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

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

Commonwealth Of Massachusetts (NPI 1205965258)

Field	Value
Entity Type	Organization
Organization	Commonwealth Of Massachusetts
Address	55 Technology Dr
City	Lowell
State	MA
ZIP	01851
Taxonomy	Case Management Agency
NPI Enumerated	March 5, 2007

Payer Source	Total Paid
Medicaid	$306.3M
Medicare	$0

Key Findings

This provider is effectively single-payer in the Medicare/Medicaid mix: there is no Medicare billing on file and all recorded lifetime revenue is Medicaid-based, totaling $306.3M. That concentration means Medicaid policy, waiver rules, and state-level reimbursement decisions will drive its financial performance.

Revenue is extremely concentrated in a single service line: the top 3 Medicaid codes by revenue account for 94.1% of this provider's total Medicaid revenue. The dominant code is T2016 (Habilitation, residential, waiver; per diem), which alone accounts for $250.5M (81.8% of total Medicaid revenue) with 29.2K claims and an $8573 avg paid/claim, indicating the organization’s operations are heavily weighted toward residential habilitation under waiver programs.

Although T2016 generates the bulk of revenue, the provider’s statewide position on that code is not dominant: T2016 ranks #15 of 25 providers in-state (42th percentile; typical, unremarkable volume for this code). In other words, this entity earns a large share of its own Medicaid revenue from residential habilitation but is only a mid-ranked performer among peers on volume for that code within Massachusetts.

The provider shows clear strength in adult day services: S5100 (Day care services, adult; per 15 minutes) is the second-largest Medicaid revenue driver with $25.1M (8.2% of total), 87.2K claims and a $288 avg paid/claim. S5100 ranks #7 of 189 in-state (97th percentile; notably above typical state volume), signaling a competitive advantage or scale in adult day care relative to most Massachusetts providers.

Targeted case management is a meaningful tertiary revenue stream: T2023 (Targeted case management; per month) produced $12.7M (4.2% of total) on 37.6K claims with a $339 avg paid/claim and ranks #10 of 70 in-state (87th percentile; typical, unremarkable volume). This pattern indicates the organization pairs high-revenue residential waiver services with ongoing case management capacity, consistent with integrated care/support models for disabled populations.

Beyond the top three, the provider bills a range of habilitation and community support services that together show a diversified service mix beneath the dominant residential-per-diem line: T2021 $5.5M (1.8%), H2015 $4.3M (1.4%), H2023 $3.3M (1.1%), T2019 $3.1M (1.0%), and T2003 $1.8M (0.6%). These codes reflect day habilitation, comprehensive community support, supported employment, habilitation supported employment, and non-emergency transportation, suggesting the organization operates a portfolio of community-based supports around its residential program.

The provider’s billing tenure is long-standing: the NPI was enumerated on 2007-03-05 (~19 years ago), indicating an established presence in the state Medicaid ecosystem that likely supports its large residential-waiver footprint and service network. Longevity combined with high S5100 ranking suggests organizational scale in some service lines even if its T2016 rank is only mid-range.

The revenue concentration in a few codes creates operational sensitivity: with T2016, S5100, and T2023 accounting for 94.1% of Medicaid revenue, changes in waiver per-diem rates, authorization policies for adult day services, or state-level case management rules could materially affect total revenue. Analysts should treat reimbursement and policy changes for residential habilitation and adult day care as primary drivers of future financial variability for this provider.

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	29,220	$8,570	$250.5M
S5100	Day care services, adult; per 15 minutes	87,200	$290	$25.1M
T2023	Targeted case management; per month	37,590	$340	$12.7M
T2021	Day habilitation, waiver; per 15 minutes	22,370	$250	$5.5M
H2015	Comprehensive community support services, per 15 minutes	22,030	$190	$4.3M
H2023	Supported employment, per 15 minutes	30,410	$110	$3.3M
T2019	Habilitation, supported employment, waiver; per 15 minutes	24,850	$130	$3.1M
T2003	Non-emergency transportation; encounter/trip	72,500	$30	$1.8M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

Commonwealth Of Massachusetts — 1 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	15	30	29,930	$10,070	$358.9M
T2023	Targeted case management; per month	10	70	8,210	$510	$8.6M
H2023	Supported employment, per 15 minutes	10	20	28,450	$190	$5.6M
H2015	Comprehensive community support services, per 15 minutes	54	150	7,770	$140	$4.8M
T2021	Day habilitation, waiver; per 15 minutes	11	20	20,590	$210	$4.5M
S5100	Day care services, adult; per 15 minutes	7	190	2,000	$230	$3.1M
T2019	Habilitation, supported employment, waiver; per 15 minutes	12	20	24,690	$120	$3.1M
T2003	Non-emergency transportation; encounter/trip	94	250	40,490	$30	$2.2M

Nearby Providers

Other providers in the same ZIP code as Commonwealth Of Massachusetts, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Better Life At Home LLC.	MA	Home Health Agency	$0	$31.6M
Essy Nursing Services Inc	MA	Home Health Agency	$0	$23M
Pridestar Ems Inc	MA	Land Ambulance	$4.6M	$18.1M
Trinity Ems, Inc.	MA	Land Ambulance	$0	$13.6M
Dental Dreams, LLC	MA	General Practice Dentistry	$0	$11.3M
Active Ma, Inc.	MA	Adult Day Care Clinic/Center	$0	$9.5M
Elm Tree Clinic, LLC	MA	Internal Medicine Physician	$0	$8.3M
Northeast Endoscopy Center, LLC	MA	Endoscopy Clinic/Center	$922.4K	$209.6K
Cvs Pharmacy Inc	MA	Pharmacy	$283.2K	$0
Paul Burke	MA	Vascular Surgery Physician	$218.6K	$0

Commonwealth Of Massachusetts — Billing Profile & Reimbursement Data

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Commonwealth Of Massachusetts — 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