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

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

Services By Design, Inc. (NPI 1124143946)

Field	Value
Entity Type	Organization
Organization	Services By Design, Inc.
Address	113 Applegate Ln
City	Ballwin
State	MO
ZIP	63011
Taxonomy	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NPI Enumerated	March 20, 2007

Payer Source	Total Paid
Medicaid	$73M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-focused operator: there is no Medicare billing on file and lifetime Medicaid revenue is $73M, so the organization functions as a near–single payer Medicaid provider rather than a mixed Medicare/Medicaid facility. The absence of Medicare claims suggests its patient population and services are primarily funded through state Medicaid programs and waiver structures.

Revenue is highly concentrated in a narrow set of waiver and per-diem services: the precomputed top three Medicaid codes account for 99.0% of this provider's total Medicaid revenue, led by T2016 ($53.4M, 73.2%) and S5136 ($18M, 24.7%), with T2001 contributing $848.9K (1.2%). This concentration indicates most billing comes from a few high-volume service categories rather than a broad mix of fee-for-service clinical codes.

The code mix identifies SERVICES BY DESIGN, INC. as a residential habilitation and long‑term support operator: T2016 (Habilitation, residential, waiver; per diem) and S5136 (Companion care, adult; per diem) together make up the vast majority of revenue, which is consistent with group-home or long‑term residential waiver operations that bill per‑diem habilitation and companion care. Smaller line items such as T1002 (Rn services, up to 15 minutes) and transportation codes show supportive clinical and logistic services but not primary revenue drivers.

Operational scale is reflected in large claim volumes for per‑diem services: T2016 has 104.5K claims at an average paid/claim of $511, and S5136 has 73.8K claims at $244 avg paid/claim, demonstrating high day‑or‑shift volumes consistent with residential census billing. By contrast, T2001 shows 3.3K claims at $255 avg paid/claim, indicating transportation is a meaningful but much smaller component of operational activity.

State competitive standing for the dominant residential code is solid but not uniquely dominant: T2016 ranks #28 of 193 providers in-state (86th percentile) and is labeled as typical, unremarkable volume for this code, which means the provider is well above many peers in scale for residential habilitation but not an extreme outlier or near‑monopoly. This profile suggests a strong regional footprint without being the single dominant statewide provider for that service.

For companion care, the provider shows a relatively strong position within a small peer set: S5136 ranks #4 of 14 providers in-state (77th percentile) and is characterized as typical, unremarkable volume for this code, indicating the organization is among the higher-volume suppliers of companion/day support services in its specific market niche. The smaller denominator (14 providers) amplifies the significance of a #4 rank even though the activity is described as typical in statewide context.

Other billed services are marginal contributors and reflect limited diversification: T1002 (5.9K claims, $427.8K revenue; ranks #34 of 195, 83th percentile), 97155 (823 claims, $143.2K revenue; ranks #47 of 69, 32th percentile), A0120 (236 claims, $89.4K revenue; ranks #87 of 120, 28th percentile) and S9484 (439 claims, $53.1K revenue; ranks #2 of 3, 50th percentile) each account for small shares of revenue and are labeled typical, unremarkable volume. These smaller lines indicate presence of RN services, ABA-related services, non‑emergency transit variants, and crisis intervention but they do not materially alter the provider's per‑diem residential revenue concentration.

The provider has an established billing history and organizational tenure: NPI enumerated 2007-03-20 (~19 years ago), which aligns with the large cumulative Medicaid billing observed. Long tenure paired with highly concentrated per‑diem revenue streams suggests stable operations centered on residential habilitation and companion care rather than recent entry or rapidly shifting service mix.

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	104,520	$510	$53.4M
S5136	Companion care, adult (e.g., iadl/adl); per diem	73,840	$240	$18M
T2001	Non-emergency transportation; patient attendant/escort	3,330	$260	$848.9K
T1002	Rn services, up to 15 minutes	5,940	$70	$427.8K
97155	The provider, a physician or other qualified healthcare professional, administers adaptive behavior treatment face–to–face with one patient and makes modifications in the protocol targets and…	820	$170	$143.2K
A0120	Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems	240	$380	$89.4K
S9484	Crisis intervention mental health services, per hour	440	$120	$53.1K
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	30	$50	$1.6K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Missouri Distribution

Services By Design, Inc. — 0 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. Missouri median

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	28	190	38,330	$450	$27M
S5136	Companion care, adult (e.g., iadl/adl); per diem	4	10	18,080	$240	$15.9M
S9484	Crisis intervention mental health services, per hour	2	10	440	$260	$737K
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	56	60	1,810	$160	$587.2K
A0120	Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems	87	120	730	$60	$585.2K
97155	The provider, a physician or other qualified healthcare professional, administers adaptive behavior treatment face–to–face with one patient and makes modifications in the protocol targets and…	47	70	2,030	$140	$460.6K
T2001	Non-emergency transportation; patient attendant/escort	28	150	1,300	$150	$296.4K
T1002	Rn services, up to 15 minutes	34	200	1,720	$50	$194.4K

Nearby Providers

Other providers in the same ZIP code as Services By Design, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Aging Ahead	MO	Meals Provider	$0	$10.7M
Hometeam Cds LLC	MO	Home Health Agency	$0	$6.2M
Clarkson Optometry, Inc	MO	Optometrist	$0	$5.4M
West County Ems And Fire Protection District	MO	Land Ambulance	$443K	$374.5K
St. Louis Women's Surgery Center, LLC	MO	Ambulatory Surgical Clinic/Center	$213.8K	$0
Costco Wholesale Corporation	MO	Community/Retail Pharmacy	$210K	$0
Samir Dalia	MO	Hematology & Oncology Physician	$154.7K	$0
Amelia Kohnen	MO	Occupational Therapist	$98.6K	$0
Brian Mahaffey	MO	Sports Medicine (Family Medicine) Physician	$77.3K	$0
Missouri Cvs Pharmacy, L.L.C.	MO	Pharmacy	$72.4K	$0

Services By Design, Inc. — Billing Profile & Reimbursement Data

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Services By Design, 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