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

Why is the Medicaid comparison limited to North Carolina 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. North Carolina (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.

Abound Health, LLC (NPI 1063798031)

Field	Value
Entity Type	Organization
Organization	Abound Health, LLC
Address	5309 Idlewild Rd N
City	Mint Hill
State	NC
ZIP	28227
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	October 22, 2011

Payer Source	Total Paid
Medicaid	$49.8M
Medicare	$0

Key Findings

ABOUND HEALTH, LLC is effectively a Medicaid-focused community/behavioral health agency: it reports $49.8M in lifetime Medicaid revenue and has no Medicare billing on file, indicating a near‑exclusive reliance on Medicaid programs for its billed services. The code mix is dominated by habilitation and waiver services (T2013, T2012, T2016), which aligns with the provider taxonomy of Community/Behavioral Health Agency and suggests operations centered on day, residential and educational habilitation programs.

Revenue is highly concentrated in a small set of waiver habilitation codes: the precomputed top three Medicaid codes account for 84.0% of the provider’s total Medicaid revenue, driven primarily by T2013 ($22.2M, 44.6%), T2012 ($15.1M, 30.2%), and T2016 ($4.5M, 9.1%). This concentration implies business risk and operational focus tied to a narrow set of service lines (per‑hour habilitation and per‑diem waiver services).

Within those top codes, reimbursement levels are moderate and consistent with service intensity: T2012 averages $180 paid/claim, T2013 averages $153 paid/claim, and T2016 averages $148 paid/claim. These per‑claim averages, combined with high claim volumes (e.g., 145.3K claims for T2013 and 83.7K claims for T2012), indicate a throughput model where scale of encounters drives revenue rather than high unit prices.

Competitive standing is mixed across the major codes at the state level. ABOUND ranks #18 of 185 for T2013 (around the 91st percentile) and #11 of 110 for T2012 (around the 91st percentile), which are described as typical volumes for those codes statewide; by contrast, it ranks #6 of 92 for T2016 (95th percentile) and is characterized as notably above typical state volume for that residential habilitation code, indicating relative strength in residential waiver services.

The provider’s product mix extends beyond its top three codes into complementary community supports and respite services, with H2015 contributing $2.9M (5.9%) and S5150 contributing $1.7M (3.4%) of Medicaid revenue. Presence of day habilitation (T2020, $1.5M) and multiple respite codes (H0045, H0045U4) shows a broader service footprint serving both in‑community and non‑home respite care, which can help diversify operational offerings even though most revenue is concentrated.

ABOUND’s lack of Medicare billing on file makes it effectively single‑payer from a claims perspective: all reported lifetime federal reimbursement activity is through Medicaid, which carries implications for payer contracting, regulatory exposure, and revenue sensitivity to state Medicaid policy and waiver rates. Analysts should treat Medicare comparators as not applicable for this entity and focus competitive benchmarking on Medicaid peers.

The provider has a long tenure in the NPI registry, enumerated on 2011-10-22 (~15 years ago), indicating sustained operation over a multi‑year period; this longevity supports institutional experience delivering waiver habilitation and community support services in its market. Sustained claim volumes across multiple habilitation codes suggest established referral and authorization pathways within state waiver programs.

There are a few statistical and peer‑comparison notes of interest: T2016 is flagged as notably above typical statewide volume, while most other high‑revenue codes are described as typical/unremarkable despite high absolute revenues. Additionally, H0045U4 is listed as rank #1 of 1 with no state peer volume comparison available, which may reflect use of a unique or infrequently reported variant code in the state dataset rather than widespread peer activity.

Medicaid: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2013	Habilitation, educational, waiver; per hour	145,350	$150	$22.2M
T2012	Habilitation, educational; waiver, per diem	83,690	$180	$15.1M
T2016	Habilitation, residential, waiver; per diem	30,630	$150	$4.5M
H2015	Comprehensive community support services, per 15 minutes	26,950	$110	$2.9M
S5150	Unskilled respite care, not hospice; per 15 minutes	17,040	$100	$1.7M
T2020	Day habilitation, waiver; per diem	8,260	$180	$1.5M
H0045	Respite care services, not in the home, per diem	8,650	$170	$1.5M
T2021	Day habilitation, waiver; per 15 minutes	970	$120	$113.3K
H2025	Ongoing support to maintain employment, per 15 minutes	1,290	$90	$112.1K
T2013TF	N/A	610	$160	$95.1K

Showing 1–10 of 13

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Carolina Distribution

Abound Health, LLC — 0 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. North Carolina median

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2013	Habilitation, educational, waiver; per hour	18	190	29,090	$150	$9.1M
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	11	10	130	$90	$6.9M
T2020	Day habilitation, waiver; per diem	35	50	22,570	$180	$6.2M
T2012	Habilitation, educational; waiver, per diem	11	110	21,340	$180	$6.1M
T2021	Day habilitation, waiver; per 15 minutes	185	200	25,740	$130	$4.6M
H2015	Comprehensive community support services, per 15 minutes	56	250	10,060	$130	$2.4M
T2016	Habilitation, residential, waiver; per diem	6	90	5,520	$190	$1.6M
H2025	Ongoing support to maintain employment, per 15 minutes	48	60	6,380	$120	$1.3M
H0045	Respite care services, not in the home, per diem	26	80	4,450	$100	$993.7K
S5150	Unskilled respite care, not hospice; per 15 minutes	32	170	4,310	$80	$958.4K

Showing 1–10 of 13

Nearby Providers

Other providers in the same ZIP code as Abound Health, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Abound Health, LLC	NC	Community/Behavioral Health Agency	$0	$324.1M
Abound Health, LLC	NC	Community/Behavioral Health Agency	$0	$200.8M
United Support Services Inc.	NC	Community/Behavioral Health Agency	$0	$61.6M
Ryan's Place, LLC	NC	Community/Behavioral Health Agency	$0	$24.7M
Divine Health Consultants	NC	Home Health Agency	$0	$22.8M
Still Family, LLC	NC	Community/Behavioral Health Agency	$0	$20.3M
Unique Caring Foundation, Inc	NC	Community/Behavioral Health Agency	$0	$11.2M
Securing Resources For Consumers, Inc.	NC	Community/Behavioral Health Agency	$0	$10.6M
Smiles For Life Orthodontics	NC	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$8M
Scott Baker	NC	Physical Therapist	$109.9K	$0

Abound Health, LLC — Billing Profile & Reimbursement Data

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Abound Health, 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