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

Why is the Medicaid comparison limited to Rhode Island 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. Rhode Island (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.

Bayada Home Health Care, Inc. (NPI 1912946898)

Field	Value
Entity Type	Organization
Organization	Bayada Home Health Care, Inc.
Address	171 Service Ave Ste 101&102
City	Warwick
State	RI
ZIP	02886
Taxonomy	Home Health Agency
NPI Enumerated	June 6, 2006

Payer Source	Total Paid
Medicaid	$69.5M
Medicare	$0

Key Findings

This provider is effectively single-payer in the claims record: lifetime Medicare revenue is listed as none while lifetime Medicaid revenue is $69.5M, so Medicaid accounts for the entirety of reported federal program billing on file. That concentration means any analysis of BAYADA HOME HEALTH CARE, INC. should treat Medicaid payment policies and Medicaid managed-care contracting as its primary revenue drivers rather than Medicare dynamics.

Revenue is heavily concentrated in a small set of service lines: the precomputed top 3 Medicaid codes by revenue account for 81.9% of this provider’s Medicaid receipts. Those three codes are S5125 ($25.3M, 36.4%), T1000 ($22.3M, 32.1%), and S9123 ($9.3M, 13.4%), which together drive the bulk of reported revenue and should be the focus of utilization and reimbursement reviews.

The code mix points to an operation focused on home-based personal care and both private-duty and skilled nursing services: S5125 (attendant care services; per 15 minutes) and S9123 (nursing care in the home by RN, per hour) are both large contributors, and T1000 (private duty/independent nursing service(s) - licensed, up to 15 minutes) is also a top revenue source. High claim counts for time-based personal care (for example, S5125 with 168.6K claims at $150 avg paid/claim) indicate a high-volume, minute-based delivery model common to home health and private-duty agencies.

T1000 is a standout in the provider’s competitive footprint: it generated $22.3M (32.1% of Medicaid revenue) and the provider ranks #1 of 2 providers in-state for this code (100th percentile; typical, unremarkable volume for this code). That rank indicates BAYADA is the primary reported biller of licensed private-duty nursing in the small peer set that bills this code in the state, suggesting a specialized or concentrated private-duty nursing operation relative to peers.

For S5125, the provider posts very large absolute volume but a middling competitive signal: S5125 produced $25.3M (36.4% of Medicaid revenue) with 168.6K claims and the provider ranks #10 of 83 in-state (89th percentile; typical, unremarkable volume for this code). In other words, BAYADA is a high-volume user of attendant care services in absolute terms, yet that volume sits within the broader state distribution as a routine rather than exceptional outlier.

Skilled nursing lines show above-typical state presence on several codes: S9123 generated $9.3M (13.4% of revenue) and ranks #2 of 16 in-state (93th percentile; notably above typical state volume for this code), and T1002 ranks #2 of 25 (96th percentile; notably above typical state volume for this code). Complementary codes such as S9124 and T1003 also appear with meaningful shares and above-typical rank positions for licensed practical nurse and LPN/LVN services, reinforcing a business mix that combines attendant care with substantial skilled nursing hours.

The provider’s NPI was enumerated on 2006-06-06 (~20 years ago), indicating long tenure in the market. That longevity, combined with $69.5M in Medicaid lifetime revenue, suggests an established home health operation with sustained Medicaid business and likely embedded relationships with state payers or managed-care plans.

Because 81.9% of Medicaid revenue is concentrated in three codes, the provider’s topline is sensitive to reimbursement or policy changes affecting S5125, T1000, and S9123 specifically; there is no Medicare revenue to offset payer-specific shifts. Analysts should therefore treat changes to Medicaid coverage, rate-setting, or utilization management for attendant care and private-duty/skilled nursing as primary financial risks or levers for this entity.

Medicaid: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5125	Attendant care services; per 15 minutes	168,570	$150	$25.3M
T1000	Private duty / independent nursing service(s) - licensed, up to 15 minutes	62,420	$360	$22.3M
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)	23,770	$390	$9.3M
S9124	Nursing care, in the home; by licensed practical nurse, per hour	22,480	$320	$7.2M
S9122	Home health aide or certified nurse assistant, providing care in the home; per hour	14,790	$130	$1.9M
T1003	Lpn/lvn services, up to 15 minutes	14,620	$130	$1.9M
T1002	Rn services, up to 15 minutes	15,160	$100	$1.5M
T1001	Nursing assessment / evaluation	850	$70	$60.8K
T1004	Services of a qualified nursing aide, up to 15 minutes	1,510	$10	$19.6K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Rhode Island Distribution

Bayada Home Health Care, Inc. — 3 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Rhode Island

Full comparison — all codes billed, vs. Rhode Island median

9 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	1	10	46,750	$310	$14.4M
S5125	Attendant care services; per 15 minutes	10	80	13,620	$120	$7.8M
S9124	Nursing care, in the home; by licensed practical nurse, per hour	2	10	670	$320	$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	750	$300	$1.6M
S9122	Home health aide or certified nurse assistant, providing care in the home; per hour	2	10	2,650	$130	$1M
T1003	Lpn/lvn services, up to 15 minutes	2	10	710	$120	$727K
T1002	Rn services, up to 15 minutes	2	30	280	$110	$253.3K
T1001	Nursing assessment / evaluation	17	40	460	$100	$164.4K
T1004	Services of a qualified nursing aide, up to 15 minutes	1	10	1,060	$10	$11.8K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Bayada Home Health Care, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bayada Home Health Care, Inc.	NJ	Home Health Agency	$0	$269.7M
Bayada Home Health Care, Inc.	NJ	Home Health Agency	$0	$122.6M
Bayada Home Health Care, Inc.	PA	Home Health Agency	$0	$92M
Bayada Home Health Care, Inc.	PA	Home Health Agency	$0	$85.2M
Bayada Home Health Care, Inc.	DE	Home Health Agency	$0	$61.2M
Bayada Home Health Care, Inc.	DE	Home Health Agency	$0	$56.8M
Bayada Home Health Care, Inc.	PA	Home Health Agency	$0	$51.7M
Bayada Home Health Care, Inc.	PA	Home Health Agency	$0	$47.6M
Bayada Home Health Care, Inc.	MO	Home Health Agency	$0	$41.2M
Bayada Home Health Care, Inc.	NC	Home Health Agency	$0	$40.8M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
West Bay Residential Services Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$145.8M
Kent County Memorial Hospital	RI	General Acute Care Hospital	$0	$90.8M
Avatar Residential, Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$72.9M
Thrive Behavioral Health, Inc.	RI	Community/Behavioral Health Agency	$0	$71.9M
Community Living Of Rhode Island	RI	Developmentally Disabled Services Day Training Agency	$0	$65.7M
J.arthur Trudeau Memorial Center Conversion Waivers	RI	Developmentally Disabled Services Day Training Agency	$0	$57.1M
Gateways To Change, Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$54.5M
Affinity Physicians LLC.	RI	Internal Medicine Physician	$0	$41.8M
J, Arthur Trudeau Memorial Center	RI	Developmentally Disabled Services Day Training Agency	$0	$33.9M
J.arthur Trudeau Memorial Home Based Therapy Services	RI	Community/Behavioral Health Agency	$0	$20.3M

Bayada Home Health Care, Inc. — Billing Profile & Reimbursement Data

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Bayada Home Health 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

Related Providers

Nearby Providers

Frequently Asked Questions

References