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.

Arc Mercer, Inc (NPI 1235517723)

Field	Value
Entity Type	Organization
Organization	Arc Mercer, Inc
Address	180 Ewingville Rd
City	Ewing
State	NJ
ZIP	08638
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	May 15, 2015

Payer Source	Total Paid
Medicaid	$87.5M
Medicare	$0

Key Findings

ARC MERCER, INC reports no Medicare billing on file and $87.5M in lifetime Medicaid revenue, making it effectively a single-payer (Medicaid) operation in the available claims data rather than a dual-payer provider. This concentrated payer mix means analyses of its business and utilization should focus on Medicaid program rules and waiver services.

Revenue is extremely concentrated in a small set of Medicaid codes: the precomputed top 3 codes account for 99.9% of the provider's Medicaid revenue, led by H2016 at $79.3M (90.6% of Medicaid revenue). That single-code dominance indicates the provider’s financial performance is driven overwhelmingly by one service line.

The code mix (H2016 — Comprehensive community support services, per diem; T2021 — Day habilitation, waiver, per 15 minutes; and H0004 — Behavioral health counseling and therapy, per 15 minutes) reflects a business model centered on day habilitation and community support for individuals with developmental disabilities. High claim volumes for these codes (H2016: 185.4K claims; T2021: 34.4K claims) point to ongoing, recurrent service delivery rather than episodic acute care.

H2016 performance vs. in-state peers shows a strong statewide presence: H2016 ranks #24 of 206 providers in-state (89th percentile) and is described as "typical, unremarkable volume for this code," which suggests ARC MERCER bills H2016 at levels above most peers but within the common utilization band rather than as an extreme outlier. This supports the interpretation of a sizable but conventional role in delivering comprehensive community supports.

T2021 (Day habilitation) generates $7.8M (9.0% of Medicaid revenue) and ranks #78 of 218 providers in-state (65th percentile); it is likewise labeled "typical, unremarkable volume for this code." That mid‑tier ranking signals a modest market share in structured day habilitation relative to other in-state providers rather than market leadership.

H0004 (Behavioral health counseling and therapy) appears as a small ancillary revenue stream ($252.2K, 0.3% of Medicaid revenue) but ranks #9 of 64 providers in-state (87th percentile) and is characterized as "typical, unremarkable volume for this code." This combination indicates behavioral health services are provided at relatively high percentile rank among a smaller set of peers but contribute minimally to overall revenue.

A minority, lower-revenue code set includes H2021 ($106.8K, 0.1% of Medicaid revenue; rank #119 of 194, 39th percentile) and is described as "typical, unremarkable volume for this code," reinforcing that the provider’s billing pattern follows standard state program norms across multiple service lines rather than exhibiting unusual or anomalous claims distributions.

ARC MERCER's NPI was enumerated on 2015-05-15 (~11 years ago), indicating an established operational history in the state; combined with the heavy reliance on per-diem and per-15-minute waiver services, this tenure suggests entrenched participation in New Jersey Medicaid waiver and community support programs. Given the extreme revenue concentration (99.9% from the top three codes, with H2016 alone at 90.6%), analysts should treat policy or rate changes affecting H2016 as primary drivers of financial risk and competitive dynamics 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.

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2016	Comprehensive community support services, per diem	185,380	$430	$79.3M
T2021	Day habilitation, waiver; per 15 minutes	34,420	$230	$7.8M
H0004	Behavioral health counseling and therapy, per 15 minutes	7,420	$30	$252.2K
H2021	Community-based wrap-around services, per 15 minutes	1,750	$60	$106.8K

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

Arc Mercer, Inc — 0 of 4 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

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2016	Comprehensive community support services, per diem	24	210	23,310	$490	$41.9M
T2021	Day habilitation, waiver; per 15 minutes	78	220	14,500	$170	$7.7M
H2021	Community-based wrap-around services, per 15 minutes	119	190	3,010	$260	$3.1M
H0004	Behavioral health counseling and therapy, per 15 minutes	9	60	1,570	$70	$253.4K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Capital Health System Inc	NJ	General Acute Care Hospital	$0	$114.5M
Capital Health Medical Group	NJ	Internal Medicine Physician	$0	$19.3M
Senior Star Corp. Medical Day	NJ	Adult Day Care Clinic/Center	$0	$15.3M
Phoenix Behavioral Health LLC	NJ	In Home Supportive Care Agency	$0	$9.7M
Emergency Medical Associates Chs LLC	NJ	Emergency Medicine Physician	$0	$8.3M
Trenton Healthcare, LLC	NJ	Methadone Clinic	$39.9K	$7.5M
Hadia Ata	NJ	Anatomic Pathology & Clinical Pathology Physician	$1.8M	$0
Anusuya Jeyakumar	NJ	Geriatric Medicine (Internal Medicine) Physician	$276.2K	$6K
Biagio Manna	NJ	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	$236.8K	$0
Nilesh Rana	NJ	Internal Medicine Physician	$144.2K	$50

Arc Mercer, Inc — Billing Profile & Reimbursement Data

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Arc Mercer, 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