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

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

Group Effort Of Tennessee, LLC. (NPI 1033510250)

Field	Value
Entity Type	Organization
Organization	Group Effort Of Tennessee, LLC.
Address	220 S Hickory Ave
City	Gallatin
State	TN
ZIP	37066
Taxonomy	Developmental Disabilities Clinic/Center
NPI Enumerated	September 7, 2014

Payer Source	Total Paid
Medicaid	$31.4M
Medicare	$0

Key Findings

This provider has no Medicare billing on file (none below) and is effectively a Medicaid-centric operation, reporting $31.4M in lifetime Medicaid revenue. The absence of Medicare claims means payer risk and revenue exposure are concentrated almost entirely in state Medicaid programs rather than in a mixed Medicare/Medicaid payer mix.

The Medicaid revenue base is extremely concentrated: the precomputed top 3 Medicaid codes by revenue account for 99.5% of this provider's total Medicaid revenue. In particular, T2016 alone represents $30.1M (96.0% of the provider's Medicaid revenue), making residential habilitation services the dominant revenue driver.

T2016 (T2016 – Habilitation, residential, waiver; per diem) records 25.6K claims at an average paid per claim of $1175 and $30.1M revenue. The provider ranks #3 of 45 in-state (95th percentile) for this code, but the dataset characterizes its volume as "typical, unremarkable volume for this code," indicating that while the provider is near the top of the state ranking by revenue, the activity level fits expected patterns for organizations offering residential habilitation under this taxonomy.

Supplementary service lines include psychosocial rehabilitation: H2018 (per diem) generated $678.3K on 8.8K claims ($77 avg paid/claim), and H2017 (per 15 minutes) generated $424.4K on 5.2K claims ($82 avg paid/claim). Both codes are labeled "typical, unremarkable volume for this code" in the dataset; H2018 ranks #7 of 8 in-state (14th percentile) and H2017 ranks #17 of 23 (27th percentile), indicating modest participation in structured psychosocial rehab relative to state peers.

Therapeutic behavioral services (H2020 – per diem) appears as a minor, low-volume adjunct line: 99 claims with $1437 avg paid/claim producing $142.3K (0.5% of Medicaid revenue). The small claim count and 0.5% revenue share show this is a niche or emerging component of the provider's Medicaid mix rather than a material revenue center; the dataset also labels its volume for this code as "typical, unremarkable" and ranks it #32 of 36 in-state (11th percentile).

Business/service-line implication: the coding profile and the provider taxonomy (Developmental Disabilities Clinic/Center) together point to an operation focused on residential habilitation and day/psychosocial supports under Medicaid waiver structures, with per-diem residential waiver billing driving the enterprise economics. The predominance of T2016 suggests most resource and capacity allocation is likely toward residential habilitation settings rather than time-based outpatient therapy.

Competitive standing and market position: by revenue the provider is a major Medicaid participant for its primary code (T2016) given a #3 state rank, but for ancillary codes (H2018, H2017, H2020) it is a modest to minor participant as reflected in lower ranks and percentiles. Overall, the provider appears to compete primarily on residential habilitation within Tennessee's waiver/service market rather than across a broad mix of Medicaid service lines.

Tenure and operational history: the NPI was enumerated on 2014-09-07 (~12 years ago), indicating over a decade of enrollment and claims presence in Medicaid; the sustained, concentrated revenue from T2016 suggests an established residential habilitation operation rather than a recent pivot or short-lived program.

Medicaid: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	25,630	$1,180	$30.1M
H2018	Psychosocial rehabilitation services, per diem	8,810	$80	$678.3K
H2017	Psychosocial rehabilitation services, per 15 minutes	5,180	$80	$424.4K
H2020	Therapeutic behavioral services, per diem	100	$1,440	$142.3K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Group Effort Of Tennessee, LLC. — 1 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	3	50	2,620	$430	$11.9M
H2020	Therapeutic behavioral services, per diem	32	40	880	$1,910	$5.9M
H2018	Psychosocial rehabilitation services, per diem	7	10	38,180	$80	$3.3M
H2017	Psychosocial rehabilitation services, per 15 minutes	17	20	11,380	$70	$1.9M

Nearby Providers

Other providers in the same ZIP code as Group Effort Of Tennessee, LLC., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vip Midsouth, LLC	TN	Pediatrics Physician	$0	$30.4M
Sumner Regional Medical Center LLC	TN	General Acute Care Hospital	$0	$11.8M
21st Century Rehabilitation Services	TN	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$9.5M
County Of Sumner	TN	Land Ambulance	$1.6M	$4.5M
Trinity Pediatrics, P.C.	TN	Pediatrics Physician	$0	$5.8M
Children's Dentistry Of Gallatin	TN	Pediatric Dentistry	$0	$5.4M
Emergency Physicians At Sumner PLLC	TN	Emergency Medical Services (Emergency Medicine) Physician	$0	$3.4M
Tamjeed Ahmed	TN	Hematology & Oncology Physician	$913.2K	$0
Dianna Shipley	TN	Medical Oncology Physician	$636.7K	$0
Anne Hensley	TN	Nurse Practitioner	$410.9K	$0

Group Effort Of Tennessee, LLC. — Billing Profile & Reimbursement Data

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Group Effort Of Tennessee, 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

Nearby Providers

Frequently Asked Questions

References