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

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

National Mentor Healthcare (NPI 1114070752)

Field	Value
Entity Type	Organization
Organization	National Mentor Healthcare
Address	2700 N 3rd St Ste 4000
City	Phoenix
State	AZ
ZIP	85004
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	January 18, 2007

Payer Source	Total Paid
Medicaid	$460.1M
Medicare	$0

Key Findings

NATIONAL MENTOR HEALTHCARE is effectively a single-payer Medicaid provider: it has no Medicare billing on file and reports $460.1M in lifetime Medicaid revenue, indicating its operations and scale are almost entirely driven by Medicaid-funded services. This concentrated payer footprint means analyses of utilization, reimbursement, and competitive position should focus on Medicaid program rules, waiver structures, and state-level capacity.

Three codes account for the vast majority of Medicaid revenue: T2016, S5125, and T2021 together represent 94.2% of the provider’s total Medicaid revenue. This extreme concentration implies the organization’s business model and cash flow are highly dependent on a narrow set of habilitation and attendant-care services administered under Medicaid waiver programs.

T2016 (Habilitation, residential, waiver; per diem) is by far the dominant revenue driver with $370.3M in revenue (80.5% of the provider’s Medicaid revenue) and the provider ranks #1 of 27 in-state, a 100th percentile extreme outlier. This position signals that NATIONAL MENTOR HEALTHCARE operates a large-scale residential habilitation program relative to peers and is a statewide leader, substantially above typical state volume for this code.

T2021 (Day habilitation, waiver; per 15 minutes) is also a major service line with $28M in revenue (6.1% of Medicaid revenue) and the provider ranks #1 of 48 in-state at the 100th percentile and an extreme outlier. Combined with the T2016 dominance, this mix indicates the provider delivers both residential and day habilitation at scale, suggesting vertically integrated habilitation services across settings.

S5125 (Attendant care services; per 15 minutes) contributes $35M (7.6% of Medicaid revenue) and ranks #14 of 223 in-state (94th percentile). While substantial in absolute dollars, its in-state rank and percentile indicate the provider is a strong but not unique participant in attendant-care markets—this code is an important secondary revenue stream but not the primary differentiator.

Several other Medicaid codes appear as smaller, supplemental revenue sources: T2017 ($13.2M, 2.9%), S5150 ($12.3M, 2.7%), and A0120 ($1M, 0.2%). These lines (residential 15-minute habilitation, unskilled respite, and non-emergency transportation) align with support services typically bundled around residential and day habilitation operations, reflecting a comprehensive service portfolio for individuals with developmental disabilities.

The provider’s NPI has been active since 2007-01-18 (~19 years ago), indicating long tenure in the market. This extended presence, combined with dominant rankings on key waiver habilitation codes, supports the view that NATIONAL MENTOR HEALTHCARE is an established provider whose scale in residential habilitation has likely grown or been sustained over many years.

From a competitive standpoint, the provider is a dominant statewide leader specifically for residential and day habilitation (T2016 and T2021: both 100th percentile and labeled extreme outliers) while its attendant-care offering (S5125) is strong but more typical among many providers. This split suggests the firm’s strategic advantage is concentrated in high-volume habilitation settings, with attendant care functioning as a complementary service line.

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
T2016	Habilitation, residential, waiver; per diem	1,125,670	$330	$370.3M
S5125	Attendant care services; per 15 minutes	372,360	$90	$35M
T2021	Day habilitation, waiver; per 15 minutes	261,570	$110	$28M
T2017	Habilitation, residential, waiver; 15 minutes	189,190	$70	$13.2M
S5150	Unskilled respite care, not hospice; per 15 minutes	153,510	$80	$12.3M
A0120	Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems	43,320	$20	$1M
T2019	Habilitation, supported employment, waiver; per 15 minutes	2,920	$60	$160.8K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Arizona Distribution

National Mentor Healthcare — 3 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Arizona

Full comparison — all codes billed, vs. Arizona median

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	1	30	76,220	$310	$52.4M
S5125	Attendant care services; per 15 minutes	14	220	24,500	$120	$15.5M
T2017	Habilitation, residential, waiver; 15 minutes	7	60	32,290	$90	$9M
T2021	Day habilitation, waiver; per 15 minutes	1	50	19,210	$100	$5.3M
T2019	Habilitation, supported employment, waiver; per 15 minutes	13	20	19,190	$90	$2.9M
S5150	Unskilled respite care, not hospice; per 15 minutes	6	190	5,090	$100	$2.9M
A0120	Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems	70	510	5,500	$10	$267.6K

Nearby Providers

Other providers in the same ZIP code as National Mentor Healthcare, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Native American Connections, Inc.	AZ	Substance Abuse Rehabilitation Facility	$0	$15.6M
Maricopa County Special Health Care District	AZ	Federally Qualified Health Center (FQHC)	$0	$14.5M
Recovia LLC	AZ	Specialist	$0	$11M
Taylord LLC	AZ	Cognitive & Behavioral Psychologist	$0	$10.6M
Gellert Health	AZ	Community/Behavioral Health Agency	$0	$7.3M
Panayiotis Savvides	AZ	Hematology & Oncology Physician	$1.2M	$0
Ana Grace	AZ	Radiation Oncology Physician	$842.8K	$0
Phoenix Endoscopy LLC	AZ	Ambulatory Surgical Clinic/Center	$433.4K	$0
Nathalie Zeitouni	AZ	Dermatology Physician	$314K	$0
Frank Agnone	AZ	Internal Medicine Physician	$241.2K	$0

National Mentor Healthcare — Billing Profile & Reimbursement Data

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National Mentor Healthcare — 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