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

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

Spectrum Community Services (NPI 1164577391)

Field	Value
Entity Type	Organization
Organization	Spectrum Community Services
Address	28303 Joy Rd
City	Westland
State	MI
ZIP	48185
Taxonomy	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NPI Enumerated	January 25, 2007

Payer Source	Total Paid
Medicaid	$166.6M
Medicare	$0

Key Findings

This provider is effectively single‑payer: there is no Medicare billing on file and the provider reports Total Medicaid revenue of $166.6M, indicating operations are funded almost entirely through Medicaid programs rather than Medicare. This concentration in one payer should frame any contracting or utilization review assumptions.

Revenue is highly concentrated in three codes: the top 3 Medicaid codes by revenue account for 81.0% of this provider's total Medicaid revenue. The largest single code is H2016 ($79M, 47.4%), followed by T1020 ($32M, 19.2%) and H2015 ($23.9M, 14.3%), together driving the overwhelming majority of billed Medicaid dollars.

The code mix points to a community‑based intellectual/developmental disabilities services model: H2016 (Comprehensive community support services, per diem) and H2015 (Comprehensive community support services, per 15 minutes) indicate high volumes of ongoing community support/treatment services, while T1020 (Personal care services, per diem) and H0043 (Supported housing, per diem; $16.5M, 9.9%) reflect residential and personal‑care operations. This pattern is consistent with a community‑based residential treatment facility delivering daily supports, hands‑on personal care, and supported housing rather than outpatient medical procedures.

On competitive standing within Michigan this provider is a major in specific service lines: H2016 ranks #7 of 297 providers in-state (98th percentile) and T1020 ranks #5 of 221 providers (98th percentile), both described as notably above typical state volume for these codes. By contrast, H2015 ranks #21 of 614 (97th percentile) and is characterized as typical/unremarkable for the code, indicating strong dominance in a subset of services but more ordinary participation in others.

There are distinct statistical outliers in both high‑volume and niche services. H2016 and T1020 are flagged as notably above typical state volume, underscoring the provider’s outsized role in per‑diem community supports and personal care, while G0176 (Activity therapy) is ranked #1 of 16 providers in-state (100th percentile; notably above typical state volume) — a meaningful outlier for activity therapy despite its relatively small revenue contribution ($496.1K).

The provider’s business risk profile is concentrated: heavy dependence on a few per‑diem and per‑15‑minute Medicaid codes (top 3 = 81.0% of Medicaid revenue) plus the absence of Medicare revenue creates vulnerability to changes in Medicaid policy, per‑diem rate adjustments, or state program priorities. Any payer contracting, utilization, or audit strategy should prioritize monitoring of H2016, T1020, and H2015 activity.

Despite the revenue concentration, the provider shows a broader service footprint beyond the top three codes: meaningful secondary lines include H0043 (Supported housing, $16.5M, 9.9%), T1017 (Targeted case management, $5.4M, 3.2%), and T1016 (Case management, $3.4M, 2.1%), plus smaller volumes in respite, psychotherapy, and nursing assessments. This mix indicates the organization operates a continuum of support services (housing, case management, respite and behavioral therapies) that supplement its core per‑diem community supports.

The provider has an established presence in the Medicaid market with an NPI enumerated 2007-01-25 (~19 years ago), suggesting long tenure and operational experience in state programs; that longevity, combined with high state rankings on key codes, supports the assessment of this entity as a stable, specialized Medicaid service provider rather than a transient or newly entered vendor.

Medicaid: Complete Services Breakdown

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

23 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2016	Comprehensive community support services, per diem	177,870	$440	$79M
T1020	Personal care services, per diem, 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…	176,910	$180	$32M
H2015	Comprehensive community support services, per 15 minutes	327,380	$70	$23.9M
H0043	Supported housing, per diem	51,210	$320	$16.5M
T1017	Targeted case management, each 15 minutes	20,300	$270	$5.4M
T1016	Case management, each 15 minutes	17,080	$200	$3.4M
T2027	Specialized childcare, waiver; per 15 minutes	57,770	$60	$3.2M
T2022	Case management, per month	4,650	$260	$1.2M
T1005	Respite care services, up to 15 minutes	6,210	$130	$776.5K
G0176	Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more)	5,510	$90	$496.1K

Showing 1–10 of 23

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Michigan Distribution

Spectrum Community Services — 4 of 23 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

23 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2022	Case management, per month	20	40	3,310	$490	$9.4M
H2016	Comprehensive community support services, per diem	7	300	6,660	$310	$8.7M
T1017	Targeted case management, each 15 minutes	80	180	10,890	$210	$8.1M
H2015	Comprehensive community support services, per 15 minutes	21	610	14,740	$90	$6M
T2027	Specialized childcare, waiver; per 15 minutes	16	40	23,640	$70	$4.8M
T1020	Personal care services, per diem, 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…	5	220	7,030	$170	$4.6M
H0043	Supported housing, per diem	13	130	10,330	$210	$4.5M
T1016	Case management, each 15 minutes	37	120	8,060	$210	$3.4M
T1005	Respite care services, up to 15 minutes	47	110	4,910	$80	$2.2M
H0031	Mental health assessment, by non-physician	181	180	1,290	$250	$1.1M

Showing 1–10 of 23

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hegira Health, Inc	MI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$109.5M
Hegira Health, Inc.	MI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$17M
Barbara Fowkes	MI	Community Health Worker	$0	$9.6M
City Of Westland And 18th District Court	MI	Land Ambulance	$450.8K	$3M
Andrew Colman	MI	General Practice Physician	$166.5K	$0
Jenna Mckeever	MI	Family Nurse Practitioner	$121.3K	$0
Leigh Rubin	MI	Podiatrist	$99.4K	$0
Jennifer Gerteisen	MI	Foot & Ankle Surgery Podiatrist	$71K	$0
Rebecca Szymaszek	MI	Adult Health Nurse Practitioner	$56.1K	$0

Spectrum Community Services — Billing Profile & Reimbursement Data

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Spectrum Community Services — 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