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

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

Valley Help At Home Senior Care LLC (NPI 1912320318)

Field	Value
Entity Type	Organization
Organization	Valley Help At Home Senior Care LLC
Address	3965 W 2000 S
City	Rexburg
State	ID
ZIP	83440
Taxonomy	In Home Supportive Care Agency
NPI Enumerated	January 22, 2014

Payer Source	Total Paid
Medicaid	$7.9M
Medicare	$0

Key Findings

VALLEY HELP AT HOME SENIOR CARE LLC operates as an in-home supportive care agency based on its dominant procedure mix: the top revenue-generating codes are T1019 (personal care services, per 15 minutes), S5130 (homemaker service, per 15 minutes), and S5125 (attendant care services, per 15 minutes). These codes indicate a labor-intensive, community-based personal care and homemaker service model focused on repeated, time-based visits rather than episodic clinical interventions. The presence of a small number of nursing assessment claims (T1001) supports the view that clinical evaluations are a minor component of the operation.

Revenue concentration is highly focused: total Medicaid revenue on file is $7.9M and the precomputed top 3 Medicaid codes by revenue account for 99.8% of this provider's total Medicaid revenue. Individually, T1019 generated $5.7M (72.8% of Medicaid revenue), S5130 generated $1.2M (14.9%), and S5125 generated $954.2K (12.1%), indicating nearly all Medicaid dollars flow through time-based personal care and homemaker codes. This concentration suggests operational and financial exposure to reimbursement or utilization changes for these specific service lines.

This provider is effectively single-payer in the dataset: there is no Medicare billing on file and all recorded federal payer revenue is $7.9M of Medicaid receipts. Because Medicare revenue is absent, analyses of clinical acuity tied to Medicare claims are not applicable here; strategic or utilization insights should be drawn primarily from Medicaid time-based personal care services and related program rules. Any changes in state Medicaid policy would therefore have an outsized impact on the provider's revenue base.

Competitive standing versus in-state peers is modest to mid-tier across its top codes. T1019 ranks #10 of 101 providers in-state at the 91th percentile, described in the source as a typical, unremarkable volume for this code; S5130 ranks #15 of 77 providers at the 82th percentile (also typical, unremarkable); and S5125 ranks #11 of 44 providers at the 77th percentile (typical, unremarkable). These rankings indicate the provider has meaningful scale in standard personal care and homemaker services within Idaho but is not an outlier or statewide dominant operator for these service lines.

Service-mix implications: the heavy reliance on time-based codes (T1019, S5130, S5125) indicates operations will be driven by scheduling, visit duration, and workforce capacity rather than high-acuity clinical workflows. Billing patterns (70.7K claims for T1019, 40.5K for S5130, 10.8K for S5125) show large volume of short-interval services, which typically translates to many discrete caregiver visits and administrative burden for authorization and time documentation. The relatively low count and revenue for T1001 (158 claims, $13.9K, 0.2% of Medicaid revenue) suggests assessments are performed but are not a major revenue or capacity driver.

Statistical standing and risk profile: despite high absolute counts, each top code is characterized as typical/unremarkable in statewide distributions, so the provider is not an extreme outlier in utilization patterns. The source labels for each top code indicate the provider’s volumes fall within expected ranges for in-state peers rather than showing anomalous behavior, and the T1001 nursing assessment volume similarly ranks in the middle (rank #28 of 45, 39th percentile). Analysts should therefore interpret the provider’s performance as consistent with standard in-home supportive care operations rather than indicative of atypical billing patterns.

Tenure and operational history: the provider’s NPI was enumerated on 2014-01-22 (~12 years ago), indicating roughly a decade-plus of enrollment and potential continuity in Medicaid participation. This tenure supports interpretation that the observed billing mix and volumes are established patterns rather than short-term anomalies, and it may reflect an operational focus maintained over multiple state Medicaid policy cycles.

Medicaid: Complete Services Breakdown

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

4 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…	70,710	$80	$5.7M
S5130	Homemaker service, nos; per 15 minutes	40,490	$30	$1.2M
S5125	Attendant care services; per 15 minutes	10,840	$90	$954.2K
T1001	Nursing assessment / evaluation	160	$90	$13.9K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Idaho Distribution

Valley Help At Home Senior Care LLC — 0 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. Idaho median

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5125	Attendant care services; per 15 minutes	11	40	5,180	$110	$2.3M
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…	10	100	11,400	$80	$2M
S5130	Homemaker service, nos; per 15 minutes	15	80	12,220	$20	$537.5K
T1001	Nursing assessment / evaluation	28	50	260	$60	$77K

Nearby Providers

Other providers in the same ZIP code as Valley Help At Home Senior Care LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
County Of Madison School District 321	ID	Local Education Agency (LEA)	$0	$17.1M
Upper Valley Community Health Services Inc	ID	Federally Qualified Health Center (FQHC)	$0	$7.6M
Mhd Therapies, PLLC	ID	Physical Therapist	$0	$7.4M
Upper Valley Options, Inc.	ID	Developmentally Disabled Services Day Training Agency	$0	$3.7M
Madison Co Memorial Hospital	ID	Obstetrics & Gynecology Physician	$0	$2.6M
Teton Medical Group PLLC	ID	Family Medicine Physician	$0	$2.1M
Clubhouse Pediatric Dentistry Of Madison	ID	Pediatric Dentistry	$0	$1.9M
Seasons Medical, PLLC	ID	Obstetrics & Gynecology Physician	$0	$1.8M
Fall River Medical, PLLC	ID	Primary Care Clinic/Center	$0	$1.7M
Complete Family Care PLLC	ID	Family Medicine Physician	$0	$1.7M

Valley Help At Home Senior Care LLC — Billing Profile & Reimbursement Data

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Valley Help At Home Senior Care LLC — Billing Profile & Reimbursement Data

Sign up for Valley Help At Home Senior Care LLC — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References