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 District of Columbia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to District of Columbia 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. District of Columbia (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.

Capital Care, Inc (NPI 1851834501)

Field	Value
Entity Type	Organization
Organization	Capital Care, Inc
Address	6120 Kansas Ave Nw
City	Washington, Dc
State	DC
ZIP	20011
Taxonomy	Home Health Agency
NPI Enumerated	November 29, 2016

Payer Source	Total Paid
Medicaid	$83.4M
Medicare	$0

Key Findings

This provider is effectively a single-payer Medicaid operation: there is no Medicare billing on file and total Medicaid revenue is $83.4M, so all observed claims-based revenue activity is concentrated in the Medicaid program. The absence of any Medicare volume suggests payer exposure and growth are tied to state Medicaid policy and rates rather than Medicare market dynamics.

Revenue concentration is extreme within the provider's Medicaid portfolio: the precomputed top 3 codes account for 100.0% of Medicaid revenue, with T1019 alone representing $81.1M (97.2% of this provider's total Medicaid revenue). This indicates the organization’s financial performance is heavily dependent on one Medicaid service line.

The operational profile implied by the code mix is a home- and community-based personal care model: T1019 (Personal care services, per 15 minutes) dominates billing, supplemented by G0299 (direct RN skilled nursing, each 15 minutes). That pattern—very large volume of personal care services with a much smaller share for skilled nursing—aligns with a Home Health Agency that focuses on long-duration personal care rather than a primarily skilled-nursing or medical therapy provider.

Payment levels and claim volumes emphasize the economics of that personal-care focus: T1019 shows 474.1K claims at $171 avg paid/claim generating $81.1M in revenue, while G0299 reports 21K claims at $113 avg paid/claim generating $2.4M. The large claim count and relatively higher per-claim payment on T1019 drive the provider’s Medicaid revenue profile and suggest staffing and scheduling are structured around 15-minute personal-care units.

Competitive standing is mixed within the state: for T1019 the provider ranks #11 of 29 in-state (64th percentile; typical, unremarkable volume for this code), indicating a modest-to-moderate market position for its main revenue driver. By contrast G0299 ranks #7 of 32 (81th percentile; typical, unremarkable volume for this code), which signals a relatively stronger presence among peers for skilled nursing visits even though G0299 contributes a much smaller share of revenue.

S9123 shows an anomalous administrative pattern: the provider reports 997 claims but lists $0 avg paid/claim and $0 revenue while ranking #2 of 16 providers in-state (93th percentile; typical, unremarkable volume for this code). That combination—high rank and claim count but no paid dollars—points to a billing or reimbursement idiosyncrasy (e.g., nonreimbursed reporting, contractual write-offs, or zero-dollar state reporting) rather than material revenue impact.

The provider has been enumerated for approximately a decade (NPI registered 2016-11-29, ~10 years ago), indicating an established presence in the local home-care market. This tenure supports operational scale required to generate the reported high-volume T1019 activity.

From a business-risk perspective, the narrow service mix concentrated in T1019 creates sensitivity to rate changes, policy edits to personal care code usage, or utilization-management actions by the state; with 97.2% of Medicaid revenue tied to that single code, any adverse reimbursement or eligibility shifts for T1019 could materially affect total revenue. The limited Medicare exposure removes one diversification path and reinforces dependence on state Medicaid trends.

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…	474,120	$170	$81.1M
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	21,010	$110	$2.4M
S9123	Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)	1,000	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. District of Columbia Distribution

Capital Care, Inc — 0 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — District of Columbia

Full comparison — all codes billed, vs. District of Columbia median

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	11	30	405,140	$140	$47.5M
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	7	30	13,380	$80	$1.3M
S9123	Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)	2	20	130	$20	$17.2K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Integrated Community Services, Inc.	DC	Home Health Agency	$0	$145.9M
National Children's Center, Inc.	DC	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$101M
Aba Inc	DC	In Home Supportive Care Agency	$0	$80.8M
Premium Select Home Care Inc	DC	Home Health Agency	$0	$63.9M
Ideal Nursing Services Inc	DC	Home Health Agency	$0	$58M
Total Care Services, Inc.	DC	Developmentally Disabled Services Day Training Agency	$0	$54.7M
Metro Homes Inc	DC	Developmental Disabilities Clinic/Center	$0	$45.1M
Citycare Health Services, Inc	DC	Community/Behavioral Health Agency	$0	$36.4M
Janilcar Inc	DC	Durable Medical Equipment & Medical Supplies	$0	$32.7M
Dc Health Care Inc	DC	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$24.2M

Capital Care, Inc — Billing Profile & Reimbursement Data

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Capital Care, 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