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

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

Creative Options, LLC (NPI 1245699461)

Field	Value
Entity Type	Organization
Organization	Creative Options, LLC
Address	1660 Ohio St
City	Bangor
State	ME
ZIP	04401
Taxonomy	Intellectual and/or Developmental Disabilities Residential Treatment Facility
NPI Enumerated	February 16, 2016

Payer Source	Total Paid
Medicaid	$78.7M
Medicare	$0

Key Findings

This provider is effectively single-payer in scale: it reports no Medicare billing on file and $78.7M in lifetime Medicaid revenue, indicating its operations are concentrated almost entirely on Medicaid-funded services. Analysts should treat Medicaid reporting as the primary source of revenue and utilization signal for this entity.

Revenue is highly concentrated in a narrow set of service lines: the top three Medicaid codes — S5140, T2016, and T2017 — together account for 94.7% of this provider’s total Medicaid revenue. Those three codes alone are S5140 (44.7K claims, $1052 avg paid/claim, $47M revenue; 59.7% of Medicaid revenue), T2016 (8.9K claims, $2445 avg paid/claim, $21.7M revenue; 27.5% of Medicaid revenue), and T2017 (19.4K claims, $301 avg paid/claim, $5.8M revenue; 7.4% of Medicaid revenue).

The code mix and payment levels indicate a residential habilitation and foster-care–oriented operation: S5140 is a foster care, adult per diem code and dominates revenue, while T2016 and T2017 are residential habilitation waiver services billed as per diem and 15-minute units respectively. This suggests the provider’s business model centers on per-diem residential placements supplemented by time-based habilitation services rather than outpatient medical care.

Competitive standing for the largest revenue driver, S5140, is relatively strong in-state: the provider ranks #5 of 31 and sits in the 87th percentile for that code, which positions it among the larger foster-care per diem billers in Maine even though the record characterizes the volume as typical and unremarkable. The combination of high rank and a characterization of ‘typical’ suggests it is a sizable but not extraordinary participant for foster-care placements.

For residential habilitation per diem (T2016), the provider is mid-pack statewide: it ranks #34 of 75 and is at the 55th percentile, with 8.9K claims and $21.7M revenue. That placement indicates a modest footprint on the per-diem habilitation side relative to the full set of in-state providers, consistent with the supplied label of typical volume.

The provider shows stronger relative volume on the time-based habilitation code T2017, ranking #6 of 34 and the 85th percentile with 19.4K claims and $5.8M revenue, which signals a meaningful role delivering 15-minute habilitation units even as that code represents a smaller share of total revenue. By contrast, day habilitation code T2021 is a minor contributor ($4.2M, 13.3K claims, 5.3% of revenue) and ranks near the median at the 48th percentile, indicating limited exposure in day habilitation relative to peers.

The provider has an established operational tenure: its NPI was enumerated on 2016-02-16 (~10 years ago). Given nearly a decade of enrollment and $78.7M in Medicaid revenue, the entity appears to be a stable, long-running participant in Maine’s residential habilitation and foster-care Medicaid market.

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
S5140	Foster care, adult; per diem	44,710	$1,050	$47M
T2016	Habilitation, residential, waiver; per diem	8,870	$2,450	$21.7M
T2017	Habilitation, residential, waiver; 15 minutes	19,410	$300	$5.8M
T2021	Day habilitation, waiver; per 15 minutes	13,310	$310	$4.2M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Maine Distribution

Creative Options, LLC — 0 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maine

Full comparison — all codes billed, vs. Maine median

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	34	80	7,300	$1,670	$30.8M
S5140	Foster care, adult; per diem	5	30	9,310	$530	$13.6M
T2021	Day habilitation, waiver; per 15 minutes	38	70	13,340	$200	$5.1M
T2017	Habilitation, residential, waiver; 15 minutes	6	30	8,960	$260	$3M

Nearby Providers

Other providers in the same ZIP code as Creative Options, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eastern Maine Medical Center	ME	General Acute Care Hospital	$0	$159.3M
Mas Medical Staffing Corporation	ME	Community/Behavioral Health Agency	$0	$62.5M
Ohi	ME	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$61.9M
Ohi	ME	Mental Illness Community Based Residential Treatment Facility	$0	$39.6M
St. Joseph Hospital	ME	General Acute Care Hospital	$0	$38.8M
Mert Enterprises, Inc.	ME	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$36.3M
Penobscot Community Health Center	ME	Federally Qualified Health Center (FQHC)	$0	$27.3M
Amicus	ME	Developmentally Disabled Services Day Training Agency	$0	$26.1M
Branches, LLC	ME	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$25.4M
Lifeflight Of Maine, LLC	ME	Air Ambulance	$2.4M	$19.8M

Creative Options, LLC — Billing Profile & Reimbursement Data

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Creative Options, LLC — 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