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.

3rivers, Inc. (NPI 1174769822)

Field	Value
Entity Type	Organization
Organization	3rivers, Inc.
Address	15 Saunders Way
City	Westbrook
State	ME
ZIP	04092
Taxonomy	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NPI Enumerated	December 31, 2008

Payer Source	Total Paid
Medicaid	$78.6M
Medicare	$0

Key Findings

This entity reports $78.6M in lifetime Medicaid revenue and has no Medicare billing on file, meaning its payer exposure is effectively single-payer Medicaid rather than a mixed Medicare/Medicaid practice profile. The absence of Medicare claims should be treated as a defining characteristic of its revenue base and competitive positioning.

Revenue is highly concentrated in a very small set of codes: the precomputed top three Medicaid codes account for 99.2% of this provider's total Medicaid revenue, indicating most of the business is driven by a narrow set of service lines rather than a broad portfolio of Medicaid billings. This concentration raises business sensitivity to policy or rate changes for those specific codes.

S5140 (Foster care, adult; per diem) is the largest single revenue driver with 11.7K claims, $3825 avg paid/claim, and $44.6M in revenue (56.8% of the provider's Medicaid revenue). The per-diem foster care volume and payment level indicate the organization operates substantial adult foster/residential placements as a core service line, and its statewide rank of #14 of 31 (57th percentile) suggests a typical in-state scale for this service rather than a dominant market position.

T2016 (Habilitation, residential, waiver; per diem) is the second major driver with 4.2K claims, $7428 avg paid/claim, and $31.1M in revenue (39.6% of the provider's Medicaid revenue). High per-diem payments and sizable revenue share for T2016 reinforce that the provider’s operation centers on residential habilitation services for individuals with intellectual and developmental disabilities, but its in-state rank of #49 of 75 (35th percentile) places it as a modest participant for this specific waiver service.

G9012 (Other specified case management service not elsewhere classified) contributes $2.2M (2.8% of Medicaid revenue) across 37.6K claims at $59 avg paid/claim and ranks #22 of 50 (57th percentile). This pattern shows a meaningful case management footprint supporting the residential operations, with claim frequency high but per-claim payment low, consistent with bundled administrative/casework services that accompany residential care.

T2021 (Day habilitation, waiver; per 15 minutes) is a very small revenue contributor at $605.7K (0.8% of Medicaid revenue) with 573 claims and a low statewide rank (#69 of 72, 4th percentile). The low claim volume and rank for T2021 indicate the provider does not operate a significant day habilitation program relative to peers and relies predominantly on residential per-diem services rather than time-based day habilitation.

Competitive standing across the reported codes is uniformly described in the source as "typical, unremarkable volume" for the top codes; none of the three principal codes show an extreme outlier status. In-state ranks and percentiles (S5140 at the 57th, T2016 at the 35th, G9012 at the 57th) point to a provider that is an established but not dominant statewide player in its core residential and case management services.

The provider’s NPI was enumerated on 2008-12-31 (~18 years ago), indicating long-tenured enrollment; combined with the concentrated per-diem revenue mix this suggests an operational focus maintained over many years rather than a recent pivot in service lines. Analysts should treat this as a stable, Medicaid-focused residential habilitation/foster-care operator whose financial sensitivity will track changes to S5140 and T2016 reimbursement policies.

Medicaid: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5140	Foster care, adult; per diem	11,670	$3,830	$44.6M
T2016	Habilitation, residential, waiver; per diem	4,190	$7,430	$31.1M
G9012	Other specified case management service not elsewhere classified	37,630	$60	$2.2M
T2021	Day habilitation, waiver; per 15 minutes	570	$1,060	$605.7K

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

3rivers, Inc. — 0 of 4 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

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	49	80	7,300	$1,670	$30.8M
S5140	Foster care, adult; per diem	14	30	9,310	$530	$13.6M
T2021	Day habilitation, waiver; per 15 minutes	69	70	13,340	$200	$5.1M
G9012	Other specified case management service not elsewhere classified	22	50	25,820	$80	$3M

Nearby Providers

Other providers in the same ZIP code as 3rivers, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Creative Works	ME	Developmentally Disabled Services Day Training Agency	$0	$144.1M
Woodfords Family Services	ME	Community/Behavioral Health Agency	$0	$101.5M
Safe Residential Care, LLC	ME	Physical Disabilities Residential Treatment Facility	$0	$94.6M
Woodfords Family Services	ME	Community/Behavioral Health Agency	$0	$46.3M
Alliance Case Management	ME	Case Management Agency	$0	$17.8M
Woodfords Family Services	ME	In Home Supportive Care Agency	$0	$11.3M
Woodfords Family Services	ME	Case Management Agency	$0	$9.4M
Mas Medical Staffing Corporation	ME	Home Health Agency	$0	$8.1M
Maine Community Homecare	ME	In Home Supportive Care Agency	$0	$8.1M
Cap Quality Care, Inc.	ME	Methadone Clinic	$202.6K	$7.1M

3rivers, Inc. — Billing Profile & Reimbursement Data

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3rivers, 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