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

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

Creative Community Options Inc (NPI 1023149267)

Field	Value
Entity Type	Organization
Organization	Creative Community Options Inc
Address	9550 White Oak Ln
City	Johnston
State	IA
ZIP	50131
Taxonomy	Day Training/Habilitation Specialist
NPI Enumerated	March 8, 2007

Payer Source	Total Paid
Medicaid	$41.5M
Medicare	$0

Key Findings

This entity bills exclusively to Medicaid at scale: Total Medicaid revenue on file is $41.5M while there is none for Medicare (no Medicare billing on file), indicating an effectively single-payer Medicaid footprint rather than a mixed Medicare/Medicaid business model. The provider’s NPI was enumerated 2007-03-08 (~19 years ago), showing long tenure in the market.

Revenue is highly concentrated in a small set of community-support and companion-care codes: the top three Medicaid codes (H2016, H2015, S5136) account for 94.0% of the provider’s Medicaid revenue, with H2016 alone representing 68.7% of total Medicaid revenue, H2015 16.0%, and S5136 9.3%. This concentration indicates the organization’s financial performance is heavily dependent on a narrow set of service lines.

The code mix points to a day habilitation/community support operating model: large volumes of H2016 (Comprehensive community support services, per diem) and H2015 (Comprehensive community support services, per 15 minutes) together drive the majority of revenue, which is consistent with a program that delivers structured, time- or day-based community support services. Substantial S5136 (Companion care, adult; per diem) revenue further implies hands-on IADL/ADL support is a key part of the service offering.

Unit payment characteristics reinforce the operational interpretation: H2016 averages $300 paid/claim and is the single largest revenue generator at $28.5M, while H2015 averages $146 paid/claim for time-based services and contributes $6.6M. S5136 averages $214 paid/claim and contributes $3.9M, and H2025 (ongoing employment support) pays a higher $345 avg/claim but contributes a smaller $2M (4.8% of Medicaid revenue). These payment levels suggest per-diem and time-based Medicaid reimbursement patterns drive margins and capacity decisions.

State competitive standing varies by code: H2015 is a clear area of relative strength—this provider ranks #5 of 95 in-state (96th percentile) and is described as "notably above typical state volume for this code," indicating a leading position for time-based comprehensive community support. By contrast, H2016 ranks #24 of 176 (87th percentile) and S5136 ranks #29 of 82 (65th percentile) and are both characterized as "typical, unremarkable volume for this code," meaning the provider is solid but not dominant statewide on those per-diem and companion-care lines.

Beyond the top three, the provider bills smaller amounts for related habilitation and behavioral codes: H2025 (per 15 minutes) yields $2M and ranks #16 of 65 (77th percentile) and is noted as "typical, unremarkable volume for this code," while T2018 (supported employment waiver, per diem) contributes $359.2K and ranks #4 of 33 (91th percentile) but is also labeled "typical, unremarkable volume." These smaller lines indicate service breadth into employment supports and waiver habilitation, but they do not materially change the revenue concentration profile.

Operational risk and strategic implication: because 94.0% of Medicaid revenue is clustered in a few community-support and companion-care codes, the provider is highly exposed to Medicaid policy, rate changes, and utilization shifts affecting H2016/H2015/S5136. Payers and network planners should view this provider as a specialized Medicaid-day/community-support operator whose financial performance is sensitive to changes in per-diem and time-based reimbursement.

The provider’s long enumeration date (~19 years) combined with concentrated, high-volume billing in a few Medicaid community-support codes suggests an established, specialized presence in the state’s Medicaid habilitation ecosystem. For competitor analysis and contracting, this looks like an entrenched Medicaid-focused day/companion care provider with a market-leading position specifically in H2015 services and solid but not dominant standing on other high-revenue codes.

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
H2016	Comprehensive community support services, per diem	95,120	$300	$28.5M
H2015	Comprehensive community support services, per 15 minutes	45,440	$150	$6.6M
S5136	Companion care, adult (e.g., iadl/adl); per diem	18,100	$210	$3.9M
H2025	Ongoing support to maintain employment, per 15 minutes	5,780	$350	$2M
T2018	Habilitation, supported employment, waiver; per diem	3,070	$120	$359.2K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	2,170	$60	$136.6K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	80	$30	$2.4K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	20	$90	$1.3K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	20	$50	$920

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Iowa Distribution

Creative Community Options Inc — 1 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Iowa

Full comparison — all codes billed, vs. Iowa median

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5136	Companion care, adult (e.g., iadl/adl); per diem	29	80	9,410	$490	$17.9M
H2016	Comprehensive community support services, per diem	24	180	10,790	$390	$15.2M
H2025	Ongoing support to maintain employment, per 15 minutes	16	70	2,970	$300	$1.9M
H2015	Comprehensive community support services, per 15 minutes	5	100	4,130	$160	$1.9M
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	205	680	670	$70	$343.5K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	108	120	980	$50	$230.3K
T2018	Habilitation, supported employment, waiver; per diem	4	30	440	$100	$140.6K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	347	400	110	$100	$101.1K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	269	280	530	$40	$80.1K

Nearby Providers

Other providers in the same ZIP code as Creative Community Options Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Childserve Community Options, Inc.	IA	Child Intellectual and/or Developmental Disabilities Respite Care	$0	$47.6M
Diabetic Equipment And Supplies LLC	IA	Customized Equipment (DME)	$0	$42.3M
Johnston Csd	IA	Local Education Agency (LEA)	$0	$13.9M
Childserve Homes Inc.	IA	Mental Illness Intermediate Care Facility	$0	$10M
Youth Homes Of Mid-america	IA	Rehabilitation Clinic/Center	$0	$9.4M
Childserve Therapy, Inc.	IA	Physical Therapist	$0	$4.5M
The Childserve Clinic Inc	IA	Pediatrics Physician	$0	$4.5M
Goodwill Industries Of Central Iowa	IA	Developmentally Disabled Services Day Training Agency	$0	$3.7M
Childserve Medical Equipment & Supply Inc.	IA	Durable Medical Equipment & Medical Supplies	$0	$2.7M
Mending Minds, LLC	IA	Psychiatric/Mental Health Nurse Practitioner	$0	$2.5M

Creative Community Options Inc — Billing Profile & Reimbursement Data

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Creative Community Options Inc — 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