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

Why is the Medicaid comparison limited to Virginia 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. Virginia (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 Systems, Inc. (NPI 1225048457)

Field	Value
Entity Type	Organization
Organization	Community Systems, Inc.
Address	8136 Old Keene Mill Rd
City	Springfield
State	VA
ZIP	22152
Taxonomy	Intellectual and/or Developmental Disabilities Residential Treatment Facility
NPI Enumerated	August 9, 2006

Payer Source	Total Paid
Medicaid	$75.1M
Medicare	$0

Key Findings

This entity reports no Medicare billing on file and $75.1M in lifetime Medicaid revenue, so its commercial/public payer footprint is effectively single-payer Medicaid rather than a mixed Medicare/Medicaid operation. Analysts should treat Medicaid reimbursement policy and state waiver rules as the primary drivers of this provider's revenue performance.

Revenue is heavily concentrated in a very small set of services: the precomputed top three Medicaid codes account for 99.6% of the provider's total Medicaid revenue, with H2022 alone generating $68.2M (90.8% of Medicaid revenue). This concentration means the provider's financial profile is dominated by billing for a single per-diem community service.

The code mix is consistent with an Intellectual and/or Developmental Disabilities residential treatment operation that centers on community-based wrap-around services and habilitation. Specifically, large per-diem billing under H2022 (7.2K claims, $9407 avg paid/claim) combined with day habilitation T2021 (2.3K claims, $1617 avg paid/claim) and habilitation educational T2013 (626 claims, $4589 avg paid/claim) indicates a service model built on residential/community supports plus day and educational habilitation programs.

H2022 is the firm's dominant product line but is not an outlier winner statewide: it ranks #43 of 136 providers in-state (69th percentile) and is labeled a typical, unremarkable volume for this code. That positioning suggests the provider is a solid mid-to-upper-tier Medicaid vendor for wrap-around services rather than a statewide leader.

T2021 (day habilitation) is a meaningful secondary revenue stream at $3.7M (4.9% of Medicaid revenue) and ranks #45 of 108 providers in-state (59th percentile), a typical level of volume; this places the provider as a modest, middle-ranked participant in day habilitation provisioning.

T2013 (habilitation, educational) contributes $2.9M (3.8% of Medicaid revenue) but is billed by relatively few peers; the provider ranks #5 of 8 in-state (43th percentile) and is described as typical. The small peer group for T2013 suggests this is a narrower service line within the state’s habilitation market, where this provider participates but does not dominate.

Use of miscellaneous therapeutic procedures (97139) is minimal: 223 claims, $1445 avg paid/claim for $322.2K (0.4% of Medicaid revenue), and a rank of #65 of 77 providers in-state (16th percentile), again categorized as typical. This low-volume code appears to be a peripheral adjunct to the primary wrap-around and habilitation services rather than a core revenue driver.

Tenure data show the NPI was enumerated on 2006-08-09 (~20 years ago), indicating the organization has a long-established presence in the state Medicaid market; combined with the revenue concentration, that longevity likely reflects an embedded operational model tied to Medicaid waiver/service structures and existing payer relationships.

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
H2022	Community-based wrap-around services, per diem	7,250	$9,410	$68.2M
T2021	Day habilitation, waiver; per 15 minutes	2,280	$1,620	$3.7M
T2013	Habilitation, educational, waiver; per hour	630	$4,590	$2.9M
97139	Use 97139 to report therapeutic procedures that do not have a specific code.	220	$1,450	$322.2K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Virginia Distribution

Community Systems, Inc. — 0 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2022	Community-based wrap-around services, per diem	43	140	4,450	$1,150	$15.3M
T2021	Day habilitation, waiver; per 15 minutes	45	110	1,500	$340	$1.3M
T2013	Habilitation, educational, waiver; per hour	5	10	640	$1,010	$1.3M
97139	Use 97139 to report therapeutic procedures that do not have a specific code.	65	80	750	$300	$802.7K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Aaa Home Health Inc	VA	Home Health Agency	$0	$12.8M
Inova Health Care Services	VA	Physical Therapist	$0	$8.9M
Haresh Ailani	VA	Ophthalmology Physician	$733K	$0
Phuong Mai	VA	Physical Medicine & Rehabilitation Physician	$296.3K	$0
Oral Alpan	VA	Allergy & Immunology Physician	$279.3K	$0
Sumeet Gupta	VA	Ophthalmology Physician	$245.7K	$0
Robert Deangelis	VA	Dermatology Physician	$183.8K	$0
Joshua Oppenheim	VA	Otolaryngology Physician	$100.6K	$0
Christele Behalal-bock	VA	Rheumatology Physician	$82.2K	$0
Richard Gardner	VA	Otolaryngology Physician	$63.4K	$0

Community Systems, Inc. — Billing Profile & Reimbursement Data

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Community Systems, 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