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

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

Mentor Abi, LLC (NPI 1033426739)

Field	Value
Entity Type	Organization
Organization	Mentor Abi, LLC
Address	986 Sebago Rd
City	Sebago
State	ME
ZIP	04029
Taxonomy	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NPI Enumerated	September 2, 2010

Payer Source	Total Paid
Medicaid	$68.6M
Medicare	$0

Key Findings

MENTOR ABI, LLC is effectively a single-payer Medicaid provider with no Medicare billing on file; total Medicaid revenue is $68.6M and there is explicitly no Medicare revenue reported, indicating the organization’s operations are concentrated entirely within Medicaid-funded services. This payer mix suggests programmatic focus on state waiver and habilitation services rather than fee-for-service Medicare markets.

Revenue is highly concentrated in a small set of Medicaid codes: the precomputed top three Medicaid codes together account for 85.8% of the provider’s total Medicaid revenue. That concentration implies the provider’s financial performance and utilization profile are heavily dependent on a narrow set of service lines rather than a broad array of billing codes.

T2016 is the dominant revenue driver for this provider, generating $48.5M (70.7% of the provider’s total Medicaid revenue) from 139.1K claims and ranking #3 of 75 providers in-state. The code description (Habilitation, residential, waiver; per diem) and the extreme outlier designation indicate that Mentor ABI operates a substantial residential habilitation/waiver program at scale relative to Maine peers.

The remaining top revenue codes reflect high-volume behavioral and cognitive therapy services delivered in group and individual formats: 96165 ($6.8M, 9.9% of Medicaid revenue), 97130 ($3.5M, 5.2%), and related psychology/therapy codes such as 96164, 96159, 96158 and 97129 also appear in the top line-up. This mix indicates a program model combining residential habilitation with substantial cognitive/behavioral therapy provided both one-on-one and in group sessions.

Competitive standing varies by code: Mentor ABI is an extreme outlier on T2016 (70.7% share and 97th percentile statewide), a clear market leader for residential habilitation capacity in Maine. It is also ranked at the top for some psychology codes (96159 and 96158 are both 100th percentile statewide), showing unusually high volume for specific psychological service lines compared with in-state peers. Other high-volume therapy codes (96165, 97130, 96164) rank in the typical to unremarkable range for the state, indicating some services are comparable to peers while a few are uniquely concentrated.

The provider’s claims volume for several codes is very large in absolute terms (e.g., 139.1K claims for T2016, 38.5K claims for 96165, 30K claims for 97130), which together with the per-diem nature of T2016 suggests ongoing, census-driven revenue (residential bed-days) rather than episodic, short-term outpatient encounters. That operational profile is consistent with a community-based residential treatment facility focused on long-term habilitation and recurring therapy sessions.

MENTOR ABI, LLC has a long tenure in the NPI registry, enumerated on 2010-09-02 (~16 years ago), which supports interpretation of the organization as an established provider in the state’s Medicaid ecosystem rather than a recent entrant. This longevity combined with concentrated code volumes suggests entrenched service delivery capacity for waiver/residential habilitation programs.

While T2016 accounts for the majority of Medicaid revenue, several high-revenue therapy codes (96165, 97130, 96153, 96164, G0515) together form the secondary revenue base, indicating a two-part business model: a large residential habilitation backbone supported by intensive cognitive/behavioral therapy offerings. This composition is relevant for payers and network planners assessing utilization drivers, capacity needs, and potential leverage points for care management or contract negotiations.

Medicaid: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	139,080	$350	$48.5M
96165	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of the patients’ physical health…	38,490	$180	$6.8M
97130	The provider works directly one–on–one with the patient to help him improve cognitive functions such as thinking, remembering, reasoning, and problem solving and the ability to plan, organize, and…	29,990	$120	$3.5M
96153	N/A	4,960	$670	$3.3M
96164	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of the patients’ physical health…	41,430	$40	$1.7M
G0515	Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes	4,070	$400	$1.6M
96159	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of a patient’s physical health…	12,950	$70	$867.9K
97129	The provider works directly one–on–one with the patient to help him improve cognitive functions such as thinking, remembering, reasoning, and problem solving and the ability to plan, organize, and…	30,320	$30	$788.3K
96158	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of a patient’s physical health…	16,920	$40	$693.5K
96152	N/A	2,630	$150	$397.1K

Showing 1–10 of 12

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Maine Distribution

Mentor Abi, LLC — 3 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maine

Full comparison — all codes billed, vs. Maine median

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	3	80	7,300	$1,670	$30.8M
96165	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of the patients’ physical health…	2	10	22,450	$200	$5M
96153	N/A	3	10	4,960	$270	$2.8M
97130	The provider works directly one–on–one with the patient to help him improve cognitive functions such as thinking, remembering, reasoning, and problem solving and the ability to plan, organize, and…	2	10	21,520	$100	$2.2M
96164	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of the patients’ physical health…	2	10	22,320	$40	$996K
G0515	Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes	3	10	4,070	$130	$965K
97129	The provider works directly one–on–one with the patient to help him improve cognitive functions such as thinking, remembering, reasoning, and problem solving and the ability to plan, organize, and…	2	10	9,230	$20	$345.3K
S5102	Day care services, adult; per diem	1	10	3,930	$60	$251.4K
96159	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of a patient’s physical health…	1	10	510	$60	$117.3K
96158	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of a patient’s physical health…	1	10	990	$40	$113K

Showing 1–10 of 12

Mentor Abi, LLC — Billing Profile & Reimbursement Data

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Mentor Abi, LLC — 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

Frequently Asked Questions

References