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

Why is the Medicaid comparison limited to New Jersey 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. New Jersey (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.

The Arc Middlesex County (NPI 1093194896)

Field	Value
Entity Type	Organization
Organization	The Arc Middlesex County
Address	1100 Cornwall Road, 1st Floor, Suite 100
City	Monmouth Junction
State	NJ
ZIP	08852
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	May 26, 2015

Payer Source	Total Paid
Medicaid	$73M
Medicare	$0

Medicaid: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2016	Comprehensive community support services, per diem	167,000	$380	$62.6M
T2021	Day habilitation, waiver; per 15 minutes	88,770	$100	$8.8M
T2024	Service assessment/plan of care development, waiver	3,840	$310	$1.2M
T2015	Habilitation, prevocational, waiver; per hour	10,450	$20	$250.8K
H2014	Skills training and development, per 15 minutes	2,960	$20	$65.2K
T1005	Respite care services, up to 15 minutes	500	$50	$25.9K
T2019	Habilitation, supported employment, waiver; per 15 minutes	100	$60	$6.1K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Jersey Distribution

The Arc Middlesex County — 0 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Jersey

Full comparison — all codes billed, vs. New Jersey median

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2016	Comprehensive community support services, per diem	32	210	23,310	$490	$41.9M
T2021	Day habilitation, waiver; per 15 minutes	41	220	14,500	$170	$7.7M
T2024	Service assessment/plan of care development, waiver	90	180	3,700	$300	$2.7M
T2019	Habilitation, supported employment, waiver; per 15 minutes	59	60	1,540	$110	$696.7K
T2015	Habilitation, prevocational, waiver; per hour	13	70	2,810	$100	$671.2K
H2014	Skills training and development, per 15 minutes	40	160	990	$120	$462.7K
T1005	Respite care services, up to 15 minutes	26	40	830	$100	$313.7K

Nearby Providers

Other providers in the same ZIP code as The Arc Middlesex County, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cliffside Labs L.L.C.	NJ	Clinical Medical Laboratory	$22.4M	$324.8K
Vidhata Genomics LLC	NJ	Clinical Molecular Genetics Physician	$127.3K	$616.2K
Tiffany Bautista	NJ	Occupational Therapist	$295.6K	$0
Genophyll Enterprises LLC	NJ	Clinical Medical Laboratory	$46K	$206.9K

The Arc Middlesex County — Billing Profile & Reimbursement Data

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The Arc Middlesex County — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References