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.

3rivers, Inc. (NPI 1063473866)

Field	Value
Entity Type	Organization
Organization	3rivers, Inc.
Address	25 Winter St
City	Gardiner
State	ME
ZIP	04345
Taxonomy	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NPI Enumerated	March 31, 2006

Payer Source	Total Paid
Medicaid	$36.3M
Medicare	$0

Key Findings

3RIVERS, INC. is classified as an Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility and its Medicaid code mix—dominated by T2016 (Habilitation, residential, waiver; per diem) and supplemented by T2021 (Day habilitation, waiver; per 15 minutes) and G9012 (other specified case management)—is consistent with a residential and day habilitation operator that also provides case management services to waiver-enrolled beneficiaries. The heavy emphasis on per‑diem residential habilitation and time-based day habilitation indicates on-site residential supports and structured day programs are the core service lines.

The provider’s Medicaid revenue is highly concentrated: the precomputed top 3 Medicaid codes by revenue account for 100.0% of this provider's total Medicaid revenue, and total Medicaid revenue on file is $36.3M. Within that concentration, T2016 alone represents $32.6M (89.6% of Medicaid revenue), underscoring that residential habilitation is the primary revenue driver.

On payer mix the entity is effectively single-payer: there is no Medicare billing on file while Medicaid revenue totals $36.3M, so operational and financial performance appears tightly coupled to Medicaid program policy, waiver rates, and state contracting. This makes the provider sensitive to changes in state waiver rules, per‑diem rates, and Medicaid case-management funding models.

T2016 generated 3.4K claims with a $9513 avg paid/claim and $32.6M in revenue (89.6% of this provider's total Medicaid revenue), but the provider ranks #52 of 75 providers in-state (31th percentile; typical, unremarkable volume for this code). In other words, while T2016 is the dominant revenue source for this provider internally, it is a modest participant on this code relative to other in-state residential habilitation providers.

G9012—30.5K claims, $70 avg paid/claim, $2.1M revenue (5.9% of this provider's total Medicaid revenue)—positions the provider as a middle-ranked case management supplier statewide, ranking #23 of 50 providers in-state (55th percentile; typical, unremarkable volume for this code). The large claim count for G9012 suggests ongoing case-management activity supporting waiver participants, but it is not a primary revenue driver compared with residential habilitation.

T2021 produced 1.8K claims with a $896 avg paid/claim and $1.6M in revenue (4.5% of this provider's total Medicaid revenue) and the provider ranks #65 of 72 providers in-state (10th percentile; typical, unremarkable volume for this code). This indicates comparatively limited scale in day habilitation relative to peers, so day-program operations are present but secondary to residential services.

The NPI was enumerated on 2006-03-31 (~20 years ago), indicating a long-tenured Medicaid participant in the state market. That tenure, combined with concentrated Medicaid revenue and an emphasis on residential habilitation, suggests established operational relationships with state waiver authorities and a business model reliant on sustained Medicaid waiver enrollments and per‑diem funding.

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	3,420	$9,510	$32.6M
G9012	Other specified case management service not elsewhere classified	30,470	$70	$2.1M
T2021	Day habilitation, waiver; per 15 minutes	1,830	$900	$1.6M

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

3rivers, Inc. — 0 of 3 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

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	52	80	7,300	$1,670	$30.8M
T2021	Day habilitation, waiver; per 15 minutes	65	70	13,340	$200	$5.1M
G9012	Other specified case management service not elsewhere classified	23	50	25,820	$80	$3M

Nearby Providers

Other providers in the same ZIP code as 3rivers, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
City Of Gardiner	ME	Land Ambulance	$260.9K	$2M
Bio-medical Applications Of Maine, Inc.	ME	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$735.3K
Jennifer Lehto	ME	Nurse Practitioner	$10.9K	$0
Ozgur Turkoglu	ME	Psychologist	$8.5K	$0
Christiane Becker-varney	ME	Family Nurse Practitioner	$5.1K	$0

3rivers, Inc. — Billing Profile & Reimbursement Data

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3rivers, 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