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 1245354000)

Field	Value
Entity Type	Organization
Organization	Commonwealth Of Massachusetts
Address	519 Station Avenue
City	South Yarmouth
State	MA
ZIP	02664
Taxonomy	Case Management Agency
NPI Enumerated	March 19, 2007

Payer Source	Total Paid
Medicaid	$881.9M
Medicare	$0

Key Findings

COMMONWEALTH OF MASSACHUSETTS reports no Medicare billing on file and is effectively a single-payer Medicaid operation, with total Medicaid revenue of $881.9M. Analysts should treat Medicaid as the primary and nearly exclusive payer when evaluating this entity's financial exposure and contracting footprint.

Revenue for this provider is highly concentrated: the precomputed top 3 Medicaid codes account for 94.9% of total Medicaid revenue, and a single code, T2016, represents $801.1M or 90.8% of the provider's Medicaid revenue. That level of concentration indicates the business is overwhelmingly dependent on one service line for topline Medicaid receipts.

The dominant code T2016 (Habilitation, residential, waiver; per diem) drives the operation’s core business model: 62.9K claims with an average paid/claim of $12742 and $801.1M revenue. The per-diem, residential habilitation nature of T2016 suggests substantial investment in staffed residential settings or waiver-funded long-stay placements rather than brief episodic care.

T2003 (Non-emergency transportation; encounter/trip) is a major operational outlier in volume: 489.2K claims and $13.2M revenue with a $27 avg paid/claim, and it ranks #4 of 245 providers in-state at the 99th percentile (labeled an "extreme outlier"). The very high trip count relative to payment per trip implies the organization operates or coordinates large-scale transportation services in support of its members or network.

Beyond the top per-diem habilitation code, the provider offers a portfolio of community support and case management services: H2015 (62K claims, $22.8M revenue, $367 avg paid/claim) ranks #18 of 147 (88th percentile) and T2023 (34.7K claims, $11.8M revenue, $339 avg paid/claim) ranks #12 of 70 (84th percentile). These lines generate meaningful but much smaller revenue than T2016 and indicate bundled community habilitation, comprehensive community support, and monthly targeted case management capabilities.

Competitive standing is mixed by service line: for the core residential habilitation code T2016 the provider ranks #4 of 25 in-state (88th percentile), marking it as a sizable but not singularly dominant residential habilitation provider; in contrast, its T2003 transportation activity is unusually large by state standards (99th percentile, extreme outlier), positioning it as a top-tier player in non-emergency transportation. Analysts should evaluate market power separately by code.

The provider has a long tenure in the NPI registry (enumerated 2007-03-19, ~19 years ago), which supports interpreting current billing patterns as established lines of business rather than short-term program experiments. Longevity increases the likelihood that the current code mix reflects deliberate, stable service offerings and operational scale.

Given the extreme revenue concentration in one per-diem residential habilitation code and the massive transportation claim volume, the provider’s financial and operational risk profile is concentrated: reimbursement or policy changes affecting T2016 or changes to transportation authorization/claims rules for T2003 would likely have outsized effects on reported Medicaid revenue. Stakeholders should prioritize monitoring waiver policy and transportation utilization controls when assessing future revenue stability.

Medicaid: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	62,870	$12,740	$801.1M
H2015	Comprehensive community support services, per 15 minutes	62,020	$370	$22.8M
T2003	Non-emergency transportation; encounter/trip	489,250	$30	$13.2M
T2023	Targeted case management; per month	34,660	$340	$11.8M
H2023	Supported employment, per 15 minutes	20,190	$370	$7.5M
S5100	Day care services, adult; per 15 minutes	32,580	$230	$7.4M
S5125	Attendant care services; per 15 minutes	17,300	$320	$5.6M
T2021	Day habilitation, waiver; per 15 minutes	23,420	$170	$4.1M
T2019	Habilitation, supported employment, waiver; per 15 minutes	29,860	$130	$3.8M
T2033	Residential care, not otherwise specified (nos), waiver; per diem	320	$6,680	$2.1M

Showing 1–10 of 15

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 15 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

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	4	30	29,930	$10,070	$358.9M
T2025	Waiver services; not otherwise specified (nos)	9	10	230	$160	$86.5M
T2023	Targeted case management; per month	12	70	8,210	$510	$8.6M
H2023	Supported employment, per 15 minutes	17	20	28,450	$190	$5.6M
H2015	Comprehensive community support services, per 15 minutes	18	150	7,770	$140	$4.8M
S5125	Attendant care services; per 15 minutes	9	40	3,390	$300	$4.7M
T2021	Day habilitation, waiver; per 15 minutes	9	20	20,590	$210	$4.5M
T2033	Residential care, not otherwise specified (nos), waiver; per diem	2	10	320	$6,480	$3.3M
S5100	Day care services, adult; per 15 minutes	24	190	2,000	$230	$3.1M
T2019	Habilitation, supported employment, waiver; per 15 minutes	11	20	24,690	$120	$3.1M

Showing 1–10 of 15

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
Community Connections, Inc.	MA	Developmentally Disabled Services Day Training Agency	$0	$65.9M
Kennedy Donovan Center, Inc	MA	Adult Care Home Facility	$0	$15.7M
Transitions Centers Inc.	MA	Developmentally Disabled Services Day Training Agency	$0	$6.5M
Town Of Yarmouth	MA	Land Ambulance	$959.6K	$1.4M
Gerald Tanguilig	MA	Ophthalmology Physician	$492.9K	$0
Cvs Pharmacy Inc	MA	Pharmacy	$407.4K	$0
Jorge Alfonso	MA	Internal Medicine Physician	$297.5K	$0
Ann Gryboski	MA	Internal Medicine Physician	$238.5K	$0
Arthur Kalil	MA	Podiatrist	$210K	$24.2K
Danielle Leighton	MA	Nurse Practitioner	$152.7K	$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