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

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

Discovery Living, Inc. (NPI 1265578439)

Field	Value
Entity Type	Organization
Organization	Discovery Living, Inc.
Address	220 Northland Ct Ne
City	Cedar Rapids
State	IA
ZIP	52402
Taxonomy	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NPI Enumerated	January 29, 2007

Payer Source	Total Paid
Medicaid	$82M
Medicare	$0

Key Findings

DISCOVERY LIVING, INC. is effectively a single-payer Medicaid provider: it reports no Medicare billing on file and $82M in lifetime Medicaid revenue, indicating its operations are concentrated entirely in the Medicaid market rather than split across Medicare and Medicaid. Analysts should treat this entity as a Medicaid-centric operator when comparing payer mix or forecasting revenue sensitivity to state Medicaid policy changes.

The provider’s Medicaid revenue is extremely concentrated in a very small set of services: the precomputed top 3 Medicaid codes account for 99.9% of total Medicaid revenue, with S5136, H2016, and T2020 together driving nearly the entire $82M figure. This concentration implies that changes in reimbursement or utilization for those codes would disproportionately affect the provider’s financial performance.

S5136 is the dominant revenue driver: S5136 (Companion care, adult; per diem) generated $58M (70.7% of this provider's total Medicaid revenue) across 15.6K claims with an average paid/claim of $3726. The provider ranks #34 of 82 in-state (59th percentile) on S5136, described as a typical, unremarkable volume for this code, which signals it is a significant but not exceptionally large state participant on its primary revenue stream.

H2016 is the second major line: H2016 (Comprehensive community support services; per diem) produced $22.2M (27.0% of this provider's total Medicaid revenue) from 3.8K claims at $5871 avg paid/claim. The provider sits at #118 of 176 in-state (33th percentile) and that performance is labeled typical, unremarkable volume for this code, indicating a modest state-level footprint in community support services relative to peers.

The remaining Medicaid codes contribute only marginally: T2020 (Day habilitation, waiver; per diem) produced $1.8M (2.2% of total Medicaid revenue) with $260 avg paid/claim and ranks #62 of 101 in-state (39th percentile), while T2021 is effectively immaterial at $60.2K (0.1% of total) with $43 avg paid/claim and a #69 of 103 rank (33th percentile). Both T2020 and T2021 are described as typical, unremarkable volume for their codes, reinforcing that the provider’s operational focus is not on day habilitation.

The code mix aligns with the provider’s taxonomy: as an Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility, heavy revenue from S5136 (companion/adl/iadl care) and H2016 (community support) is consistent with a residential and community-support service model, rather than acute clinical care or physician services. This suggests operational emphasis on per-diem residential supports and comprehensive community services rather than diversified clinical lines.

Competitive standing is modest rather than dominant across measured Medicaid codes: ranking in the mid- to lower-percentile ranges for its top services (S5136 at the 59th percentile and H2016 at the 33th percentile) indicates the provider is a meaningful local participant but not a statewide leader for these service lines. Given the provider’s near-total reliance on a few Medicaid codes, its competitive posture should be evaluated by comparing utilization intensity and per-diem rates for S5136 and H2016 against nearby peers.

The provider has long tenure in the national enrollment system, with its NPI enumerated on 2007-01-29 (~19 years ago), which may reflect an established presence and operational history in the local Medicaid market. This duration, combined with concentrated Medicaid revenue, suggests institutional stability but also exposure to policy or rate changes affecting the small set of dominant codes.

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
S5136	Companion care, adult (e.g., iadl/adl); per diem	15,570	$3,730	$58M
H2016	Comprehensive community support services, per diem	3,770	$5,870	$22.2M
T2020	Day habilitation, waiver; per diem	6,940	$260	$1.8M
T2021	Day habilitation, waiver; per 15 minutes	1,400	$40	$60.2K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Iowa Distribution

Discovery Living, Inc. — 0 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Iowa

Full comparison — all codes billed, vs. Iowa median

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5136	Companion care, adult (e.g., iadl/adl); per diem	34	80	9,410	$490	$17.9M
H2016	Comprehensive community support services, per diem	118	180	10,790	$390	$15.2M
T2020	Day habilitation, waiver; per diem	62	100	10,960	$110	$3M
T2021	Day habilitation, waiver; per 15 minutes	69	100	2,780	$60	$386.9K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Prk Williams Inc.	IA	In Home Supportive Care Agency	$0	$57.4M
St Luke's Methodist Hospital	IA	General Acute Care Hospital	$0	$36.2M
Life Connection, L.c.	IA	Early Intervention Provider Agency	$0	$26.3M
Medical Laboratories Of Eastern Iowa Lc	IA	Clinical Medical Laboratory	$1.4M	$14.4M
East Central Iowa Acute Care, PLLC	IA	Emergency Medicine Physician	$0	$10.6M
Covenant Family Solutions, LLC	IA	Community/Behavioral Health Agency	$0	$8.5M
Radiology Consultants Of Iowa, Plc	IA	Diagnostic Radiology Physician	$0	$5.5M
Weland Clinical Laboratories, P.C.	IA	Clinical Medical Laboratory	$1.2M	$3.8M
St. Luke's Methodist Hospital	IA	Cardiovascular Disease Physician	$0	$3.9M
Comfort Care Medicare, Inc	IA	Home Health Agency	$0	$3.9M

Discovery Living, Inc. — Billing Profile & Reimbursement Data

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Discovery Living, 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