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.

Care & Comfort (NPI 1265433486)

Field	Value
Entity Type	Organization
Organization	Care & Comfort
Address	180 Main St
City	Waterville
State	ME
ZIP	04901
Taxonomy	Mental Health Counselor
NPI Enumerated	August 10, 2005

Payer Source	Total Paid
Medicaid	$24.8M
Medicare	$0

Key Findings

CARE & COMFORT is effectively a single-payer Medicaid provider: Medicare revenue is listed as none (no Medicare billing on file), while total Medicaid revenue is $24.8M. This concentration means the organization’s financial footprint and payer risk are tied almost entirely to Medicaid policy, reimbursement changes, and managed care contracting in Maine.

Revenue is highly concentrated in a small set of service lines: the top three Medicaid codes by revenue (T1019, H2021, G0299) account for 79.4% of the provider’s total Medicaid revenue. That concentration suggests the organization focuses on a narrow set of high-volume Medicaid-funded supports rather than a broad array of lower-revenue services.

T1019 (Personal care services) is the single largest revenue driver with $11.8M in revenue (47.6% of Medicaid revenue) and 149K claims, and CARE & COMFORT ranks #5 of 110 providers in-state (96th percentile). The dataset labels this as an extreme outlier, indicating the provider is operating at volumes for T1019 far above typical state peers and is a major statewide participant for personal care services.

H2021 (Community-based wrap-around services) and G0299 (Direct skilled nursing services of an RN) are the next largest contributors with $4.4M (17.6%) and $3.5M (14.2%) respectively, and both rank in the upper state percentiles (H2021 around the 81st percentile, G0299 around the 86th percentile). These rankings portray CARE & COMFORT as a significant, though not singularly dominant, provider of community wrap-around and in-home skilled nursing compared with in-state peers.

Despite a taxonomy of Mental Health Counselor, the dominant billing mix (T1019, H2021, G0299) points to an operational model centered on Medicaid-funded personal care, community wrap-around supports, and skilled nursing/home-based services; behavioral health counseling (H0004) appears but represents a smaller share. H0004 generates $1.5M (6.1% of Medicaid revenue) and ranks #33 of 290 providers in-state (89th percentile), confirming they do deliver behavioral health therapy but it is not the primary revenue engine.

There are several notable service-line distinctions in the provider’s portfolio: T1017 (Targeted case management) and T2021 (Day habilitation) contribute meaningful but smaller shares ($1.7M and $1.1M respectively), while T1004 (Qualified nursing aide services) shows $348.7K and is listed as rank #1 of 1 providers in-state, indicating a unique billing footprint for that code in the available dataset. These patterns suggest a mix of direct care and care coordination services that supports both habilitation and home-based care models.

From a competitive-stance perspective, CARE & COMFORT is a regional leader for T1019 (extreme outlier) and a high-volume participant for several other Medicaid codes (H2021, G0299, H0004). This profile positions the provider as a major operational player in Maine’s Medicaid personal-care and home-support market, with limited or no presence in Medicare markets.

The provider has longstanding enrollment in the NPI registry (NPI enumerated 2005-08-10, ~21 years ago), indicating established operations over two decades; combined with the concentrated revenue mix, that tenure suggests sustained specialization in Medicaid community and home-based services rather than recent or transient activity.

Medicaid: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1019	Personal care services, per 15 minutes, 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…	149,000	$80	$11.8M
H2021	Community-based wrap-around services, per 15 minutes	28,510	$150	$4.4M
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	51,820	$70	$3.5M
T1017	Targeted case management, each 15 minutes	23,290	$70	$1.7M
H0004	Behavioral health counseling and therapy, per 15 minutes	17,210	$90	$1.5M
T2021	Day habilitation, waiver; per 15 minutes	6,310	$170	$1.1M
T2017	Habilitation, residential, waiver; 15 minutes	1,390	$330	$455.7K
T1004	Services of a qualified nursing aide, up to 15 minutes	1,820	$190	$348.7K
T1005	Respite care services, up to 15 minutes	210	$50	$10.9K

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

Care & Comfort — 1 of 9 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

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2021	Day habilitation, waiver; per 15 minutes	48	70	13,340	$200	$5.1M
H2021	Community-based wrap-around services, per 15 minutes	21	100	8,660	$290	$5.1M
T1019	Personal care services, per 15 minutes, 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…	5	110	8,200	$220	$4.7M
T2017	Habilitation, residential, waiver; 15 minutes	28	30	8,960	$260	$3M
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	8	50	8,360	$150	$2.9M
T1017	Targeted case management, each 15 minutes	20	100	4,690	$90	$1M
H0004	Behavioral health counseling and therapy, per 15 minutes	33	290	860	$80	$805.1K
T1005	Respite care services, up to 15 minutes	13	20	590	$90	$407.9K
T1004	Services of a qualified nursing aide, up to 15 minutes	1	10	1,820	$190	$348.1K

Nearby Providers

Other providers in the same ZIP code as Care & Comfort, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kennebec Valley Mental Health Center	ME	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$143M
Jmpb Inc.	ME	Community/Behavioral Health Agency	$0	$40.2M
Discovery House Of Central Maine, Inc.	ME	Methadone Clinic	$398.8K	$24.5M
Eastern Maine Healthcare Systems Inland Hospital	ME	General Acute Care Hospital	$0	$18.3M
Blue Sky Counseling P.C.	ME	Community/Behavioral Health Agency	$0	$11.6M
Maine General Community Care	ME	Case Management Agency	$0	$11.4M
Delta Ambulance Corp.	ME	Land Ambulance	$985.5K	$9.8M
Paramount Behavioral Services, Inc	ME	Community/Behavioral Health Agency	$0	$9.3M
Waters Edge Therapy, Inc	ME	Community/Behavioral Health Agency	$0	$5.2M
R&k LLC	ME	Community/Behavioral Health Agency	$0	$4.6M

Care & Comfort — Billing Profile & Reimbursement Data

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Care & Comfort — 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