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.

Community Connections Inc (NPI 1134244510)

Field	Value
Entity Type	Organization
Organization	Community Connections Inc
Address	401 W 2nd Street
City	Winner
State	SD
ZIP	57580
Taxonomy	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NPI Enumerated	March 21, 2007

Payer Source	Total Paid
Medicaid	$22.6M
Medicare	$0

Key Findings

This provider is effectively single‑payer at scale: there is no Medicare billing on file and all recorded lifetime government revenue comes from Medicaid, totaling $22.6M. The absence of Medicare activity indicates the organization’s operations and reimbursement experience are concentrated entirely within state Medicaid programs.

Revenue is highly concentrated in a very small set of Medicaid codes: the precomputed top 3 Medicaid codes account for 96.8% of this provider’s total Medicaid revenue. That concentration suggests limited service-line diversification and sensitivity of overall revenue to changes in reimbursement or utilization for those specific waiver and coordination services.

T2016 is the single largest revenue driver, with 3.1K claims, $4789 avg paid/claim and $15M in revenue, representing 66.3% of the provider’s Medicaid revenue. The code description (Habilitation, residential, waiver; per diem) and the large average paid per claim imply the provider’s core operation is facility‑based residential habilitation services billed on a per‑diem basis, making residential care the dominant business line.

T2020 is the second major code with 4.4K claims, $1245 avg paid/claim and $5.5M in revenue, accounting for 24.2% of Medicaid revenue; this code (Day habilitation, waiver; per diem) indicates a substantial day‑program component to the operation. Together with T2016, T2020 reinforces a business mix centered on waiver habilitation services delivered across residential and day settings rather than brief outpatient encounters.

S0281 contributes $1.4M (6.3% of Medicaid revenue) across 2.6K claims at $547 avg paid/claim and is billed for medical home program activities (comprehensive care coordination and planning). Its presence as the third largest revenue source indicates a secondary emphasis on care coordination and service planning that supports the habilitation programs, but it is not a primary revenue engine.

Competitive standing across these leading Medicaid codes is modest rather than dominant: T2016 ranks #18 of 21 providers in‑state (15th percentile), T2020 ranks #15 of 20 (26th percentile), and S0281 ranks #18 of 21 (15th percentile), each described as typical, unremarkable volume for the code. These rank/percentile positions indicate the provider is a regional participant in South Dakota’s waiver service market but not a leading statewide provider for these code categories.

Other Medicaid codes listed (T2018, T2025, T2028, T2014, T2019) each represent small shares of revenue (individually 1.4% down to 0.2%) and are characterized as typical volumes within their in‑state peer groups; there are no statistical outliers flagged in the available code mix. This pattern reinforces that operational focus and financial exposure are concentrated in the top per‑diem habilitation and coordination services rather than a broader array of high‑volume ancillary or clinical codes.

The provider’s NPI has been enumerated since 2007‑03‑21 (~19 years ago), indicating a relatively long tenure in the Medicaid market; combined with the concentrated revenue mix, this suggests an established provider with a stable, specialization‑driven service model in residential and day habilitation for individuals with intellectual and developmental disabilities.

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	3,130	$4,790	$15M
T2020	Day habilitation, waiver; per diem	4,380	$1,250	$5.5M
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	2,610	$550	$1.4M
T2018	Habilitation, supported employment, waiver; per diem	1,510	$210	$320.8K
T2025	Waiver services; not otherwise specified (nos)	2,090	$110	$236.1K
T2028	Specialized supply, not otherwise specified, waiver	910	$70	$65.7K
T2014	Habilitation, prevocational, waiver; per diem	220	$280	$63.6K
T2019	Habilitation, supported employment, waiver; per 15 minutes	200	$210	$41.8K

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

Community Connections Inc — 0 of 8 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

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	18	20	6,880	$1,660	$31.6M
T2020	Day habilitation, waiver; per diem	15	20	7,340	$500	$8.9M
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	18	20	6,090	$420	$3M
T2025	Waiver services; not otherwise specified (nos)	16	20	5,410	$180	$1.9M
T2018	Habilitation, supported employment, waiver; per diem	9	20	1,510	$80	$433.9K
T2014	Habilitation, prevocational, waiver; per diem	16	20	1,210	$130	$410.3K
T2019	Habilitation, supported employment, waiver; per 15 minutes	11	20	480	$90	$288.6K
T2028	Specialized supply, not otherwise specified, waiver	17	30	910	$50	$169.8K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southern Plains Behavioral Health Services Inc	SD	Community/Behavioral Health Agency	$0	$6.8M
Winner Regional Healthcare Center	SD	Rural Health Clinic/Center	$0	$3M
Twobros. Inc.	SD	Assisted Living Facility	$0	$1.3M
Guardian Flight LLC	SD	Air Ambulance	$336.6K	$405K
Dr Daniel L Peters Od PC	SD	Optometrist	$0	$396.6K
Winner Regional Healthcare Center	SD	Critical Access Hospital	$0	$390.1K
Manke Family Dentistry, PC	SD	Dentist	$0	$224.9K
County Of Tripp	SD	Land Ambulance	$154.3K	$65.3K
Winner Regional Health Clinic	SD	Family Nurse Practitioner	$0	$192.7K
Winner Physical Therapy Inc	SD	Physical Therapy Clinic/Center	$0	$162K

Community Connections Inc — Billing Profile & Reimbursement Data

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Community Connections 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