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

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

Helping Restore Ability (NPI 1124158175)

Field	Value
Entity Type	Organization
Organization	Helping Restore Ability
Address	4300 Beltway Place, Suite 130
City	Arlington
State	TX
ZIP	76018
Taxonomy	Supports Brokerage Agency
NPI Enumerated	March 7, 2007

Payer Source	Total Paid
Medicaid	$106.9M
Medicare	$0

Key Findings

This provider operates as an effectively single-payer Medicaid provider: there is no Medicare billing on file and reported lifetime Medicaid revenue totals $106.9M, indicating its entire documented federally billed footprint is driven by Medicaid programs. The absence of Medicare revenue means analyses of its performance should focus on state Medicaid policy and waiver program rules rather than Medicare market dynamics.

Revenue is highly concentrated in a few waiver and personal-care codes: the top three Medicaid codes (T2016, S5125, T1019) together account for 73.9% of Medicaid revenue. T2016 alone represents $47.7M or 44.6% of Medicaid revenue, making it the single largest revenue driver for this entity and a critical dependency for overall financial performance.

The code mix points to a core business in home- and community-based services and waiver support rather than traditional medical care. High revenue and claim counts for T2016 (Habilitation, residential, waiver; 139K claims, $47.7M) combined with large volumes for S5125 (Attendant care services; 273.2K claims, $19.7M) and T1019 (Personal care services; 153.9K claims, $11.7M) indicate operations centered on residential habilitation, attendant/personal care and ongoing in-home support rather than clinic- or procedure-based services.

Competitive standing by code is mixed but generally sits in the upper percentiles without being flagged as extreme: T2016 ranks #8 of 109 providers in-state (94th percentile) while the dataset characterizes the volume as typical/unremarkable; S5125 ranks #231 of 1678 (86th percentile) and T1019 ranks #112 of 1050 (89th percentile), both also labeled typical. In practical terms this means the provider is a significant presence in key waiver services within Texas but is not reported as an unusual outlier beyond the normal competitive range for these code families.

Operational scale is substantial for time-based, direct-care services: the top codes show very large claim counts (T2016 139K claims; S5125 273.2K claims; T1019 153.9K claims), consistent with a labor-intensive delivery model that bills by per-diem or per-15-minute units. Those claim volumes, paired with the per-claim rates shown, imply this provider runs a sizable direct-support workforce or manages care through brokerage/self-directed structures.

There is some revenue diversification beyond the top three codes into related waiver and support services, but these are materially smaller shares of total revenue. Examples include M0355 ($5.3M, 4.9% of Medicaid revenue), S9125 ($3.8M, 3.6%), and T2040 ($3.2M, 3.0%), plus occasional billing for infusion-related home services (M0241 $436.7K), which together suggest ancillary offerings around respite, financial management for self-directed care, and limited clinical-at-home services.

The provider’s taxonomy (Supports Brokerage Agency) aligns with claims for T2040 (financial management, self-directed waiver) and other self-direction/respite codes; this supports an operational model where brokerage or fiscal-management functions are a meaningful part of service delivery and revenue capture. Presence of T2040 alongside heavy attendant/personal care billing suggests a mixed model of direct service delivery and brokerage/fiscal-management for self-directed beneficiaries.

The NPI has been enumerated since 2007-03-07 (~19 years ago), indicating a long tenure in the market which is consistent with the scale observed in Medicaid billing. Long-standing enrollment combined with concentrated dependence on a small set of waiver codes (top three = 73.9% of Medicaid revenue) means the provider’s revenue profile is sensitive to state waiver rate changes or program policy shifts affecting those code families.

Medicaid: Complete Services Breakdown

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

21 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	138,990	$340	$47.7M
S5125	Attendant care services; per 15 minutes	273,180	$70	$19.7M
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	153,860	$80	$11.7M
M0355	N/A	25,030	$210	$5.3M
S9125	Respite care, in the home, per diem	34,840	$110	$3.8M
T2040	Financial management, self-directed, waiver; per 15 minutes	75,250	$40	$3.2M
T1005	Respite care services, up to 15 minutes	37,680	$80	$3M
T2017	Habilitation, residential, waiver; 15 minutes	34,630	$80	$2.9M
H2015	Comprehensive community support services, per 15 minutes	29,610	$80	$2.5M
G0226	N/A	9,390	$200	$1.9M

Showing 1–10 of 21

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Texas Distribution

Helping Restore Ability — 0 of 21 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. Texas median

21 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5125	Attendant care services; per 15 minutes	231	1,680	50,290	$60	$9.5M
T2016	Habilitation, residential, waiver; per diem	8	110	6,810	$200	$8.1M
M0355	N/A	4	10	17,420	$290	$6.2M
S9125	Respite care, in the home, per diem	7	20	18,690	$100	$3.5M
M0361	N/A	4	10	9,410	$190	$3.2M
T2017	Habilitation, residential, waiver; 15 minutes	13	60	19,340	$80	$3M
G0226	N/A	5	10	2,550	$200	$2.5M
T2040	Financial management, self-directed, waiver; per 15 minutes	7	40	4,490	$30	$2.5M
G0749	N/A	15	20	8,140	$180	$2.2M
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	112	1,050	23,280	$30	$1.8M

Showing 1–10 of 21

Nearby Providers

Other providers in the same ZIP code as Helping Restore Ability, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Promptime Home Healthcare Services Inc	TX	Home Health Agency	$0	$23.8M
American Medical Response Ambulance Service Inc	TX	Ambulance	$2.4M	$6.7M
Health Imaging Partners, LLC	TX	Physiological Laboratory	$1.5M	$79K
Lema Sbenaty	TX	Optometrist	$156.4K	$0
Mirta Parra	TX	Registered Dietitian	$28.6K	$0

Helping Restore Ability — Billing Profile & Reimbursement Data

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Helping Restore Ability — 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