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

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

Commonwealth Of Massachusetts (NPI 1023140498)

Field	Value
Entity Type	Organization
Organization	Commonwealth Of Massachusetts
Address	1900 Crown Colony Drive
City	Quincy
State	MA
ZIP	02169
Taxonomy	Case Management Agency
NPI Enumerated	March 12, 2007

Payer Source	Total Paid
Medicaid	$447.5M
Medicare	$0

Key Findings

COMMONWEALTH OF MASSACHUSETTS presents as an effectively single-payer Medicaid provider: there is no Medicare billing on file and the organization reports $447.5M in lifetime Medicaid revenue. The absence of Medicare activity combined with large Medicaid receipts indicates its operations and reimbursement risk are concentrated within state Medicaid programs rather than diversified across federal Medicare billing.

Revenue is highly concentrated in a very small set of Medicaid codes: the precomputed top three codes account for 93.4% of this provider's total Medicaid revenue, and a single code, T2016, represents $371.4M (83.0% of the provider's Medicaid revenue). This concentration implies that changes to residential habilitation policy, waiver rules, or per-diem rates for T2016 could materially affect overall revenue.

The provider's operational footprint is dominated by residential and community habilitation services: T2016 (Habilitation, residential, waiver; per diem) is by far the largest revenue driver, and S5100 (Day care services, adult; per 15 minutes) and T2023 (Targeted case management; per month) are the next-largest sources. Together these codes suggest the organization primarily delivers waiver-funded residential habilitation, adult day services, and ongoing case management rather than acute medical or procedure-based care.

Competitive standing on the flagship code is substantial in absolute dollars but not uniquely dominant statewide: T2016 generates $371.4M and the provider ranks #5 of 25 in-state and sits near the 83rd percentile, a placement described in the source as typical or unremarkable for this code. In other words, the provider is a major participant in residential habilitation by revenue size, yet other in-state providers also capture significant share of this market segment.

The provider shows relative strength in adult day services and transportation compared with peers: S5100 produced $33.5M (7.5% of total Medicaid revenue) and ranks #4 of 189 providers in-state at the 98th percentile, which the source labels notably above typical state volume; similarly, T2003 (Non-emergency transportation) generated $7.3M and ranks #7 of 245 at the 98th percentile, also noted as notably above typical. These positions indicate the organization is a top-tier provider of per-15-minute adult day services and of trip-based non-emergency transportation within the state network.

Case management and community support services are meaningful but secondary revenue lines: T2023 (Targeted case management) contributed $12.8M (2.9% of revenue) and ranks #9 of 70 (88th percentile), while H2015 (Comprehensive community support services) added $9.7M (2.2% of revenue) and ranks #51 of 147 (66th percentile). These placements are described as typical or unremarkable, suggesting these services complement the core habilitation/residential operations rather than serving as primary revenue engines.

High claim volumes underline the per-diem and time-based nature of delivery: T2016 shows 47.4K claims and S5100 shows 103.1K claims, indicating heavy reliance on frequent-per-unit billing (per diem and per 15-minute increments) rather than episodic, high-dollar procedures. This operational model aligns with long-term, community-based supports that generate large claim counts at lower unit prices for many beneficiary-days or beneficiary-hours.

The provider is an established Medicaid participant with sustained tenure: the NPI was enumerated on 2007-03-12 (~19 years ago), indicating long-standing participation in the state Medicaid system. That tenure, combined with the concentration in waiver-based habilitation codes, suggests institutional experience in administering residential and community support programs under Massachusetts Medicaid rules.

Medicaid: Complete Services Breakdown

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	47,410	$7,840	$371.4M
S5100	Day care services, adult; per 15 minutes	103,060	$330	$33.5M
T2023	Targeted case management; per month	37,730	$340	$12.8M
H2015	Comprehensive community support services, per 15 minutes	24,780	$390	$9.7M
T2003	Non-emergency transportation; encounter/trip	281,870	$30	$7.3M
T2021	Day habilitation, waiver; per 15 minutes	30,900	$200	$6.2M
T2019	Habilitation, supported employment, waiver; per 15 minutes	30,690	$100	$3M
H2023	Supported employment, per 15 minutes	20,900	$140	$2.8M
S5125	Attendant care services; per 15 minutes	1,070	$590	$629.6K
H0045	Respite care services, not in the home, per diem	240	$550	$133.8K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

Commonwealth Of Massachusetts — 2 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	5	30	29,930	$10,070	$358.9M
T2023	Targeted case management; per month	9	70	8,210	$510	$8.6M
H2023	Supported employment, per 15 minutes	16	20	28,450	$190	$5.6M
H2015	Comprehensive community support services, per 15 minutes	51	150	7,770	$140	$4.8M
S5125	Attendant care services; per 15 minutes	29	40	3,390	$300	$4.7M
T2021	Day habilitation, waiver; per 15 minutes	4	20	20,590	$210	$4.5M
S5100	Day care services, adult; per 15 minutes	4	190	2,000	$230	$3.1M
T2019	Habilitation, supported employment, waiver; per 15 minutes	10	20	24,690	$120	$3.1M
T2003	Non-emergency transportation; encounter/trip	7	250	40,490	$30	$2.2M
H0045	Respite care services, not in the home, per diem	3	10	340	$260	$380.3K

Nearby Providers

Other providers in the same ZIP code as Commonwealth Of Massachusetts, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
South Shore Mental Health Center, Inc.	MA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$84.4M
Nextmargin Corporation	MA	In Home Supportive Care Agency	$0	$72.3M
Bay State Community Services, Inc.	MA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$28.4M
Caring Bees Healthcare Inc.	MA	Home Health Agency	$0	$20.8M
Fallon Service, Inc.	MA	Land Ambulance	$0	$11.8M
Anodyne Homemaker Services Corp	MA	Home Health Agency	$0	$11.6M
Rainbow Adhc Of Quincy LLC	MA	Adult Day Care Clinic/Center	$0	$10.3M
Commonwealth Of Massachusetts-dmh	MA	Case Management Agency	$0	$9.4M
Allied Home Health Care, Inc.	MA	Home Health Agency	$0	$7.9M
Advantage Imaging Solutions, LLC	MA	Sonography Radiologic Technologist	$44.7K	$3.4M

Commonwealth Of Massachusetts — 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