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

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

Commonwealth Of Massachusetts (NPI 1114058872)

Field	Value
Entity Type	Organization
Organization	Commonwealth Of Massachusetts
Address	300 Howard Street
City	Framingham
State	MA
ZIP	01702
Taxonomy	Case Management Agency
NPI Enumerated	March 7, 2007

Payer Source	Total Paid
Medicaid	$350.2M
Medicare	$0

Key Findings

This entity is effectively a Medicaid-focused provider: there is no Medicare billing on file and lifetime Medicaid revenue is $350.2M, indicating a single-payer operational footprint concentrated on state Medicaid programs rather than Medicare. The provider’s taxonomy of Case Management Agency aligns with the service mix reported in claims.

Revenue is highly concentrated in a few Medicaid codes: the top three codes account for 94.0% of the provider’s total Medicaid revenue, with T2016 alone representing $292.2M or 83.5% of Medicaid revenue. That level of concentration signals a business model heavily dependent on a single service line rather than a broad, balanced revenue mix.

The code mix reflects a residential and community habilitation focus combined with case management and day services: T2016 (Habilitation, residential, waiver; per diem), S5100 (Day care services, adult; per 15 minutes), and T2023 (Targeted case management; per month) together drive the bulk of billing activity. As a Case Management Agency, this pattern suggests primary operations are waiver-funded residential habilitation supplemented by adult day services and monthly case management.

Operational economics differ markedly across the top codes: T2016 shows 36.7K claims at $7966 avg paid/claim, reflecting high per-diem residential payments, while S5100 has 82.5K claims at $317 avg paid/claim and T2023 has 31.7K claims at $338 avg paid/claim. This contrast indicates the provider mixes high-dollar, lower-frequency residential billing with high-frequency, lower-unit-value day and case-management services in its service portfolio.

Competitive standing is mixed across codes: for T2016 the provider ranks #9 of 25 providers in-state (67th percentile; typical, unremarkable volume for this code), so its dominant-revenue code does not equate to top-tier statewide market share. By contrast S5100 ranks #9 of 189 providers in-state (96th percentile; notably above typical state volume), identifying the provider as a strong regional participant in adult day care services despite that code being a much smaller share of total revenue than T2016.

The next-tier codes show typical, modest participation: T2023 ranks #18 of 70 providers in-state (75th percentile; typical, unremarkable volume for this code) and H2015 reported $7.8M (2.2% of revenue) and ranks #57 of 147 providers in-state (62th percentile; typical, unremarkable volume for this code). These placements indicate the provider participates across community support and case-management lines but is not unusually dominant in those categories.

The provider also bills a range of ancillary services at low revenue shares, including T2021 ($6.4M; 1.8% of revenue, rank #8 of 24 in-state, 70th percentile; typical), T2003 (111K claims, $26 avg paid/claim, $2.9M revenue; 0.8% of revenue, rank #60 of 245 in-state, 76th percentile; typical), and smaller volumes for supported employment and attendant/companion care codes. These secondary lines show breadth of service offerings tied to waiver and community supports but represent limited diversification given the dominance of T2016.

The provider’s NPI was enumerated on 2007-03-07 (~19 years ago), indicating a long-tenured presence in the state Medicaid market; combined with $350.2M in lifetime Medicaid revenue and the large T2016 footprint, this suggests established operational capacity in waiver residential habilitation and related community services.

Medicaid: Complete Services Breakdown

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	36,690	$7,970	$292.2M
S5100	Day care services, adult; per 15 minutes	82,470	$320	$26.1M
T2023	Targeted case management; per month	31,690	$340	$10.7M
H2015	Comprehensive community support services, per 15 minutes	20,010	$390	$7.8M
T2021	Day habilitation, waiver; per 15 minutes	25,490	$250	$6.4M
T2003	Non-emergency transportation; encounter/trip	110,970	$30	$2.9M
T2019	Habilitation, supported employment, waiver; per 15 minutes	22,750	$120	$2.7M
H2023	Supported employment, per 15 minutes	5,090	$150	$752.9K
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	6,370	$90	$567K
S5125	Attendant care services; per 15 minutes	230	$40	$9.7K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

Commonwealth Of Massachusetts — 1 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	9	30	29,930	$10,070	$358.9M
T2023	Targeted case management; per month	18	70	8,210	$510	$8.6M
H2023	Supported employment, per 15 minutes	22	20	28,450	$190	$5.6M
H2015	Comprehensive community support services, per 15 minutes	57	150	7,770	$140	$4.8M
S5125	Attendant care services; per 15 minutes	34	40	3,390	$300	$4.7M
T2021	Day habilitation, waiver; per 15 minutes	8	20	20,590	$210	$4.5M
S5100	Day care services, adult; per 15 minutes	9	190	2,000	$230	$3.1M
T2019	Habilitation, supported employment, waiver; per 15 minutes	14	20	24,690	$120	$3.1M
T2003	Non-emergency transportation; encounter/trip	60	250	40,490	$30	$2.2M
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	28	70	2,890	$90	$1.4M

Nearby Providers

Other providers in the same ZIP code as Commonwealth Of Massachusetts, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vhs Acquisition Subsidiary Number 9 Inc	MA	General Acute Care Hospital	$0	$58.9M
South Middlesex Opportunity Council Inc	MA	Community/Behavioral Health Agency	$0	$37.4M
New England Family Dental PC	MA	Point of Service	$0	$14.6M
Justice Resource Institute, Inc.	MA	Developmentally Disabled Services Day Training Agency	$0	$14.2M
Advanced Home Care Services LLC	MA	Home Health Agency	$0	$12.4M
New Horizons Medical, Inc.	MA	Addiction (Substance Use Disorder) Counselor	$0	$11.7M
Robert Johnston	MA	Psychiatry Physician	$10.9K	$11M
Hdc Care Solutions, LLC	MA	Nurse Practitioner	$0	$8M
Alec H. Jaret, Dmd, PC	MA	Dentist	$0	$7.3M
New England Aftercare Ministries, Inc.	MA	Substance Abuse Rehabilitation Facility	$0	$6.4M

Commonwealth Of Massachusetts — Billing Profile & Reimbursement Data

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Commonwealth Of Massachusetts — 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