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

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

National Mentor Healthcare Network (NPI 1013093616)

Field	Value
Entity Type	Organization
Organization	National Mentor Healthcare Network
Address	4550 Ricker Rd
City	Jacksonville
State	FL
ZIP	32210
Taxonomy	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NPI Enumerated	October 27, 2006

Payer Source	Total Paid
Medicaid	$114.9M
Medicare	$0

Key Findings

This provider is effectively single-payer: there is no Medicare billing on file and the lifetime Medicaid revenue reported is $114.9M, indicating the organization’s revenue is concentrated in state Medicaid programs rather than federal Medicare reimbursement streams. The absence of Medicare activity suggests operations and contracting are oriented toward Medicaid eligibility, benefits, and waiver-managed care models rather than Medicare-covered clinical services.

Revenue is highly concentrated in a very small set of Medicaid codes: the top 3 Medicaid codes together account for 96.8% of this provider’s total Medicaid revenue. The dominant codes are T2023, T2016, and S5102, and this concentration implies financial results are driven by a tight set of programmatic services rather than a broad mix of billable activities.

Operationally, the code mix strongly signals an Intellectual/Developmental Disabilities service model focused on long-term supports: T2023 (Targeted case management; per month), T2016 (Habilitation, residential, waiver; per diem), and S5102 (Day care services, adult; per diem) make up the bulk of revenue. These codes indicate the provider’s core service lines are case management, residential habilitation under waiver programs, and adult day services — consistent with the stated taxonomy as a community-based residential treatment facility for IDD populations.

T2023 is the single largest revenue driver and an extreme outlier in-state: the provider reported 16.5K T2023 claims, $4124 avg paid/claim, and $67.9M revenue (59.1% of the provider’s Medicaid revenue); it ranks #1 of 43 providers in the state (100th percentile; extreme outlier). This combination of very high per-month payments and high claim volume indicates a strategic emphasis on monthly targeted case management as a primary revenue engine and a competitive position that is materially above typical state volumes for this code.

T2016 represents a second major operational pillar with 157.9K claims, $238 avg paid/claim, and $37.6M revenue (32.7% of the provider’s Medicaid revenue); it ranks #1 of 7 providers in-state (100th percentile) but is characterized as a typical, unremarkable volume profile for the code. The large number of per-diem habilitation claims suggests substantial residential capacity or occupancy in waiver-funded settings, and being the top-ranked provider among a small peer set reflects scale within that narrower market segment.

S5102 (Day care services, adult) provides a meaningful but much smaller revenue stream at 27.6K claims, $211 avg paid/claim, and $5.8M revenue (5.1% of Medicaid revenue); the provider ranks #23 of 331 in-state (93th percentile). This indicates the organization is a high-volume participant in adult day services relative to many peers, but S5102 remains a secondary line compared with T2023 and T2016. Other listed Medicaid codes (for example H2019, T2003, T2002) appear as ancillary service lines that supplement the core case management and residential habilitation revenues.

Competitive standing is concentrated and market-leading for the top two codes: the provider’s #1 ranks and 100th percentile positions on T2023 and T2016 show dominant statewide placement in those funded services, while its positioning on S5102 (93th percentile, #23 of 331) shows above-average scale for day services without sole dominance. For analysts, this means the provider is a major player in Florida’s Medicaid waiver and targeted case management markets but relatively specialized rather than broadly diversified across Medicaid service categories.

The provider’s NPI was enumerated on 2006-10-27 (approximately 20 years ago), indicating an established tenure in the Medicaid market that could reflect long-standing contracts, program relationships, or operational experience with waiver-funded service delivery. That tenure, combined with the heavy reliance on a few high-revenue Medicaid codes, suggests an institutionally embedded business model that is efficient within its niche but also exposed to policy, rate, or eligibility changes affecting those specific codes or waiver programs.

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
T2023	Targeted case management; per month	16,460	$4,120	$67.9M
T2016	Habilitation, residential, waiver; per diem	157,860	$240	$37.6M
S5102	Day care services, adult; per diem	27,650	$210	$5.8M
H2019	Therapeutic behavioral services, per 15 minutes	35,610	$40	$1.6M
T2003	Non-emergency transportation; encounter/trip	45,550	$30	$1.4M
T2002	Non-emergency transportation; per diem	2,590	$150	$391.2K
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	5,950	$40	$250K
T2020	Day habilitation, waiver; per diem	490	$70	$34.4K
H0043	Supported housing, per diem	640	$40	$28.2K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Florida Distribution

National Mentor Healthcare Network — 2 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Florida

Full comparison — all codes billed, vs. Florida median

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	1	10	49,730	$260	$18.3M
T2023	Targeted case management; per month	1	40	660	$3,920	$7.7M
S5102	Day care services, adult; per diem	23	330	4,610	$110	$958K
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	266	540	5,780	$40	$596.2K
H2019	Therapeutic behavioral services, per 15 minutes	103	1,880	1,010	$70	$544.5K
H0043	Supported housing, per diem	9	10	1,650	$170	$536.7K
T2003	Non-emergency transportation; encounter/trip	11	60	4,470	$30	$534.3K
T2002	Non-emergency transportation; per diem	31	110	1,290	$30	$62.3K
T2020	Day habilitation, waiver; per diem	1	10	490	$70	$34.7K

Nearby Providers

Other providers in the same ZIP code as National Mentor Healthcare Network, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jeffrey Caudill	FL	Pain Medicine (Anesthesiology) Physician	$688.2K	$0
Jairo De La Hoz	FL	Family Medicine Physician	$367K	$0
Syed Hussain	FL	Family Medicine Physician	$91.3K	$0

National Mentor Healthcare Network — Billing Profile & Reimbursement Data

Sign up for National Mentor Healthcare Network — Billing Profile & Reimbursement Data policy alerts

National Mentor Healthcare Network — Billing Profile & Reimbursement Data

Sign up for National Mentor Healthcare Network — 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