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

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

Focus-family Options & Community Supports, Inc (NPI 1124199872)

Field	Value
Entity Type	Organization
Organization	Focus-family Options & Community Supports, Inc
Address	501 S Main St
City	Council Bluffs
State	IA
ZIP	51503
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	November 13, 2006

Payer Source	Total Paid
Medicaid	$41.2M
Medicare	$0

Key Findings

Payer mix is effectively single-payer: Medicare revenue is none (no Medicare billing on file) while reported Medicaid revenue totals $41.2M, indicating this entity operates almost entirely within Medicaid-funded programs. Analysts should treat Medicaid reimbursement trends and state policy changes as the primary drivers of this provider's financial performance.

Revenue is extremely concentrated in a very small set of Medicaid codes: the top three Medicaid codes by revenue account for 94.9% of this provider's total Medicaid revenue, with H2016 contributing $19.5M (47.3%), S5136 contributing $17.7M (43.0%), and H2015 contributing $1.9M (4.6%). This concentration means shifts in payment rates, utilization, or authorization for any of those three codes would have outsized impact on overall revenue.

Operational profile implied by code mix: the dominant codes H2016 (Comprehensive community support services, per diem) and S5136 (Companion care, adult; per diem) point to day habilitation/community support and companion/adl/iadl services as the core business lines, consistent with the listed taxonomy Developmentally Disabled Services Day Training Agency. The presence of both per diem comprehensive supports and companion care suggests the provider delivers ongoing daily support programs rather than episodic medical services.

Volume and payment characteristics differ across the two principal codes: H2016 shows high claim volume (17K claims) with a $1149 avg paid/claim generating $19.5M, whereas S5136 has fewer claims (3.7K) but a much higher $4779 avg paid/claim generating $17.7M. These contrasting utilization and unit-payment patterns indicate one revenue stream driven by scale (H2016) and the other driven by higher per-day reimbursement (S5136), which has implications for staffing and capacity planning.

Competitive standing within the state is modest rather than dominant for the top codes: H2016 ranks #72 of 176 providers in-state (59th percentile; typical, unremarkable volume for this code) and S5136 ranks #53 of 82 providers in-state (36th percentile; typical, unremarkable volume for this code). These rankings suggest the provider is a routine participant in these service lines regionally but not a leading statewide operator for either code.

Smaller Medicaid code lines provide limited diversification: T2020 (Day habilitation, waiver; per diem) appears with $1.8M (4.4%) from 4.6K claims at $395 avg paid/claim and ranks #70 of 101 in-state (31th percentile), while T2021 and S5150 together contribute negligible shares ($182.4K, 0.4% and $87.6K, 0.2% respectively). The low revenue shares from these ancillary codes indicate limited offset to the provider's heavy dependence on H2016 and S5136.

Tenure and concentration risk: the NPI was enumerated 2006-11-13 (~20 years ago), indicating the provider is an established market participant with long-running Medicaid relationships; however, the combination of long tenure and a revenue base where the top three codes equal 94.9% of Medicaid revenue highlights material concentration risk if state coverage, rate-setting, or utilization management for those codes changes.

Medicaid: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2016	Comprehensive community support services, per diem	16,950	$1,150	$19.5M
S5136	Companion care, adult (e.g., iadl/adl); per diem	3,710	$4,780	$17.7M
H2015	Comprehensive community support services, per 15 minutes	3,190	$600	$1.9M
T2020	Day habilitation, waiver; per diem	4,610	$400	$1.8M
T2021	Day habilitation, waiver; per 15 minutes	2,640	$70	$182.4K
S5150	Unskilled respite care, not hospice; per 15 minutes	260	$340	$87.6K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Iowa Distribution

Focus-family Options & Community Supports, Inc — 0 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Iowa

Full comparison — all codes billed, vs. Iowa median

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5136	Companion care, adult (e.g., iadl/adl); per diem	53	80	9,410	$490	$17.9M
H2016	Comprehensive community support services, per diem	72	180	10,790	$390	$15.2M
T2020	Day habilitation, waiver; per diem	70	100	10,960	$110	$3M
H2015	Comprehensive community support services, per 15 minutes	55	100	4,130	$160	$1.9M
S5150	Unskilled respite care, not hospice; per 15 minutes	35	40	2,200	$240	$1.6M
T2021	Day habilitation, waiver; per 15 minutes	56	100	2,780	$60	$386.9K

Nearby Providers

Other providers in the same ZIP code as Focus-family Options & Community Supports, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Trivium Life Services	IA	Developmentally Disabled Services Day Training Agency	$0	$149.2M
Vocational Development Center Inc	IA	Developmentally Disabled Services Day Training Agency	$0	$59M
Rem Iowa Community Services, Inc	IA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$54.3M
Council Bluffs Community School District	IA	Local Education Agency (LEA)	$0	$17.5M
Family Connections, Inc	IA	Case Management Agency	$0	$15.1M
Alegent Health Bergan Mercy Health System	IA	General Acute Care Hospital	$0	$13M
Jennie Edmundson Memorial Hospital	IA	General Acute Care Hospital	$0	$9.8M
Alegent Creighton Clinic	IA	Family Medicine Physician	$0	$9.6M
City Of Council Bluffs	IA	Ambulance	$425.7K	$6.2M
Alegent Creighton Health	IA	Psychiatry Physician	$0	$5.8M

Focus-family Options & Community Supports, Inc — Billing Profile & Reimbursement Data

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Focus-family Options & Community Supports, 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