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.

John F Murphy Homes, Inc. (NPI 1063431070)

Field	Value
Entity Type	Organization
Organization	John F Murphy Homes, Inc.
Address	800 Center St
City	Auburn
State	ME
ZIP	04210
Taxonomy	Nursing Facility/Intermediate Care Facility
NPI Enumerated	July 19, 2006

Payer Source	Total Paid
Medicaid	$260.1M
Medicare	$0

Key Findings

This provider is effectively single‑payer: there is no Medicare billing on file while Medicaid revenue totals $260.1M, so the organization’s financial footprint is driven almost entirely by Medicaid reimbursements. Analysts should treat this entity as a Medicaid-centric operator when assessing payer risk or contracting exposure.

Revenue is highly concentrated in a very small set of services: the precomputed top three Medicaid codes (H2021, T2016, H2012) account for 87.4% of the provider’s total Medicaid revenue. In particular, H2021 ($108.6M, 41.8%) and T2016 ($104.7M, 40.2%) together make up the vast majority of dollars, with H2012 contributing $14M (5.4%).

The code mix indicates the provider’s core business is community-based behavioral health and residential habilitation: H2021 (community-based wrap-around services, per 15 minutes) and T2016 (habilitation, residential, waiver; per diem) are the dominant revenue drivers, and H2012 (behavioral health day treatment, per hour) is also present. This mix is consistent with an operator that runs high-volume, labor‑intensive residential and community habilitation programs that bill both per‑diem and per‑15‑minute habilitation services.

On statewide competitive standing the provider is a leading outlier for its two largest lines: H2021 ranks #2 of 104 providers (99th percentile) and T2016 ranks #2 of 75 providers (99th percentile), both described as extreme outliers and far above typical state volume for these codes. Those rankings indicate the organization is a major, high-volume participant in Maine for wrap-around and residential habilitation services rather than a modest or average provider.

Not all service lines are equally dominant: H2012 (behavioral health day treatment) ranks #15 of 42 providers (66th percentile), which is described as typical and unremarkable in state volume. Other mid‑level revenue lines such as S5140 (foster care, adult; $12.7M, 4.9%, rank #8 of 31, 77th percentile) and T2021 (day habilitation, waiver; $9.1M, 3.5%, rank #7 of 72, 92th percentile) show meaningful activity but do not approach the concentration seen in H2021 and T2016.

Several ancillary therapy and coordination codes are concentrated above typical state volumes, signaling a broad service mix beyond core residential habilitation: 92507 ($3.1M, rank #2 of 144, 99th percentile) and 97530 ($1.7M, rank #2 of 201, 100th percentile) are labeled extreme outliers, while G9007 ($2.6M, rank #1 of 25, 100th percentile) indicates unusually high use of coordinated care fees. These code-level outliers suggest sustained investment in speech/communication therapy, therapeutic activities, and formal care coordination processes.

Operationally, the dominance of per‑diem (T2016, S5140) and per‑15‑minute (H2021, T2021, H2023) billing lines implies a labor‑intensive model with heavy claims volume and frequent unit billing. For payers and network managers, this profile points to claims processing and utilization management attention on high-frequency habilitation and wrap-around services.

The provider has an established tenure in the market: the NPI was enumerated on 2006-07-19 (~20 years ago), which combined with $260.1M in lifetime Medicaid revenue suggests long‑running participation in Maine’s Medicaid system and potential scale advantages in residential and community behavioral health services.

Medicaid: Complete Services Breakdown

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2021	Community-based wrap-around services, per 15 minutes	112,340	$970	$108.6M
T2016	Habilitation, residential, waiver; per diem	176,490	$590	$104.7M
H2012	Behavioral health day treatment, per hour	25,320	$560	$14M
S5140	Foster care, adult; per diem	37,590	$340	$12.7M
T2021	Day habilitation, waiver; per 15 minutes	71,240	$130	$9.1M
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	56,930	$50	$3.1M
G9007	Coordinated care fee, scheduled team conference	52,640	$50	$2.6M
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	54,980	$30	$1.7M
H2023	Supported employment, per 15 minutes	15,280	$100	$1.6M
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	4,390	$240	$1M

Showing 1–10 of 19

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

John F Murphy Homes, Inc. — 7 of 18 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

19 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	2	80	7,300	$1,670	$30.8M
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	22	30	13,990	$560	$23.9M
S5140	Foster care, adult; per diem	8	30	9,310	$530	$13.6M
T2021	Day habilitation, waiver; per 15 minutes	7	70	13,340	$200	$5.1M
H2021	Community-based wrap-around services, per 15 minutes	2	100	8,660	$290	$5.1M
H2012	Behavioral health day treatment, per hour	15	40	13,180	$230	$5.1M
G9012	Other specified case management service not elsewhere classified	46	50	25,820	$80	$3M
H2023	Supported employment, per 15 minutes	2	20	2,330	$160	$673K
G9007	Coordinated care fee, scheduled team conference	1	30	950	$60	$258.2K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	2	140	1,690	$40	$168K

Showing 1–10 of 19

Nearby Providers

Other providers in the same ZIP code as John F Murphy Homes, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Happy Haven, LLC	ME	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$65.3M
Health Affiliates Maine, LLC	ME	Community/Behavioral Health Agency	$0	$61.6M
Opportunity Enterprises, Inc.	ME	Developmentally Disabled Services Day Training Agency	$0	$47.6M
New Communities, Inc.	ME	Mental Illness Community Based Residential Treatment Facility	$0	$26.4M
Bedard Medical Inc	ME	Durable Medical Equipment & Medical Supplies	$0	$24.6M
Personal Onsite Development	ME	Developmentally Disabled Services Day Training Agency	$0	$9M
Community Clinical Services, Inc.	ME	Federally Qualified Health Center (FQHC)	$0	$5.2M
New England Home Therapies, Inc.	ME	Oxygen Equipment & Supplies (DME)	$0	$4.2M
Maine Oral & Maxillofacial Surgery Associates, P.A.	ME	Oral and Maxillofacial Surgery (Dentist)	$0	$3.5M
City Of Auburn	ME	Land Ambulance	$317.2K	$2.7M

John F Murphy Homes, 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