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

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

Choice Home Care, LLC (NPI 1982126173)

Field	Value
Entity Type	Organization
Organization	Choice Home Care, LLC
Address	10465 Melody Dr Ste 325
City	Northglenn
State	CO
ZIP	80234
Taxonomy	In Home Supportive Care Agency
NPI Enumerated	July 10, 2017

Payer Source	Total Paid
Medicaid	$34.3M
Medicare	$0

Key Findings

CHOICE HOME CARE, LLC shows a concentrated payer profile: Total Medicare revenue is none (no Medicare billing on file) while lifetime Medicaid revenue is $34.3M, making Medicaid effectively the sole public payer supporting this operation. This means analyses of utilization, reimbursement trends, and policy exposure should focus on Medicaid programs rather than Medicare dynamics.

Revenue is highly concentrated in three Medicaid service codes: H0038 ($17M, 49.6%), T1019 ($14.6M, 42.5%), and S5130 ($2.7M, 7.8%), which precompute to account for 100.0% of the provider's Medicaid revenue. That concentration indicates a narrow revenue base driven almost entirely by in-home support and related non-medical services rather than a diversified set of procedure codes.

The top codes reflect the provider’s service model: H0038 is self-help/peer services, T1019 is personal care services per 15 minutes, and S5130 is homemaker service per 15 minutes. Collectively these codes suggest the organization operates as an in-home supportive care agency focused on personal care, homemaking, and peer/self-help behavioral supports rather than skilled home health or medical procedures.

Competitive standing by code: H0038 is ranked #18 of 276 providers in-state (94th percentile) and is described in the source as "typical, unremarkable volume for this code," indicating a comparatively high statewide placement but still within the expected distribution for peer/self-help services. T1019 ranks #35 of 475 (93th percentile; typical, unremarkable volume for this code) and S5130 ranks #36 of 342 (90th percentile; typical, unremarkable volume for this code), so the provider appears to be a strong regional player across its core service lines without being an outlier beyond typical state-level practice patterns.

Operational scale is substantial: the provider reported 57.9K claims for H0038, 70.8K claims for T1019, and 26.5K claims for S5130, reflecting high encounter volumes that imply significant staffing, scheduling, and coordination demands for in-home delivery. These claim volumes combined with per-claim reimbursements drive the sizable $34.3M Medicaid lifetime revenue.

Payment characteristics show variability in average reimbursement: H0038 averages $294 avg paid/claim, T1019 averages $206 avg paid/claim, and S5130 averages $101 avg paid/claim. The higher per-claim payment for H0038 contributes materially to its 49.6% share of Medicaid revenue despite slightly fewer or comparable claim counts to T1019, underscoring how mix and unit price both shape revenue concentration.

The provider’s NPI was enumerated on 2017-07-10 (~9 years ago), indicating several years of operation under the current enrollment and sufficient tenure to establish its present Medicaid caseload and billing patterns. This tenure supports the interpretation that current code mix and market positioning are stable and not just transitional.

From a strategic and risk perspective, CHOICE HOME CARE’s reliance on Medicaid and on three codes that together represent 100.0% of Medicaid revenue creates concentration exposure: changes to state Medicaid policy, rate-setting for H0038/T1019/S5130, or shifts in utilization patterns could have outsized financial impact. Absent Medicare billing or broader service diversification in the claims record, pursuing new payer relationships or service lines would be the primary levers to materially change the current revenue profile.

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0038	Self‑help/peer services, per 15 minutes	57,880	$290	$17M
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…	70,770	$210	$14.6M
S5130	Homemaker service, nos; per 15 minutes	26,510	$100	$2.7M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

Choice Home Care, LLC — 0 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0038	Self‑help/peer services, per 15 minutes	18	280	2,330	$210	$4.8M
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…	35	480	5,200	$150	$3.5M
S5130	Homemaker service, nos; per 15 minutes	36	340	3,530	$80	$1.2M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
North Metro Community Services, Inc.	CO	Developmentally Disabled Services Day Training Agency	$0	$107.8M
Evergreen Home Healthcare, LLC	CO	In Home Supportive Care Agency	$0	$28.6M
Trust Home Care, LLC	CO	Home Health Agency	$0	$14.4M
Vitalcare Corporation	CO	Home Health Agency	$0	$11M
Childrens Therapy Services Of Colorado, Inc.	CO	Speech-Language Pathologist	$0	$9.9M
C & D Choices, Inc	CO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$9.6M
Trust Home Care, LLC	CO	Home Health Agency	$0	$9.1M
North Metro Community Services, Inc	CO	Case Management Agency	$0	$7.6M
North Metro Community Services, Inc	CO	Developmentally Disabled Services Day Training Agency	$0	$6.5M
Roth Medical Inc	CO	Durable Medical Equipment & Medical Supplies	$0	$6.5M

Choice Home Care, LLC — Billing Profile & Reimbursement Data

Sign up for Choice Home Care, LLC — Billing Profile & Reimbursement Data policy alerts

Choice Home Care, LLC — Billing Profile & Reimbursement Data

Sign up for Choice Home 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