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.

Alpha Sigma Health Group, Inc. (NPI 1932477205)

Field	Value
Entity Type	Organization
Organization	Alpha Sigma Health Group, Inc.
Address	2804 East 26th Street
City	Sioux Falls
State	SD
ZIP	57103
Taxonomy	Home Health Agency
NPI Enumerated	December 1, 2011

Payer Source	Total Paid
Medicaid	$4M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and is effectively a Medicaid-only operator at the present time, with total Medicaid revenue of $4M reported. The absence of Medicare revenue makes payer concentration a core feature of its profile and signals that analysis of competitive dynamics and revenue stability should focus on Medicaid-driven service lines rather than Medicare fee schedules or beneficiaries.

Revenue concentration is high: the precomputed top three Medicaid codes account for 92.9% of this provider's total Medicaid revenue. That concentration means a small set of service lines — explicitly S5130, T1019 and S5135 — drive nearly all of the reported revenue and create sensitivity to changes in reimbursement, utilization, or state policy affecting those codes.

The provider’s top revenue-generating codes indicate a home- and personal-care business model: S5130 (Homemaker service) and T1019 (Personal care services) together represent the largest revenue shares, and S5135 (Companion care) is the third contributor. These code descriptions point to a focus on non-skilled activities such as homemaker/personal care and companion services rather than skilled home health nursing, consistent with a Home Health Agency taxonomy operating in community-based long-term supports.

Code-level volumes and unit payment patterns show operational scale on high-volume, lower-unit-value visits alongside smaller-volume, higher-paid services: S5130 has 24.5K claims at $69 avg paid/claim and T1019 has 17.2K claims at $88 avg paid/claim, while S5135 has 3K claims at $169 avg paid/claim and T1000 has 5K claims at $57 avg paid/claim. This mix suggests a delivery model built on frequent, short-interval personal care and homemaker visits supplemented by fewer companion or nursing shifts that pay at a higher rate per claim.

Competitive standing within the state is modest-to-strong on the primary codes: S5130 ranks #5 of 48 providers in-state (91th percentile) and T1019 ranks #6 of 33 providers in-state (84th percentile), indicating above-average scale for those service lines locally. By contrast, S5135 sits at #10 of 21 (55th percentile), which is near the middle of in-state peers for companion care, so the provider is not uniformly dominant across all its service categories.

All four listed Medicaid codes are described in the source data as typical or unremarkable in volume for this provider: the dataset labels S5130, T1019, S5135 and T1000 as "typical, unremarkable volume for this code." In plain terms, while the provider shows above-average rank for some codes, its utilization patterns for these services fall within expected in-state norms rather than being statistical extremes.

Tenure on file shows an NPI enumeration date of 2011-12-01 (~15 years ago), indicating this entity has an established presence in the market. That length of enrollment supports the observed claim volumes as coming from an experienced operator rather than a newly entered provider.

From a risk and business-strategy perspective, the combination of single-payer concentration (no Medicare billing) and the fact that the top three codes account for 92.9% of Medicaid revenue suggests limited diversification. Payer or policy shifts affecting homemaker or personal care reimbursement in the state would disproportionately affect this provider’s revenue, so payers and competitors should monitor changes to S5130 and T1019 reimbursement rules and utilization closely.

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
S5130	Homemaker service, nos; per 15 minutes	24,530	$70	$1.7M
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…	17,170	$90	$1.5M
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	2,960	$170	$500.1K
T1000	Private duty / independent nursing service(s) - licensed, up to 15 minutes	4,950	$60	$282.4K

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

Alpha Sigma Health Group, Inc. — 0 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
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…	6	30	6,050	$80	$894.1K
T1000	Private duty / independent nursing service(s) - licensed, up to 15 minutes	7	30	2,790	$120	$627.7K
S5130	Homemaker service, nos; per 15 minutes	5	50	5,130	$70	$607.5K
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	10	20	2,520	$110	$518.5K

Nearby Providers

Other providers in the same ZIP code as Alpha Sigma Health Group, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Chris Dickes Dentistry Prof LLC	SD	General Practice Dentistry	$0	$4.3M
Recover Health Of Iowa, Inc.	SD	Home Health Agency	$0	$4M
Loyal In-home Care LLC	SD	In Home Supportive Care Agency	$0	$2.9M
Holden Health Group Inc.	SD	Secured Medical Transport (VAN)	$0	$1.5M
Gift Home Health Care LLC	SD	In Home Supportive Care Agency	$0	$1.3M
River Ridge Oral & Maxillofacial Surgical Center	SD	Oral and Maxillofacial Surgery (Dentist)	$0	$755.3K
Edgewood Greenleaf Sioux Falls LLC	SD	Assisted Living Facility	$0	$700K
Revitalized Wellness PLLC	SD	Primary Care Clinic/Center	$0	$648.3K
Diversified Enterprises, Inc.	SD	Home Health Agency	$0	$301.9K
Freed Dental Prof. L.L.C.	SD	Dental Clinic/Center	$0	$250.1K

Alpha Sigma Health Group, Inc. — Billing Profile & Reimbursement Data

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Alpha Sigma Health Group, 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