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

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

Amicus (NPI 1124160171)

Field	Value
Entity Type	Organization
Organization	Amicus
Address	96 13th St
City	Bangor
State	ME
ZIP	04401
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	February 13, 2007

Payer Source	Total Paid
Medicaid	$26.1M
Medicare	$0

Key Findings

AMICUS reports no Medicare billing on file and $26.1M in lifetime Medicaid revenue, indicating it operates effectively as a Medicaid-focused provider rather than a dual-payer practice. The absence of Medicare activity means analyses of its performance should center on Medicaid program dynamics and state waiver payment policies.

The provider’s Medicaid revenue is highly concentrated: the precomputed top 3 codes account for 100.0% of its total Medicaid revenue, signaling near-total dependence on a very small set of service lines for topline dollars. This concentration suggests any change to reimbursement or utilization for these codes would materially affect overall revenue.

T2021 dominates the revenue mix: 162.5K claims at an average paid/claim of $128 produced $20.8M in revenue, representing 79.7% of this provider's total Medicaid revenue. AMICUS ranks #1 of 72 providers in-state for T2021 and sits in the 100th percentile as an extreme outlier, which reflects an unusually large day habilitation operation far above typical state volume for this code.

G9012 and T2017 are material but far smaller contributors: G9012 generated 49.8K claims at $70 avg paid/claim for $3.5M (13.4% of Medicaid revenue) and ranks #13 of 50 providers in-state (76th percentile), while T2017 produced 13.8K claims at $132 avg paid/claim for $1.8M (7.0% of Medicaid revenue) and ranks #12 of 34 providers in-state (67th percentile). Both codes are characterized in the data as typical, unremarkable volumes in-state, indicating these services complement but do not rival the scale of the day habilitation business.

The code mix—T2021 (day habilitation, waiver; per 15 minutes), T2017 (habilitation, residential, waiver; 15 minutes), and G9012 (other specified case management)—identifies AMICUS as a developmental disabilities services organization focused on time-based waiver habilitation (day and residential) with accompanying case management. This pattern is consistent with organizations that deliver high-throughput, hands-on supports under Medicaid waiver programs.

From a competitive-stance perspective, AMICUS is a dominant statewide provider specifically for T2021 given its #1 rank and 100th-percentile extreme outlier status, while its positions on G9012 (#13 of 50, 76th percentile) and T2017 (#12 of 34, 67th percentile) indicate more typical, mid-tier participation for those supplemental services. In sum, AMICUS’s statewide market power is concentrated in day habilitation services rather than broadly across multiple service lines.

AMICUS’s NPI was enumerated on 2007-02-13 (~19 years ago), indicating a long-tenured presence in the market; this longevity likely supported the scaling required to reach the high volume observed for T2021. Sustained operation over nearly two decades is consistent with institutional knowledge and established relationships within Medicaid waiver networks.

Operationally, the heavy reliance on time-based waiver codes (per-15-minute billing for T2021 and T2017) and the large claim counts (162.5K for T2021; 13.8K for T2017) imply the organization’s revenue is sensitive to client hours, staffing capacity, and scheduling efficiency. Because the top three codes make up 100.0% of Medicaid revenue, AMICUS has limited revenue diversification and could be particularly exposed to changes in waiver policy, rate-setting, or utilization patterns for these specific 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
T2021	Day habilitation, waiver; per 15 minutes	162,500	$130	$20.8M
G9012	Other specified case management service not elsewhere classified	49,840	$70	$3.5M
T2017	Habilitation, residential, waiver; 15 minutes	13,770	$130	$1.8M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Maine Distribution

Amicus — 1 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maine

Full comparison — all codes billed, vs. Maine median

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2021	Day habilitation, waiver; per 15 minutes	1	70	13,340	$200	$5.1M
G9012	Other specified case management service not elsewhere classified	13	50	25,820	$80	$3M
T2017	Habilitation, residential, waiver; 15 minutes	12	30	8,960	$260	$3M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eastern Maine Medical Center	ME	General Acute Care Hospital	$0	$159.3M
Creative Options, LLC	ME	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$78.7M
Mas Medical Staffing Corporation	ME	Community/Behavioral Health Agency	$0	$62.5M
Ohi	ME	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$61.9M
Ohi	ME	Mental Illness Community Based Residential Treatment Facility	$0	$39.6M
St. Joseph Hospital	ME	General Acute Care Hospital	$0	$38.8M
Mert Enterprises, Inc.	ME	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$36.3M
Penobscot Community Health Center	ME	Federally Qualified Health Center (FQHC)	$0	$27.3M
Branches, LLC	ME	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$25.4M
Lifeflight Of Maine, LLC	ME	Air Ambulance	$2.4M	$19.8M

Amicus — Billing Profile & Reimbursement Data

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Amicus — 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