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.

New Communities, Inc. (NPI 1255665899)

Field	Value
Entity Type	Organization
Organization	New Communities, Inc.
Address	7 Beal Street
City	Norway
State	ME
ZIP	04268
Taxonomy	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NPI Enumerated	September 30, 2009

Payer Source	Total Paid
Medicaid	$46.5M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-only billing entity: there is no Medicare revenue on file and the provider reports $46.5M in total Medicaid revenue, indicating reliance on Medicaid as the primary payer for all reported activity. The absence of Medicare billing suggests limited payer diversification and that analyses should focus on Medicaid program policy and waiver rates when assessing financial drivers.

Revenue is highly concentrated in a very small set of service codes: the precomputed top-3 Medicaid codes account for 100.0% of the provider's Medicaid revenue, with a single code, T2016, representing the vast majority (95.0%) and T2021 representing the remainder (5.0%). This concentration implies that changes to reimbursement or authorization for these specific waiver habilitation services would have outsized impact on overall revenue.

The provider’s taxonomy (Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility) combined with the code mix points to a primarily residential habilitation operation: T2016 (Habilitation, residential, waiver; per diem) is the dominant revenue stream, while T2021 (Day habilitation, waiver; per 15 minutes) constitutes a smaller, supportive day-services component. The pattern is consistent with an organization that operates residential waiver programs as its core service line and offers day habilitation as a secondary service.

T2016 activity shows large scale and resource intensity: the dataset lists 24.6K claims for T2016, an average paid per claim of $1797, and $44.2M in revenue (95.0% of the provider’s Medicaid revenue). The high per-diem average paid and claim volume are consistent with intensive, ongoing residential services rather than episodic outpatient care.

T2021 is a much smaller revenue contributor and reflects lower intensity, shorter-interval services: 5.6K claims, $410 avg paid/claim, and $2.3M revenue (5.0% of Medicaid revenue). The presence of T2021 indicates the provider also bills for day habilitation units, but this remains a minority activity relative to residential habilitation.

Statistically, both code volumes are described as typical rather than extreme outliers: T2016 is labeled “typical, unremarkable volume for this code” despite ranking #13 of 75 in-state (84th percentile), which suggests the provider is an upper-tier but not an extreme outlier for T2016 activity; T2021 is also described as “typical, unremarkable volume for this code,” and it ranks #51 of 72 (30th percentile), indicating below-median participation in day habilitation statewide.

Competitive standing is mixed: for the primary code T2016 the provider ranks #13 of 75 (84th percentile), signaling a relatively strong statewide presence in residential habilitation, while for T2021 the provider ranks #51 of 72 (30th percentile), indicating modest participation in day habilitation compared with peers. Overall, the provider is a notable state-level participant in residential waiver services but not a dominant outlier across all habilitation service types.

The provider has an established tenure: its NPI was enumerated on 2009-09-30 (~17 years ago), which supports interpreting these patterns as the activity of a longstanding, stable operator. Given the combination of long tenure and extreme Medicaid concentration, the provider’s financial profile is sensitive to state waiver policy and per-diem reimbursement changes more than to short-term market entry or exit dynamics.

Medicaid: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	24,620	$1,800	$44.2M
T2021	Day habilitation, waiver; per 15 minutes	5,630	$410	$2.3M

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

New Communities, Inc. — 0 of 2 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

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	13	80	7,300	$1,670	$30.8M
T2021	Day habilitation, waiver; per 15 minutes	51	70	13,340	$200	$5.1M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Progress Center, Inc.	ME	Developmentally Disabled Services Day Training Agency	$0	$30.6M
Bridge To Success	ME	Case Management Agency	$0	$10.6M
O.t. To Play	ME	Occupational Therapist	$0	$10.5M
Mainehealth	ME	Rural Health Clinic/Center	$0	$10M
Mainehealth	ME	Rural Health Clinic/Center	$0	$9.8M
Mainehealth	ME	Critical Access Hospital	$0	$5M
Common Ground Counseling, LLC	ME	Counselor	$0	$3M
A Life's Compass PLLC	ME	Mental Health Counselor	$0	$2.9M
Martin Whitaker	ME	Ophthalmology Physician	$1.5M	$0
Aardvark Pediatrics LLC	ME	Pediatrics Physician	$0	$1.2M

New Communities, Inc. — Billing Profile & Reimbursement Data

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New Communities, 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