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

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

Macomb Oakland Regional Center Inc. (NPI 1023199965)

Field	Value
Entity Type	Organization
Organization	Macomb Oakland Regional Center Inc.
Address	2399 E Walton Blvd
City	Auburn Hills
State	MI
ZIP	48326
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	October 18, 2006

Payer Source	Total Paid
Medicaid	$343.1M
Medicare	$0

Key Findings

MACOMB OAKLAND REGIONAL CENTER INC. is effectively a Medicaid-focused provider with $343.1M in lifetime Medicaid revenue and no Medicare billing on file; the platform records “none below” for Medicare, so this entity operates as a single-payer (Medicaid) billing organization at scale. Its NPI was enumerated 2006-10-18 (~20 years ago), indicating long-tenure operation in the state Medicaid market.

Revenue is highly concentrated in a small set of per-diem and case-management codes: the precomputed top 3 Medicaid codes by revenue account for 49.7% of the provider’s total Medicaid revenue. Specifically, H0043 (supported housing) generated $69.5M (20.6%), H2016 (comprehensive community support services, per diem) generated $52.9M (15.7%), and T1020 (personal care services, per diem) generated $45.3M (13.4%), indicating that nearly half of Medicaid revenue flows from ongoing residential and per-diem community support lines.

The code mix demonstrates an operational emphasis on long-duration, community-based supports and case management rather than episodic medical care: dominant revenues are from H0043 (supported housing), H2016/H2015 (comprehensive community support services), T1020 (personal care services), and time-based case management codes T1016 and T1017. This combination—large per‑diem supported housing plus frequent 15‑minute case management entries—points to an integrated service model providing housing, personal care, and intensive care coordination for high-need beneficiaries.

Competitive standing in Michigan is dominant for multiple core service lines: H0043 ranks #1 of 130 providers in-state (100th percentile; extreme outlier) and T1020 ranks #1 of 221 providers in-state (100th percentile; extreme outlier), while H2016 ranks #2 of 297 providers (100th percentile; extreme outlier). Those rank/percentile positions signal that this organization is a major, outlier-scale provider of supported housing, comprehensive community supports, and personal care within Michigan’s Medicaid program.

Several additional codes show outsized state presence for care coordination and behavioral health: T1016 (case management, each 15 minutes) produced $44.1M (13.1%) and ranks #1 of 123 providers (100th percentile; extreme outlier), and T1017 (targeted case management) produced $42.1M (12.5%) and ranks #10 of 175 providers (95th percentile; notably above typical state volume). These high-volume time-based case-management lines reinforce that a substantial portion of revenue is driven by billable care-coordination time rather than brief clinical visits.

The provider’s service mix includes both Medicaid waiver/long-term-support elements and specialty behavioral/developmental treatments: codes like T2025 (waiver services), 97153 and 0365T (adaptive behavior/ABA services), and H2000 (comprehensive multidisciplinary evaluation) appear in the top codes list. Presence of 97153 (22.6K claims, $4.6M) and H2000 ($2M, rank #2 of 154, 99th percentile; extreme outlier) indicates material delivery of developmental/behavioral evaluation and therapy alongside residential and case-management programs.

Several high-revenue codes are explicitly labeled as statistical outliers in-state, which should inform competitive benchmarking and contract negotiations: H0043, H2016, T1020, T1016, H2000, and H0032 are all described as “extreme outlier” or near‑extreme in their rank/percentile notes, underscoring unusually large volume relative to peers. Analysts should treat those lines as the provider’s core market leverage when modeling volume risk or setting rates for similar services.

Not all codes are outliers—many ancillary and therapy codes fall in modest percentiles (for example, 97153 at the 64th percentile, 97155 at the 62nd percentile, and several respite and training codes in the mid-percentiles), indicating a mix of dominant core services plus routine, peer‑typical offerings. This suggests the organization operates a broad suite of community behavioral health services but concentrates strategic scale in supported housing, comprehensive community supports, personal care, and intensive case management.

Medicaid: Complete Services Breakdown

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

54 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0043	Supported housing, per diem	371,740	$190	$69.5M
H2016	Comprehensive community support services, per diem	545,700	$100	$52.9M
T1020	Personal care services, per diem, 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…	545,420	$80	$45.3M
T1016	Case management, each 15 minutes	186,810	$240	$44.1M
T1017	Targeted case management, each 15 minutes	169,000	$250	$42.1M
H2015	Comprehensive community support services, per 15 minutes	396,970	$80	$30.6M
H0032	Mental health service plan development by non-physician	49,460	$230	$11.2M
H0031	Mental health assessment, by non-physician	21,810	$480	$10.4M
T1005	Respite care services, up to 15 minutes	121,070	$50	$5.4M
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	22,620	$200	$4.6M

Showing 1–10 of 54

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Michigan Distribution

Macomb Oakland Regional Center Inc. — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

54 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2016	Comprehensive community support services, per diem	2	300	6,660	$310	$8.7M
T1017	Targeted case management, each 15 minutes	10	180	10,890	$210	$8.1M
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	48	130	11,590	$190	$7.6M
H2015	Comprehensive community support services, per 15 minutes	15	610	14,740	$90	$6M
T2027	Specialized childcare, waiver; per 15 minutes	27	40	23,640	$70	$4.8M
T1020	Personal care services, per diem, 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…	1	220	7,030	$170	$4.6M
H0043	Supported housing, per diem	1	130	10,330	$210	$4.5M
H2014	Skills training and development, per 15 minutes	69	130	20,660	$50	$3.8M
T1016	Case management, each 15 minutes	1	120	8,060	$210	$3.4M
T2025	Waiver services; not otherwise specified (nos)	6	30	2,980	$100	$2.3M

Showing 1–10 of 54

Related Providers

Other providers that share a Tax Identification Number (TIN) with Macomb Oakland Regional Center Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kimberly Jeroue	MI	Occupational Therapist	$2.6K	$0
Kerri Gonda	MI	Speech-Language Pathologist	$1.7K	$0
Hildy Scholar	MI	Occupational Therapist	$1.2K	$0

Nearby Providers

Other providers in the same ZIP code as Macomb Oakland Regional Center Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Easterseals Morc Health Care, Inc.	MI	Psychiatry Physician	$0	$188.2M
New Horizons Rehabilitation Services, Inc.	MI	Developmentally Disabled Services Day Training Agency	$0	$34M
Oakland County Community Mental Health Authority	MI	Developmental Disabilities Clinic/Center	$0	$6.4M
Christofer Buatti	MI	Dermatology Physician	$875.7K	$0
Michael Bischoff	MI	Diagnostic Radiology Physician	$352.1K	$0
Corey Haber	MI	Family Medicine Physician	$213.3K	$0
Michael Yusaf	MI	Sports Medicine (Orthopaedic Surgery) Physician	$204.8K	$0
John Samani	MI	Adult Reconstructive Orthopaedic Surgery Physician	$185.3K	$0
Ayoub Innabi	MI	Pulmonary Disease Physician	$184.9K	$0
Ali Najar	MI	Pulmonary Disease Physician	$165.7K	$0

Macomb Oakland Regional Center Inc. — Billing Profile & Reimbursement Data

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Macomb Oakland Regional Center 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

Related Providers

Nearby Providers

Frequently Asked Questions

References