Hope House Foundation — Billing Profile & Reimbursement Data

HOPE HOUSE FOUNDATION is effectively a single-payer Medicaid operator: it reports no Medicare billing on file and $77.9M in total Medicaid revenue, indicating the organization’s scale is concentrated entirely within Medicaid-funded services. The absence of Medicare activity suggests its service mix and patient population are aligned with long-term developmental disability supports reimbursed by state Medicaid programs rather than Medicare-covered medical services.

Revenue is extremely concentrated in a single procedure group: the provider’s top 3 Medicaid codes account for 100.0% of its Medicaid revenue, with one code dominating the mix. This concentration implies the business model is heavily dependent on a narrow set of Medicaid service lines and payment rules tied to those codes.

H2014 is the dominant revenue driver and defines the operation’s service line: H2014 (Skills training and development, per 15 minutes) accounts for $77.8M and 20.5K claims — 99.9% of the provider’s Medicaid revenue. The high volume of per‑15‑minute habilitation billing indicates the organization primarily delivers day training and skills‑development services consistent with its Developmentally Disabled Services Day Training Agency taxonomy.

The provider is a major in-state player for H2014: it ranks #4 of 73 providers in Virginia and sits in the 96th percentile for this code, which the source characterizes as notably above typical state volume. That ranking positions HOPE HOUSE FOUNDATION as a leading supplier of skills training and development services relative to peer organizations in the state.

Other billed codes are immaterial to revenue and show more typical utilization patterns: 97530 generated 562 claims for $54.5K (0.1% of total Medicaid revenue), with an average paid/claim of $97, and ranks #296 of 401 providers in-state (26th percentile). This indicates therapeutic-activity billing is present but unremarkable and not a meaningful revenue diversification for the organization.

The provider has a long operational tenure: the NPI was enumerated on 2006-03-07 (~20 years ago), suggesting established participation in the Medicaid program and potential institutional relationships with state Medicaid payers and local referral sources. That longevity, combined with dominant H2014 volumes, may reflect an entrenched service footprint in the local developmental‑disability day‑services market.

The extreme revenue concentration in H2014 creates operational and reimbursement sensitivity: changes to H2014 policy, reimbursement rates, or utilization monitoring could materially affect the provider’s financial performance given that H2014 represents 99.9% of its Medicaid revenue. Analysts should view the provider as operationally specialized with limited internal hedges against payer or policy shifts affecting habilitation per‑15‑minute reimbursement.