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

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

Developmental Pathways Inc (NPI 1093254898)

Field	Value
Entity Type	Organization
Organization	Developmental Pathways Inc
Address	14280 E Jewell Ave Ste A
City	Aurora
State	CO
ZIP	80012
Taxonomy	Case Management Agency
NPI Enumerated	February 14, 2017

Payer Source	Total Paid
Medicaid	$37.2M
Medicare	$0

Key Findings

DEVELOPMENTAL PATHWAYS INC is effectively a Medicaid-focused provider with no Medicare billing on file; its reported lifetime Medicaid revenue is $37.2M and Medicare revenue is listed as none, indicating the organization operates almost entirely within Medicaid-funded case management and waiver services rather than traditional Medicare clinical billing. The provider’s NPI was enumerated on 2017-02-14 (~9 years ago), establishing a multi-year presence in the state Medicaid market.

Revenue concentration is highly concentrated in a small set of case management codes: the top 3 Medicaid codes account for 100.0% of this provider’s total Medicaid revenue, with T2023 alone representing $29.3M (78.7% of Medicaid revenue). This indicates that targeted case management is the primary revenue driver for the organization and that its financial performance is tightly linked to volume and reimbursement for these specific services.

Business/service-line implications from the code mix show the provider focuses on targeted case management and related care planning activities: T2023 (Targeted case management; per month) and T2024 (Service assessment/plan of care development, waiver) together represent the vast majority of revenue, and T1017 (Targeted case management, each 15 minutes) supplements those monthly and waiver-focused services. The prominence of monthly management and waiver assessment codes suggests an operational model built around longitudinal care coordination and waiver program administration rather than episodic clinical encounters.

Competitive standing within Colorado is strong on key codes: the provider ranks #2 of 38 in the state for T2023 and is in the 97th percentile, characterized as an extreme outlier far above typical state volume for that code. For T2024 it also ranks #2 of 68 providers and is in the 99th percentile, likewise an extreme outlier, indicating the organization is one of the largest in-state providers of waiver assessment and monthly targeted case management services. By contrast, for T1017 the provider ranks #34 of 309 (89th percentile), which is typical and not exceptional relative to peers for unit-based 15-minute case management billing.

Because Medicare revenue is zero, this entity functions as a de facto single-payer (Medicaid) provider in practical terms; analysts should treat comparisons or benchmarking efforts against Medicare peers as inapplicable and focus competitive analyses on Medicaid peers and state waiver program participants. The absence of Medicare claims also implies limited engagement in fee-for-service medical procedures or outpatient services billed to Medicare beneficiaries.

The payer-code profile and high concentration in T2023 and T2024 create operational sensitivity: with T2023 accounting for $29.3M (78.7%) and T2024 $5.4M (14.6%) of Medicaid revenue, any changes in Medicaid policy, authorization, eligibility for waiver services, or reimbursement for those specific codes could materially affect the provider’s revenue stream. T1017’s smaller share ($2.5M, 6.7%) provides some diversification but does not offset the concentration risk tied to the two dominant codes.

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
T2023	Targeted case management; per month	225,310	$130	$29.3M
T2024	Service assessment/plan of care development, waiver	63,200	$90	$5.4M
T1017	Targeted case management, each 15 minutes	12,800	$200	$2.5M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

Developmental Pathways Inc — 2 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2023	Targeted case management; per month	2	40	6,060	$130	$3.9M
T1017	Targeted case management, each 15 minutes	34	310	640	$80	$494.3K
T2024	Service assessment/plan of care development, waiver	2	70	880	$90	$455.1K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Continuum Of Colorado	CO	Community/Behavioral Health Agency	$0	$61.3M
Hca Healthone LLC	CO	General Acute Care Hospital	$0	$24.4M
Ahiska Homecare LLC	CO	In Home Supportive Care Agency	$0	$22.3M
Beacon Home Care	CO	In Home Supportive Care Agency	$0	$22.1M
Developmental Pathways, Inc.	CO	Day Training/Habilitation Specialist	$0	$20.6M
Global Intersections, Inc.	CO	Developmentally Disabled Services Day Training Agency	$0	$19.7M
Bmh Corp.,llc	CO	In Home Supportive Care Agency	$0	$18.2M
Hero Dental Of Aurora PC	CO	Dentist	$0	$14M
Hans Adult Day Care LLC	CO	Adult Day Care Clinic/Center	$0	$13.2M
Windsor Lake Healthcare, Inc.	CO	Assisted Living Facility	$0	$12.9M

Developmental Pathways Inc — Billing Profile & Reimbursement Data

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Developmental Pathways 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