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

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

Encore Adhc, LLC (NPI 1962932327)

Field	Value
Entity Type	Organization
Organization	Encore Adhc, LLC
Address	2432 Regency Rd Ste 200
City	Lexington
State	KY
ZIP	40503
Taxonomy	Adult Day Care Clinic/Center
NPI Enumerated	June 18, 2017

Payer Source	Total Paid
Medicaid	$51.9M
Medicare	$0

Key Findings

ENCORE ADHC, LLC has no Medicare billing on file and $51.9M in lifetime Medicaid revenue, making it practically a Medicaid-only billing entity; its NPI was enumerated on 2017-06-18 (approximately 9 years ago), so the provider has an established presence but is not a long-standing multi-decade provider. The absence of Medicare claims combined with sizable Medicaid receipts suggests its patient mix and contracted services are concentrated in Medicaid-covered adult day and community-based services.

The provider’s service mix is dominated by codes tied to adult day and home support operations: S5108 (home care training to home care client, per 15 minutes), S5100 (day care services, adult; per 15 minutes), and T1016 (case management, each 15 minutes). These codes indicate ENCORE ADHC operates as an adult day care/center model that also delivers high-volume home care training and case management, with additional ancillary services such as home-delivered meals (S5170) appearing in the billing mix.

Revenue is highly concentrated: S5108 alone accounts for $46.3M or 89.2% of the provider’s total Medicaid revenue, and the precomputed top three Medicaid codes together account for 98.1% of its Medicaid revenue. This concentration means the provider’s financial performance is heavily dependent on reimbursement and utilization patterns for a very small set of services.

Volume and unit-payment profile reinforce that concentration: the provider reported 272.4K claims for S5108 at an average paid amount of $170 per claim, 48.4K claims for S5100 at $61 avg paid/claim, and 17.6K claims for T1016 at $95 avg paid/claim. The large claim counts for S5108 relative to other codes show the business is driven by frequent, short-interval billing events rather than a broad mix of higher-unit services.

Statewide competitive standing is moderate to strong on its principal codes but not dominant: S5108 ranks #12 of 101 providers in-state (89th percentile) and is described as "typical, unremarkable volume" for that code, S5100 is #17 of 102 (84th percentile) also labeled "typical, unremarkable volume," and T1016 is #8 of 63 (89th percentile) with the same label. These rank/percentile positions indicate ENCORE ADHC is a significant in-state participant for these services but does not appear as an extreme outlier or monopolist in the market.

Even though S5108 produces the bulk of revenue, peer-comparison labels for the top codes are "typical, unremarkable volume," which signals that the provider’s high revenue share arises from scale in commonly billed services rather than anomalous billing behavior. In other words, the provider’s patterns are consistent with high-volume provision of standard Medicaid services rather than unusual coding intensity relative to peers.

From an operational and risk perspective, heavy dependence on S5108 (272.4K claims and $46.3M revenue) means the provider’s reimbursement and utilization are sensitive to any policy or payment changes affecting home care training codes; a small shift in utilization or payment for S5108 would disproportionately affect total revenue. Analysts assessing contract negotiations, rate-setting, or program changes should prioritize the economics and authorization patterns for S5108 and the related per-15-minute service model.

Ancillary service lines such as home-delivered meals (S5170: 16.4K claims, $61 avg paid/claim, $1M revenue, ranking #15 of 56, 75th percentile) provide diversification but represent a small share (S5170 is 1.9% of Medicaid revenue). These smaller code lines could be levers for incremental revenue growth or operational expansion, but they do not materially change the provider’s concentrated Medicaid revenue profile.

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
S5108	Home care training to home care client, per 15 minutes	272,380	$170	$46.3M
S5100	Day care services, adult; per 15 minutes	48,350	$60	$2.9M
T1016	Case management, each 15 minutes	17,640	$100	$1.7M
S5170	Home delivered meals, including preparation; per meal	16,430	$60	$1M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Encore Adhc, LLC — 0 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5108	Home care training to home care client, per 15 minutes	12	100	43,820	$140	$16.6M
S5100	Day care services, adult; per 15 minutes	17	100	16,270	$70	$1.9M
T1016	Case management, each 15 minutes	8	60	3,410	$120	$970.5K
S5170	Home delivered meals, including preparation; per meal	15	60	5,170	$10	$342.6K

Nearby Providers

Other providers in the same ZIP code as Encore Adhc, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Baptist Healthcare System, Inc	KY	General Acute Care Hospital	$0	$98.1M
Center For Comprehensive Services, Inc	KY	Rehabilitation Hospital	$0	$28.7M
Lhcg Lxx, LLC	KY	Home Health Agency	$0	$27.1M
P & C Labs, LLC	KY	Clinical Medical Laboratory	$427.3K	$18M
Healthfirst Bluegrass Inc	KY	Federally Qualified Health Center (FQHC)	$0	$18.1M
Ndt Care Services, LLC	KY	Community/Behavioral Health Agency	$0	$17.5M
Lexington Urgent Care PLLC	KY	Urgent Care Clinic/Center	$0	$16.7M
Ballard Wright, Md, Psc	KY	Interventional Pain Medicine Physician	$0	$12.4M
Big Smiles Kentucky Psc	KY	Dentist	$0	$12.3M
Baptist-physicians Surgery Center	KY	Ambulatory Surgical Clinic/Center	$1.3M	$5.8M

Encore Adhc, LLC — Billing Profile & Reimbursement Data

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Encore Adhc, LLC — 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