non-emergency transportation: per mile - case worker or social worker	12	110	2,030	$50	$278.8K
T1002	Rn services, up to 15 minutes	2	150	1,980	$40	$232.6K
T1001	Nursing assessment / evaluation	2	60	200	$110	$90.3K
S5161	Emergency response system; service fee, per month (excludes installation and testing)	1	50	460	$50	$63.1K

Nearby Providers

Other providers in the same ZIP code as West Virginia's Choice, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mulberry Street Management Services, Inc.	WV	In Home Supportive Care Agency	$0	$175.6M
Mulberry Street Management Services, Inc.	WV	Community/Behavioral Health Agency	$0	$28.9M
Valley Comprehensive Community Mental Health Center	WV	Respite Care	$0	$21.8M
Valley Comprehensive Community Mental Health Center	WV	Community/Behavioral Health Agency	$0	$19.4M
Valley Comprehensive Community Mental Health Center, Inc.	WV	Mental Health Counselor	$0	$16.7M
Mulberry Street Management Services, Inc.	WV	Case Management Agency	$0	$8.3M
Baymark Health Services Of West Virginia, Inc.	WV	Substance Use Disorder Rehabilitation Clinic/Center	$80.4K	$7.9M
Dr. Cynthia D. Parks Dds, PLLC	WV	Pediatric Dentistry	$0	$2.7M
West Virginia Choice	WV	Home Health Agency	$0	$2.2M
Health Care Solutions At Home Inc.	WV	Durable Medical Equipment & Medical Supplies	$0	$1.4M

West Virginia's Choice — Billing Profile & Reimbursement Data

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West Virginia's Choice — 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