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

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

Pioneer Resources, Inc. (NPI 1245478056)

Field	Value
Entity Type	Organization
Organization	Pioneer Resources, Inc.
Address	1145 Wesley Ave
City	Muskegon
State	MI
ZIP	49442
Taxonomy	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NPI Enumerated	February 2, 2009

Payer Source	Total Paid
Medicaid	$29M
Medicare	$0

Medicaid: Complete Services Breakdown

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

35 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1020	Personal care services, per diem, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	28,880	$380	$10.9M
H2016	Comprehensive community support services, per diem	28,880	$260	$7.4M
H2015	Comprehensive community support services, per 15 minutes	60,790	$90	$5.6M
T2003	Non-emergency transportation; encounter/trip	22,370	$70	$1.5M
H2014	Skills training and development, per 15 minutes	14,010	$100	$1.3M
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	6,700	$140	$965.2K
S9976	Lodging, per diem, not otherwise classified	9,310	$30	$260.7K
0365T	Adaptive behavior tx addl	2,740	$80	$230K
97155	The provider, a physician or other qualified healthcare professional, administers adaptive behavior treatment face–to–face with one patient and makes modifications in the protocol targets and…	1,930	$110	$206K
H2025	Ongoing support to maintain employment, per 15 minutes	270	$470	$124K

Showing 1–10 of 35

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Michigan Distribution

Pioneer Resources, Inc. — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

35 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2016	Comprehensive community support services, per diem	77	300	6,660	$310	$8.7M
T1017	Targeted case management, each 15 minutes	152	180	10,890	$210	$8.1M
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	80	130	11,590	$190	$7.6M
H2015	Comprehensive community support services, per 15 minutes	134	610	14,740	$90	$6M
H0039	Assertive community treatment, face-to-face, per 15 minutes	67	70	20,710	$180	$5.1M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	85	90	8,750	$300	$4.7M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	67	70	3,240	$390	$4.7M
T1020	Personal care services, per diem, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	56	220	7,030	$170	$4.6M
H2014	Skills training and development, per 15 minutes	73	130	20,660	$50	$3.8M
T1016	Case management, each 15 minutes	106	120	8,060	$210	$3.4M

Showing 1–10 of 35

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
County Of Muskegon	MI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$151.1M
Lakeshore Home Health Care Services, Inc.	MI	Home Health Agency	$0	$18.1M
Lake Michigan Emergency Specialists, PLLC	MI	Emergency Medicine Physician	$0	$16.9M
Professional Med Team	MI	Land Ambulance	$1.4M	$12.4M
Cherry Street Services Inc	MI	Federally Qualified Health Center (FQHC)	$208.7K	$6M
Hackley Community Care Center Inc	MI	Federally Qualified Health Center (FQHC)	$0	$5.5M
Mercy Health Partners - Physician Specialist	MI	Internal Medicine Physician	$0	$5.3M
Jack Wang	MI	Radiation Oncology Physician	$2.2M	$0
Ronald Chusid	MI	Internal Medicine Physician	$50.7K	$41.1K
Benson Drug Company Inc.	MI	Community/Retail Pharmacy	$13.1K	$350

Pioneer Resources, Inc. — Billing Profile & Reimbursement Data

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Pioneer Resources, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References