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

Why is the Medicaid comparison limited to South Dakota 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. South Dakota (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.

Northern Hills Training Center, Inc. (NPI 1124174651)

Field	Value
Entity Type	Organization
Organization	Northern Hills Training Center, Inc.
Address	625 Harvard St
City	Spearfish
State	SD
ZIP	57783
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	January 26, 2007

Payer Source	Total Paid
Medicaid	$39.3M
Medicare	$0

Key Findings

NORTHERN HILLS TRAINING CENTER, INC. is effectively a Medicaid-focused operator: there is no Medicare billing on file and lifetime Medicaid revenue totals $39.3M, indicating near-exclusive reliance on Medicaid program dollars for reported service activity. This payer concentration suggests the provider’s financial footprint and growth prospects will be driven almost entirely by state waiver and habilitation reimbursement policies rather than Medicare dynamics.

Revenue is highly concentrated in a few waiver/habilitation codes: the top three Medicaid codes (T2016, T2020, S0281) together account for 87.8% of the provider’s Medicaid revenue. In particular, T2016 alone generates $25.8M (65.6% of Medicaid revenue), so changes to residential habilitation per diem rates or eligibility could meaningfully impact the provider’s topline.

The code mix and dollar amounts point to a service model built around residential and day habilitation plus care coordination: T2016 (Habilitation, residential, waiver; per diem) shows 7.7K claims at $3372 avg paid/claim and $25.8M revenue, T2020 (Day habilitation, waiver; per diem) shows 5.3K claims at $1145 avg paid/claim and $6.1M revenue, and S0281 (Medical home program, comprehensive care coordination and planning, maintenance of plan) shows 7.3K claims at $371 avg paid/claim and $2.7M revenue. This mix is characteristic of a Developmentally Disabled Services Day Training Agency that combines residential supports with day habilitation and formal care coordination.

State competitive standing is modest-to-moderate and generally described as typical for its peers: for its largest code T2016 the provider ranks #9 of 21 in-state (60th percentile) and is labeled a typical, unremarkable volume; for T2020 it ranks #14 of 20 (32th percentile) and is likewise described as typical, unremarkable volume; for S0281 it ranks #8 of 21 (65th percentile) and is described as typical, unremarkable volume. These ranks suggest the provider is not a dominant statewide leader in any single top code but holds solid, serviceable volumes across core waiver services.

Beyond the top three, the provider bills a range of waiver-related lines at materially lower revenue levels, indicating some service breadth within the waiver portfolio: T2025 contributes $2.6M (6.6%), T2018 $746K (1.9%), T2019 $595.3K (1.5%), and T2014 $404.8K (1.0%). Each of these lower-revenue codes is reported as typical, unremarkable in volume for the state, implying conventional usage patterns rather than atypical specialization in ancillary or niche habilitation items.

Although some codes reach relatively high percentile ranks (for example T2019 ranks #3 of 15 at the 86th percentile), the reporting uniformly characterizes volumes as typical and unremarkable, and there are no plain-English labels indicating extreme outlier behavior. This implies utilization patterns that align with common in-state practice rather than being statistical anomalies warranting immediate scrutiny for irregularity.

The provider’s operational longevity is established: the NPI was enumerated on 2007-01-26 (~19 years ago), which supports interpretation of the current billing pattern as the product of an established provider with multi-year participation in state waiver programs. Tenure of this length typically correlates with stable operational processes for billing and service delivery in Medicaid waiver contexts.

Given the heavy dependence on a small set of waiver codes (top three = 87.8%), the provider faces concentrated reimbursement exposure: policy changes, per-diem rate adjustments for T2016 or T2020, or shifts in waiver enrollment could disproportionately affect overall revenue. Analysts should prioritize monitoring state waiver policy, per-diem rate trends, and any changes in eligibility or program structure that would impact residential and day habilitation reimbursements.

Medicaid: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	7,650	$3,370	$25.8M
T2020	Day habilitation, waiver; per diem	5,290	$1,150	$6.1M
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	7,250	$370	$2.7M
T2025	Waiver services; not otherwise specified (nos)	5,410	$480	$2.6M
T2018	Habilitation, supported employment, waiver; per diem	4,610	$160	$746K
T2019	Habilitation, supported employment, waiver; per 15 minutes	1,450	$410	$595.3K
T2014	Habilitation, prevocational, waiver; per diem	1,340	$300	$404.8K
T2017	Habilitation, residential, waiver; 15 minutes	340	$1,030	$344.7K
T2028	Specialized supply, not otherwise specified, waiver	1,250	$60	$77.2K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Dakota Distribution

Northern Hills Training Center, Inc. — 0 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. South Dakota median

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	9	20	6,880	$1,660	$31.6M
T2020	Day habilitation, waiver; per diem	14	20	7,340	$500	$8.9M
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	8	20	6,090	$420	$3M
T2025	Waiver services; not otherwise specified (nos)	10	20	5,410	$180	$1.9M
T2017	Habilitation, residential, waiver; 15 minutes	7	10	470	$270	$437.9K
T2018	Habilitation, supported employment, waiver; per diem	5	20	1,510	$80	$433.9K
T2014	Habilitation, prevocational, waiver; per diem	7	20	1,210	$130	$410.3K
T2019	Habilitation, supported employment, waiver; per 15 minutes	3	20	480	$90	$288.6K
T2028	Specialized supply, not otherwise specified, waiver	15	30	910	$50	$169.8K

Nearby Providers

Other providers in the same ZIP code as Northern Hills Training Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lutheran Social Services Of Sd	SD	Psychiatric Residential Treatment Facility	$0	$16.9M
A.w. Holdings, LLC	SD	Case Manager/Care Coordinator	$0	$3.7M
Edgewood Spearfish Senior Living LLC	SD	Assisted Living Facility (Behavioral Disturbances)	$0	$2.3M
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$2M
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$1.8M
Spearfish Emergency Ambulance Service	SD	Land Ambulance	$540.7K	$302.3K
West River Transit Authority, Inc.	SD	Bus	$0	$788.1K
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$745.7K
Spearfish Collaborative Care LLC	SD	Assisted Living Facility	$0	$657.7K
Black Hills Psychology, LLC	SD	Clinical Psychologist	$0	$601.6K

Northern Hills Training Center, Inc. — Billing Profile & Reimbursement Data

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Northern Hills Training Center, 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