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

Why is the Medicaid comparison limited to New Jersey 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. New Jersey (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.

Pillar Care Continuum (NPI 1013395458)

Field	Value
Entity Type	Organization
Organization	Pillar Care Continuum
Address	120 Eagle Rock Ave Ste 290
City	East Hanover
State	NJ
ZIP	07936
Taxonomy	Intellectual and/or Developmental Disabilities Residential Treatment Facility
NPI Enumerated	May 18, 2015

Payer Source	Total Paid
Medicaid	$100.8M
Medicare	$0

Key Findings

PILLAR CARE CONTINUUM is effectively a single‑payer Medicaid provider: it reports no Medicare billing on file and $100.8M in lifetime Medicaid revenue, and its NPI was enumerated on 2015-05-18 (~11 years ago), indicating roughly a decade of active billing under the current registration. The absence of Medicare activity means analyses should focus on state Medicaid policy and program-level changes rather than Medicare fee schedule or national Medicare market dynamics.

Revenue is highly concentrated in a very small number of service lines: the precomputed top three Medicaid codes together account for 99.3% of the provider’s total Medicaid revenue. Those top drivers are H2016 ($74.1M, 73.5% of Medicaid revenue), T2021 ($25M, 24.8%), and T2015 ($893.3K, 0.9%), leaving very little revenue outside these items.

The code mix indicates this operation is focused on comprehensive community support and habilitation services rather than medical/specialty care: H2016 is billed as Comprehensive community support services (per diem) and T2021 is Day habilitation, waiver (per 15 minutes). This combination points to a residential and day‑program model delivering ongoing behavioral, social, and habilitative supports to individuals with intellectual and developmental disabilities.

H2016 is the single largest revenue driver at $74.1M (73.5% of Medicaid revenue) and is billed at scale as a per‑diem support service; the provider ranks #37 of 206 in-state for this code and sits at the 82th percentile, described as a typical, unremarkable volume for H2016 in New Jersey. That rank suggests PILLAR CARE CONTINUUM is a meaningful statewide participant in comprehensive community supports but not among the very largest providers for this specific per‑diem service.

T2021 (Day habilitation, waiver) is the provider’s second major line at $25M (24.8% of Medicaid revenue) and shows above‑typical activity relative to peers: the provider ranks #17 of 218 in-state and is at the 93th percentile, labeled notably above typical state volume. This strong position on day habilitation indicates the organization operates high‑volume day programming and is comparatively prominent among New Jersey waiver providers for billed habilitation minutes.

The third code, T2015 (Habilitation, prevocational, waiver; per hour), contributes a small share ($893.3K, 0.9% of Medicaid revenue) and ranks #21 of 70 in-state at the 71th percentile, characterized as typical, unremarkable volume. Additional ancillary codes such as T1005 (respite, $477K, 0.5%, rank #6 of 42, 88th percentile) and A0090 (transportation, $164.9K, 0.2%, rank #105 of 227, 54th percentile) represent modest secondary services but do not materially change the revenue concentration in the top habilitation and community support codes.

Several less‑revenue codes appear at low state percentiles (for example, S8990 at the 33th percentile, T2019 at the 26th percentile, and 97535 at the 45th percentile), reinforcing that the provider’s footprint is narrowly concentrated in a couple of core service types rather than broadly distributed across rehabilitation or ancillary therapy lines. For payer or competitor benchmarking, this profile signals a specialized habilitation/residential provider with limited diversification into other Medicaid service areas.

From a payer oversight and network strategy perspective, the extreme concentration (99.3% of Medicaid revenue in the top three codes) creates sensitivity to rate changes, waiver rule adjustments, or enrollment shifts affecting H2016 and T2021. Analysts and contracting teams should prioritize monitoring utilization and reimbursement trends for H2016 and T2021, given their outsized share of revenue and the provider’s notable state‑level position on day habilitation, while recognizing the provider has no Medicare billing exposure to diversify financial risk.

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2016	Comprehensive community support services, per diem	158,020	$470	$74.1M
T2021	Day habilitation, waiver; per 15 minutes	153,620	$160	$25M
T2015	Habilitation, prevocational, waiver; per hour	7,770	$120	$893.3K
T1005	Respite care services, up to 15 minutes	8,370	$60	$477K
A0090	Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest	9,700	$20	$164.9K
S8990	Physical or manipulative therapy performed for maintenance rather than restoration	710	$60	$43K
T2019	Habilitation, supported employment, waiver; per 15 minutes	440	$90	$41.2K
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	310	$50	$16.1K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Jersey Distribution

Pillar Care Continuum — 0 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Jersey

Full comparison — all codes billed, vs. New Jersey median

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2016	Comprehensive community support services, per diem	37	210	23,310	$490	$41.9M
T2021	Day habilitation, waiver; per 15 minutes	17	220	14,500	$170	$7.7M
T2019	Habilitation, supported employment, waiver; per 15 minutes	47	60	1,540	$110	$696.7K
T2015	Habilitation, prevocational, waiver; per hour	21	70	2,810	$100	$671.2K
S8990	Physical or manipulative therapy performed for maintenance rather than restoration	15	20	2,470	$120	$639K
T1005	Respite care services, up to 15 minutes	6	40	830	$100	$313.7K
A0090	Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest	105	230	7,800	$10	$218.8K
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	120	220	350	$60	$95.3K

Nearby Providers

Other providers in the same ZIP code as Pillar Care Continuum, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Shereen Makar	NJ	Physical Medicine & Rehabilitation Physician	$415.7K	$1.6K
Cristin Mckenna	NJ	Physical Medicine & Rehabilitation Physician	$357.6K	$0
Costco Wholesale Corporation	NJ	Community/Retail Pharmacy	$83.1K	$0
Marta Profis	NJ	Occupational Therapist	$65.7K	$0
Amy Mourad	NJ	Physical Therapist	$47.8K	$0

Pillar Care Continuum — Billing Profile & Reimbursement Data

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Pillar Care Continuum — 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