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

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

Forte Residential, Inc (NPI 1043300882)

Field	Value
Entity Type	Organization
Organization	Forte Residential, Inc
Address	120 S Lake St
City	Warsaw
State	IN
ZIP	46580
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	October 13, 2006

Payer Source	Total Paid
Medicaid	$44.8M
Medicare	$0

Key Findings

FORTE RESIDENTIAL, INC is effectively a single‑payer Medicaid provider: there is no Medicare billing on file and lifetime Medicaid revenue is $44.8M, indicating Medicaid is the dominant and sole reported public payer for this entity. The absence of Medicare activity concentrates reimbursement risk and contracting exposure squarely on Medicaid-managed and waiver programs.

Revenue is highly concentrated in a few waiver and residential care codes: the top three Medicaid codes (T2016, T2033, S5125) account for 86.2% of this provider's total Medicaid revenue. That concentration means fluctuations in reimbursement or utilization for those three codes would materially affect overall revenue.

Code-level mix and service model point to a residential habilitation and attendant-care operation: T2016 (Habilitation, residential, waiver; per diem) and T2033 (Residential care, nos, waiver; per diem) together represent the largest shares (T2016: $17.2M, 38.5%; T2033: $13.9M, 31.0%), and S5125 (Attendant care services; per 15 minutes) complements those per‑diem residential services with substantial attendant-care billings ($7.5M, 16.7%). This mix is consistent with group-home/residential waiver services combined with in‑home attendant supports.

Competitive standing varies by code: T2033 ranks #5 of 52 providers in‑state (92th percentile) and S5151 ranks #4 of 41 (93th percentile), indicating FORTE is a statewide leader for residential care and for unskilled respite care volumes. By contrast, T2016 ranks #28 of 65 (58th percentile) and S5125 ranks #45 of 109 (59th percentile), which are described as typical, unremarkable volumes and suggest more modest market position for those specific habilitation and attendant‑care activities.

Top-code utilization and unit rates show differing economics across services: T2016 has 4.9K claims with a $3526 avg paid/claim (yielding $17.2M revenue), while T2033 has higher claim volume (15.1K claims) but a lower $917 avg paid/claim ($13.9M revenue), and S5125 shows 4.2K claims at a $1797 avg paid/claim ($7.5M revenue). These figures imply a mix of high per‑diem unit value services (T2016) and higher-frequency, lower‑unit per‑diem services (T2033), with attendant-care occupying a mid‑range position.

Smaller service lines are marginal to overall revenue: T2020 ($723.7K, 1.6%), S5130 ($485.5K, 1.1%), and H2032 ($167.2K, 0.4%) collectively represent only a sliver of Medicaid revenue and mostly rank in lower percentiles in‑state. This suggests limited diversification beyond core residential and attendant/respite services and exposure if waiver funding priorities shift.

Operational tenure is long: the NPI was enumerated on 2006-10-13 (~20 years ago), indicating an established presence in the Indiana waiver/residential services market. That longevity, combined with concentration in a small set of waiver codes, signals an entrenched niche operator focused on residential habilitation and allied supportive services.

Medicaid: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	4,890	$3,530	$17.2M
T2033	Residential care, not otherwise specified (nos), waiver; per diem	15,130	$920	$13.9M
S5125	Attendant care services; per 15 minutes	4,160	$1,800	$7.5M
S5151	Unskilled respite care, not hospice; per diem	5,970	$810	$4.8M
T2020	Day habilitation, waiver; per diem	1,170	$620	$723.7K
S5130	Homemaker service, nos; per 15 minutes	1,390	$350	$485.4K
H2032	Activity therapy, per 15 minutes	850	$200	$167.2K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Indiana Distribution

Forte Residential, Inc — 0 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Indiana

Full comparison — all codes billed, vs. Indiana median

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	28	70	3,190	$630	$14.7M
T2033	Residential care, not otherwise specified (nos), waiver; per diem	5	50	1,090	$180	$2.3M
S5125	Attendant care services; per 15 minutes	45	110	2,590	$140	$1.5M
T2020	Day habilitation, waiver; per diem	51	60	5,550	$110	$1.4M
S5151	Unskilled respite care, not hospice; per diem	4	40	970	$220	$1.3M
H2032	Activity therapy, per 15 minutes	17	30	1,780	$70	$942.2K
S5130	Homemaker service, nos; per 15 minutes	28	60	1,390	$50	$297K

Nearby Providers

Other providers in the same ZIP code as Forte Residential, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bowen Health Inc	IN	Adult Mental Health Clinic/Center	$0	$508.6M
Warsaw Health System LLC	IN	General Acute Care Hospital	$0	$10M
Kosciusko Medical Group LLC	IN	Family Medicine Physician	$0	$8.8M
Joes Kids Inc	IN	Physical Therapist	$0	$2.9M
Grossnickle Eye Center, Inc.	IN	Ophthalmologic Surgery Clinic/Center	$1.8M	$0
Colin Ridenour	IN	Ophthalmology Physician	$1.2M	$0
Allison Pernic	IN	Ophthalmology Physician	$1.1M	$0
Matthew Ralstin	IN	Ophthalmology Physician	$889K	$0
Christopher Knight	IN	Ophthalmology Physician	$880.3K	$0
Ann Buikema Wiarda	IN	Ophthalmology Physician	$808.4K	$0

Forte Residential, Inc — Billing Profile & Reimbursement Data

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Forte Residential, 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