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

Why is the Medicaid comparison limited to Montana 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. Montana (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 Option Resource Enterprises, Inc. (NPI 1194893115)

Field	Value
Entity Type	Organization
Organization	Community Option Resource Enterprises, Inc.
Address	2121 Lampman Dr
City	Billings
State	MT
ZIP	59102
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	November 30, 2006

Payer Source	Total Paid
Medicaid	$9.8M
Medicare	$0

Key Findings

COMMUNITY OPTION RESOURCE ENTERPRISES, INC. is registered as a Developmentally Disabled Services Day Training Agency and has an NPI enumerated 2006-11-30 (~20 years ago). Its lifetime billing profile is heavily skewed toward Medicaid with total Medicaid revenue of $9.8M and no Medicare revenue on file, indicating this organization operates effectively as a single-payer (Medicaid) provider in its service area.

The provider is effectively single-payer: there is no Medicare billing on file while Medicaid accounts for $9.8M in lifetime revenue. This concentration means analyses of business performance and competitive positioning should focus on Medicaid program changes, waiver policy, and state-level contracting rather than Medicare dynamics.

Revenue is highly concentrated in a very small set of services: the precomputed top 3 Medicaid codes account for 84.6% of the provider’s total Medicaid revenue, driven mainly by T2021 ($5.1M, 52.1%), T2032 ($2.2M, 22.1%), and S5135 ($1M, 10.4%). That concentration signals that a majority of dollars flow through day habilitation and residential/companion services, making those lines critical to the provider’s financial health.

The code mix indicates the organization’s operational footprint: heavy billing for T2021 (Day habilitation, waiver; per 15 minutes) and T2032 (Residential care, nos, waiver; per month) shows a core focus on waiver-funded day programming and residential supports, while S5135 (Companion care, adult; per 15 minutes) and H2025 (ongoing employment support) point to complementary in-home and employment-support services. Together these codes are consistent with a community-based DDD provider that centers on day habilitation and residential waiver services with supporting transportation and attendant offerings.

On competitive standing for high-revenue codes, the provider ranks above most in-state peers for its largest lines: T2021 ranks #4 of 45 providers (93th percentile) and T2032 ranks #2 of 20 providers (95th percentile), descriptions labeled “notably above typical state volume” reflect that this organization is a major statewide participant in both day habilitation and residential-waiver revenue. Those high ranks suggest the provider is a key regional competitor for waiver-funded day and residential services in Montana.

By contrast, participation in some adjacent services is modest or typical: S5135 ranks #4 of 6 providers (40th percentile) and is described as typical/unremarkable volume, while H2025 ranks #6 of 15 (64th percentile) and T2002 ranks #11 of 32 (68th percentile). This mix indicates strong dominance in core waiver lines but more ordinary market presence in companion care, employment supports, and non-emergency transportation.

Operational scale implied by claims volume reinforces the revenue picture: the top services show substantial utilization—T2021 has 7.3K claims ($700 avg paid/claim), T2032 has 2.8K claims ($784 avg paid/claim), and S5135 has 1.4K claims ($743 avg paid/claim)—which indicates significant recurring service delivery and staffing requirements to sustain current revenue levels. These claim counts suggest the provider has established processes and capacity for high-frequency, time-based service delivery common in day habilitation and companion-support models.

The concentration of 84.6% of Medicaid revenue in three codes creates strategic and policy sensitivity: any changes to waiver rules, reimbursement rates, or state contracting for T2021 or T2032 could materially impact provider revenue. Analysts should prioritize monitoring state waiver policy, per-unit reimbursement trends for T2021 and T2032, and provider placement in state procurement given the provider’s major share in those service lines.

Medicaid: Complete Services Breakdown

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2021	Day habilitation, waiver; per 15 minutes	7,300	$700	$5.1M
T2032	Residential care, not otherwise specified (nos), waiver; per month	2,770	$780	$2.2M
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	1,380	$740	$1M
H2025	Ongoing support to maintain employment, per 15 minutes	1,220	$460	$564.7K
T2002	Non-emergency transportation; per diem	1,760	$190	$334.6K
T2020	Day habilitation, waiver; per diem	400	$680	$273.1K
S0215	Non-emergency transportation; mileage, per mile	900	$160	$142.8K
T2003	Non-emergency transportation; encounter/trip	3,910	$30	$97.7K
S5125	Attendant care services; per 15 minutes	1,110	$70	$76.8K
T1999	Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks"	60	$290	$18.5K

Showing 1–10 of 11

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Montana Distribution

Community Option Resource Enterprises, Inc. — 1 of 11 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. Montana median

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2021	Day habilitation, waiver; per 15 minutes	4	50	1,630	$1,010	$2.6M
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	4	10	1,900	$450	$1.4M
T2032	Residential care, not otherwise specified (nos), waiver; per month	2	20	1,120	$830	$1M
H2025	Ongoing support to maintain employment, per 15 minutes	6	20	940	$590	$609.8K
S5125	Attendant care services; per 15 minutes	3	10	970	$90	$505.3K
T2020	Day habilitation, waiver; per diem	1	10	240	$670	$159.6K
T2002	Non-emergency transportation; per diem	11	30	1,440	$110	$141.5K
T2003	Non-emergency transportation; encounter/trip	7	40	2,180	$30	$78K
T2004	Non-emergency transport; commercial carrier, multi-pass	6	10	660	$80	$49.1K
S0215	Non-emergency transportation; mileage, per mile	12	20	1,250	$10	$41.3K

Showing 1–10 of 11

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Youth Dynamics, Inc.	MT	Mental Illness Community Based Residential Treatment Facility	$0	$65.4M
New Day, Inc.	MT	Mental Illness Community Based Residential Treatment Facility	$0	$27.7M
Youth Dynamics, Inc.	MT	Professional Counselor	$0	$24.6M
Resource, Support, & Development, Inc.	MT	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$21.3M
Brittany Curl	MT	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$17.5M
Rimrock Pediatric Dentistry	MT	Pediatric Dentistry	$0	$15.2M
Bridges Of Montana	MT	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$12.7M
The Childrens Clinic Of Billings, PC	MT	Pediatrics Physician	$0	$10.9M
Ryan K. Larsen Dmd & Associates	MT	Dental Anesthesiology	$0	$8.3M
Brewer Dental Center PLLC	MT	General Practice Dentistry	$0	$8.3M

Community Option Resource Enterprises, Inc. — Billing Profile & Reimbursement Data

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Community Option Resource Enterprises, 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