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

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

Central Iowa Residential Services, Inc. (NPI 1073698346)

Field	Value
Entity Type	Organization
Organization	Central Iowa Residential Services, Inc.
Address	1002 S 12th Ave
City	Marshalltown
State	IA
ZIP	50158
Taxonomy	Intellectual and/or Developmental Disabilities Residential Treatment Facility
NPI Enumerated	October 26, 2006

Payer Source	Total Paid
Medicaid	$50.3M
Medicare	$0

Key Findings

CENTRAL IOWA RESIDENTIAL SERVICES, INC. is effectively a Medicaid-only biller: Total Medicare revenue is none and total Medicaid revenue on file is $50.3M, so the organization’s operating scale and reimbursement exposure are concentrated in state Medicaid flows rather than Medicare. This payer mix implies financial sensitivity to Medicaid policy and waiver decisions rather than traditional Medicare reimbursement changes.

Revenue is highly concentrated: the precomputed top 3 Medicaid codes account for 92.5% of the provider’s Medicaid revenue, with S5136 representing $31.4M (62.4%), H2016 representing $12.2M (24.2%), and H2015 representing $3M (5.9%). This concentration indicates most margin and cash flow depend on a very small set of service lines.

The code mix indicates a residential and community support operating model: S5136 (Companion care, adult; per diem) and H2016/H2015 (Comprehensive community support services, per diem and per 15 minutes) are the dominant codes, which aligns with an Intellectual and/or Developmental Disabilities Residential Treatment Facility providing daily companion care, structured community supports and time-based therapy or support visits. The prominence of per-diem and time-based community support codes suggests service delivery is organized around daily supervision and repeated short-interval contacts.

S5136 is the single largest revenue driver and the primary operational product: it generated $31.4M from 9.4K claims (62.4% of total Medicaid revenue) but the provider ranks #43 of 82 in-state (48th percentile). That rank indicates that while S5136 is dominant for this provider’s revenue, the provider’s volume for that code is typical rather than a statewide outlier or market leader.

H2016 is the second major revenue line, bringing in $12.2M from 8.8K claims (24.2% of Medicaid revenue) and ranking #96 of 176 in-state (46th percentile). This shows substantial dependence on comprehensive community support per diems as a revenue stream, but the rank/percentile again describes a typical, unremarkable statewide position rather than dominance.

H2015 (comprehensive community support, per 15 minutes) contributes $3M (5.9% of Medicaid revenue) from 12K claims and ranks #29 of 95 in-state (70th percentile), which is a comparatively stronger competitive position by percentile even though absolute revenue is smaller. This suggests the provider is relatively more active than peers in time-based community support encounters, which could reflect operational emphasis on shorter, frequent support contacts.

Smaller supporting lines—T2020 (Day habilitation, waiver; per diem) at $2.5M (5.1%), S5102 (Day care services, adult; per diem) at $1.2M (2.3%), and T2021 (Day habilitation, waiver; per 15 minutes) at $38.7K (0.1%)—collectively play a modest role in revenue. Their in-state ranks and percentiles (for example, T2020 rank #66 of 101, 35th percentile; S5102 rank #9 of 19, 56th percentile; T2021 rank #81 of 103, 22th percentile) indicate typical-to-modest participation in these ancillary service markets rather than leadership.

The provider’s NPI has been enumerated since 2006-10-26 (~20 years ago), indicating long tenure in the state market; combined with the heavy reliance on per-diem and community support codes, this suggests an established, specialty-focused operation. That long-standing presence plus the concentrated revenue mix implies stability in its service niche but also material exposure to Medicaid rate changes, waiver adjustments, or any policy shifts affecting per-diem and community-support reimbursements.

Medicaid: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5136	Companion care, adult (e.g., iadl/adl); per diem	9,380	$3,350	$31.4M
H2016	Comprehensive community support services, per diem	8,790	$1,380	$12.2M
H2015	Comprehensive community support services, per 15 minutes	12,040	$250	$3M
T2020	Day habilitation, waiver; per diem	6,030	$420	$2.5M
S5102	Day care services, adult; per diem	3,130	$380	$1.2M
T2021	Day habilitation, waiver; per 15 minutes	700	$60	$38.7K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Iowa Distribution

Central Iowa Residential Services, Inc. — 0 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Iowa

Full comparison — all codes billed, vs. Iowa median

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5136	Companion care, adult (e.g., iadl/adl); per diem	43	80	9,410	$490	$17.9M
H2016	Comprehensive community support services, per diem	96	180	10,790	$390	$15.2M
T2020	Day habilitation, waiver; per diem	66	100	10,960	$110	$3M
H2015	Comprehensive community support services, per 15 minutes	29	100	4,130	$160	$1.9M
S5102	Day care services, adult; per diem	9	20	3,060	$90	$1.1M
T2021	Day habilitation, waiver; per 15 minutes	81	100	2,780	$60	$386.9K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wolfe Clinic Inc	IA	Ophthalmology Physician	$0	$18.2M
Unitypoint Health - Marshalltown	IA	General Acute Care Hospital	$0	$15.9M
Primary Health Care, Inc.	IA	Federally Qualified Health Center (FQHC)	$0	$11.5M
Center Associates	IA	Cognitive & Behavioral Psychologist	$0	$8.8M
Marshalltown Community School District	IA	Local Education Agency (LEA)	$0	$6.9M
Primary Health Care, Inc.	IA	Federally Qualified Health Center (FQHC)	$0	$5.3M
Unitypoint Health - Marshalltown	IA	Rural Health Clinic/Center	$0	$3.7M
Unitypoint Health - Marshalltown	IA	Emergency Medicine Physician	$0	$3.6M
Central Iowa Physio LLC	IA	Physical Therapy Clinic/Center	$0	$2.3M
Substance Abuse Treatment Unit Of Central Iowa	IA	Substance Abuse Rehabilitation Facility	$0	$1.6M

Central Iowa Residential Services, Inc. — Billing Profile & Reimbursement Data

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Central Iowa Residential Services, 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