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

Why is the Medicaid comparison limited to South Dakota 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. South Dakota (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.

Independent Living Choices (NPI 1922140060)

Field	Value
Entity Type	Organization
Organization	Independent Living Choices
Address	4107 S Carnegie Circle
City	Sioux Falls
State	SD
ZIP	57106
Taxonomy	Home Health Agency
NPI Enumerated	February 13, 2007

Payer Source	Total Paid
Medicaid	$13M
Medicare	$0

Key Findings

This entity is registered as a Home Health Agency and its billing pattern is overwhelmingly Medicaid-focused: total Medicare revenue is none (no Medicare billing on file) while total Medicaid revenue is $13M. The provider’s NPI was enumerated on 2007-02-13 (~19 years ago), indicating an established presence in the market that has operated primarily under Medicaid reimbursement.

Revenue concentration is extreme within Medicaid: the top 3 Medicaid codes by revenue account for 100.0% of this provider's total Medicaid revenue, and S5125 alone accounts for the bulk of that total at $12.9M (99.6% of Medicaid revenue). This indicates operational scale is driven almost entirely by a single service line rather than a diversified payor or code mix.

The dominant billed service is S5125 (Attendant care services; per 15 minutes), with 46.9K claims at an average paid amount of $276 per claim totaling $12.9M. Given that S5125 is labor‑intensive by description, this code mix suggests the provider operates primarily as a high-volume attendant care/home personal assistance provider rather than focusing on episodic skilled nursing or therapy services.

Competitive standing on S5125 is modest statewide: the provider ranks #2 of 4 in-state and sits at the 67th percentile, characterized as typical and unremarkable volume for this code. In other words, the operation is a meaningful but not dominant in-state participant for attendant care—significant scale but not market-leading on this code.

The provider is the in-state top reporter for several low-revenue, specialized codes despite their small contribution to total Medicaid dollars: S5115 (Home care training, non-family; per 15 minutes) shows 1.5K claims, $25 avg paid/claim, $36.4K revenue and ranks #1 of 2 providers in-state (100th percentile) while S5165 (Home modifications; per service) shows 14 claims, $1081 avg paid/claim, $15.1K revenue and ranks #1 of 1 in-state. These items indicate the agency offers ancillary services such as caregiver training and home modifications, but they do not materially diversify revenue.

Two additional codes appear with minimal volume and no peer comparison: T1028 (assessment of home environment) has 30 claims, $84 avg paid/claim, $2.5K revenue and is reported as #1 of 1 in-state with no state peer volume comparison available. The presence of these niche codes suggests the agency performs assessments and occasional modification services, but their contribution to revenue is immaterial relative to attendant care.

Payer-mix implications are straightforward: this provider is effectively single-payer from an operational-revenue perspective, reliant on Medicaid ($13M) with no Medicare billing on file. That concentration means reimbursement changes or policy shifts affecting Medicaid attendant care rates or eligibility would have outsized impact on this provider’s financials and service volumes.

From a strategic viewpoint, the provider’s long tenure (~19 years) combined with very high dependence on S5125 suggests operational expertise in delivering attendant care at scale within Medicaid programs, but limited diversification across payers or major service lines. For analysts, the key considerations are the sustainability of S5125 volumes and rates, and whether the small but unique services (training, modifications, assessments) represent potential avenues for measured expansion or simply ancillary offerings.

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
S5125	Attendant care services; per 15 minutes	46,910	$280	$12.9M
S5115	Home care training, non-family; per 15 minutes	1,460	$30	$36.4K
S5165	Home modifications; per service	10	$1,080	$15.1K
T1028	Assessment of home, physical and family environment, to determine suitability to meet patient's medical needs	30	$80	$2.5K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Dakota Distribution

Independent Living Choices — 1 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. South Dakota median

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5125	Attendant care services; per 15 minutes	2	10	42,360	$210	$8.2M
S5115	Home care training, non-family; per 15 minutes	1	10	840	$20	$19.9K
S5165	Home modifications; per service	1	10	10	$1,080	$15.1K
T1028	Assessment of home, physical and family environment, to determine suitability to meet patient's medical needs	1	10	30	$80	$2.5K

Nearby Providers

Other providers in the same ZIP code as Independent Living Choices, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Universal Nursing Services, Ltd	SD	Home Health Agency	$0	$33.2M
Edgewood Prairie Crossings Sioux Falls	SD	Assisted Living Facility	$0	$1.8M
Children's Care Hospital And School	SD	Rehabilitation Hospital	$0	$1.8M
Kore Cares, LLC	SD	Home Health Agency	$0	$1.3M
Weber Home Care Services LLC	SD	Home Health Agency	$0	$1.3M
Stronghold Counseling Services Inc	SD	Counselor	$0	$1.1M
Avera Mckennan	SD	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.1M
Gpps LLC	SD	Multi-Specialty Clinic/Center	$0	$836.4K
North Central Eye, Inc.	SD	Clinic/Center	$0	$764.5K
Insight Eye Care Professionals, P.C.	SD	Optometrist	$0	$638.4K

Independent Living Choices — Billing Profile & Reimbursement Data

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Independent Living Choices — 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