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

Why is the Medicaid comparison limited to New Jersey 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. New Jersey (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.

New Horizons In Autism, Inc. (NPI 1184009235)

Field	Value
Entity Type	Organization
Organization	New Horizons In Autism, Inc.
Address	281 State Route 79 N Fl 2
City	Morganville
State	NJ
ZIP	07751
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	July 29, 2015

Payer Source	Total Paid
Medicaid	$100.4M
Medicare	$0

Key Findings

This entity is effectively a single‑payer Medicaid provider: Total Medicare revenue is none (no Medicare billing on file) while total Medicaid revenue is $100.4M, indicating Medicaid is the exclusive billed payer on file and the primary revenue source for the organization. The provider’s taxonomy as a Developmentally Disabled Services Day Training Agency aligns with this payer mix and service focus.

The provider’s activity is concentrated in waivered habilitation and community support services: the top revenue codes are H2016 (Comprehensive community support services, per diem), T2021 (Day habilitation, waiver; per 15 minutes), and T2015 (Habilitation, prevocational, waiver; per hour). This mix — high per‑diem community supports together with per‑15‑minute day habilitation and hourly prevocational habilitation — is consistent with an operation focused on day training and in‑community support for individuals with developmental disabilities.

Revenue is highly concentrated in a very small set of service codes: the precomputed top three Medicaid codes account for 99.6% of this provider’s total Medicaid revenue. Those three codes are H2016 ($74.1M, 73.9% of Medicaid revenue), T2021 ($24.8M, 24.7% of Medicaid revenue), and T2015 ($1M, 1.0% of Medicaid revenue), so reimbursement and utilization changes affecting any of these codes would materially impact overall revenue.

Competitive standing across these large codes is mixed by state percentile. H2016 generates the majority of revenue but ranks #56 of 206 providers in‑state (73th percentile), described as typical/unremarkable volume; T2021 ranks #24 of 218 providers (89th percentile) and likewise shows typical volume relative to peers despite large absolute dollars; by contrast, T2015 ranks #4 of 70 providers (96th percentile) and is characterized as notably above typical state volume, indicating the provider is a comparatively strong participant in prevocational habilitation even though that code contributes a small share of total revenue.

Claim counts and average paid per claim reveal differences in unit economics across the main lines: H2016 shows 127.4K claims at $582 avg paid/claim, T2021 shows 128.4K claims at $193 avg paid/claim, and T2015 shows 32.2K claims at $32 avg paid/claim. These reported counts and per‑claim amounts reflect a mix of high‑value per‑diem community supports (H2016) alongside high‑volume time‑based habilitation services (T2021 and T2015), which is typical for day training and waiver service providers.

Smaller ancillary codes are immaterial to revenue but present: T2028 generated $370.5K (0.4% of Medicaid revenue) with 262 claims and ranks #3 of 5 providers in‑state (50th percentile), and H0004 generated $62.4K (0.1% of Medicaid revenue) with 1.6K claims and ranks #32 of 64 providers (51th percentile). These lines — specialized supplies and behavioral health counseling — appear to be adjunct services rather than core revenue drivers for the organization.

The provider has an established operating tenure: the NPI was enumerated on 2015-07-29 (~11 years ago), which with $100.4M in Medicaid receipts indicates an entrenched presence in New Jersey’s waiver and day‑habilitation market. Given the concentration in a few waivered service codes and the provider’s longevity, analysts should treat policy or rate changes to H2016, T2021, and T2015 as high‑impact risk or opportunity areas for this entity.

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2016	Comprehensive community support services, per diem	127,360	$580	$74.1M
T2021	Day habilitation, waiver; per 15 minutes	128,370	$190	$24.8M
T2015	Habilitation, prevocational, waiver; per hour	32,240	$30	$1M
T2028	Specialized supply, not otherwise specified, waiver	260	$1,410	$370.5K
H0004	Behavioral health counseling and therapy, per 15 minutes	1,640	$40	$62.4K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Jersey Distribution

New Horizons In Autism, Inc. — 1 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Jersey

Full comparison — all codes billed, vs. New Jersey median

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2016	Comprehensive community support services, per diem	56	210	23,310	$490	$41.9M
T2021	Day habilitation, waiver; per 15 minutes	24	220	14,500	$170	$7.7M
T2015	Habilitation, prevocational, waiver; per hour	4	70	2,810	$100	$671.2K
T2028	Specialized supply, not otherwise specified, waiver	3	10	260	$1,050	$448.3K
H0004	Behavioral health counseling and therapy, per 15 minutes	32	60	1,570	$70	$253.4K

Nearby Providers

Other providers in the same ZIP code as New Horizons In Autism, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Golden Age Care, LLC	NJ	Adult Day Care Clinic/Center	$0	$13.4M
Spencer Kroll	NJ	Internal Medicine Physician	$448.4K	$0
Bradley Bodner	NJ	Physical Medicine & Rehabilitation Physician	$202.7K	$0
Ippc Inc.	NJ	Long Term Care Pharmacy	$184.6K	$2.9K
Ludmila Ridlovsky	NJ	Internal Medicine Physician	$153.9K	$0
Gerald Vernon	NJ	Interventional Pain Medicine Physician	$93.7K	$0
Stacy Goldberg	NJ	Clinical Social Worker	$79.7K	$0
Maria Choy	NJ	Neurology Physician	$63.9K	$0

New Horizons In Autism, Inc. — Billing Profile & Reimbursement Data

Sign up for New Horizons In Autism, Inc. — Billing Profile & Reimbursement Data policy alerts

New Horizons In Autism, 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