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

Why is the Medicaid comparison limited to New Jersey 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. New Jersey (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.

Rem New Jersey, Inc. (NPI 1265819106)

Field	Value
Entity Type	Organization
Organization	Rem New Jersey, Inc.
Address	100 Randolph Rd Ste 8
City	Somerset
State	NJ
ZIP	08873
Taxonomy	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NPI Enumerated	April 29, 2015

Payer Source	Total Paid
Medicaid	$218M
Medicare	$0

Key Findings

This provider is effectively a single-payer Medicaid operator: there is no Medicare billing on file and total Medicaid revenue is $218M, indicating that Medicaid is the primary and dominant revenue source for its services. The absence of Medicare activity simplifies payer exposure but concentrates financial risk and opportunity squarely within Medicaid program policies and rates.

Revenue is highly concentrated in a tight set of service lines: the precomputed top 3 Medicaid codes by revenue account for 100.0% of this provider's total Medicaid revenue, with H2016 representing 90.1%, T2021 9.9%, and H0004 0.0% of Medicaid revenue. This level of concentration indicates that performance or reimbursement changes for these specific codes would materially affect overall revenue.

Coding and payment mix point to a core operation delivering community-based supports and habilitation: H2016 (Comprehensive community support services, per diem) accounts for $196.4M revenue and 456.7K claims, while T2021 (Day habilitation, waiver; per 15 minutes) contributes $21.5M on 157.1K claims. The presence of high-volume per-diem and per-15-minute codes is consistent with an Intellectual and/or Developmental Disabilities community residential and day habilitation model rather than episodic medical care.

H2016 is a statewide high-volume performer for this code: the provider ranks #7 of 206 in-state and sits in the 97th percentile, and the dataset labels its activity as notably above typical state volume for H2016. With $430 avg paid/claim and $196.4M in revenue from 456.7K claims, H2016 is the dominant revenue driver and establishes the provider as a major supplier of comprehensive community support services in New Jersey.

T2021 also shows strong competitive standing within New Jersey: the provider ranks #14 of 218 and is at the 94th percentile for this code, described as notably above typical state volume. T2021 generated $21.5M from 157.1K claims at $137 avg paid/claim, marking the organization as a major day habilitation provider in the state complementing its H2016 volume.

H0004 is a very small component of the business and appears typical in-state: H0004 accounts for $66.3K on 1.4K claims at $48 avg paid/claim, represents 0.0% of the provider's Medicaid revenue, and ranks #34 of 64 (48th percentile), which the data characterizes as typical, unremarkable volume. This suggests counseling/therapy services are not a material revenue focus for the provider.

The operational footprint implied by claims volume is large and sustained: 456.7K H2016 claims and 157.1K T2021 claims indicate high recurring encounters consistent with a sizable residential/day habilitation census or intensive utilization patterns rather than low-frequency episodic treatments. Average paid/claim differences ($430 for H2016 vs $137 for T2021) also reflect the mix of per-diem community support versus per-15-minute habilitation billing models.

The provider has an established tenure in the Medicare/Medicaid ecosystem with NPI enumerated on 2015-04-29 (~11 years ago), and its high in-state rankings for H2016 and T2021 together suggest an entrenched role in New Jersey’s IDD community-based services market since that enrollment date. Continued prominence on these two codes would make it sensitive to state Medicaid policy or rate adjustments targeting community support and day habilitation services.

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2016	Comprehensive community support services, per diem	456,680	$430	$196.4M
T2021	Day habilitation, waiver; per 15 minutes	157,080	$140	$21.5M
H0004	Behavioral health counseling and therapy, per 15 minutes	1,380	$50	$66.3K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Jersey Distribution

Rem New Jersey, Inc. — 1 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Jersey

Full comparison — all codes billed, vs. New Jersey median

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2016	Comprehensive community support services, per diem	7	210	23,310	$490	$41.9M
T2021	Day habilitation, waiver; per 15 minutes	14	220	14,500	$170	$7.7M
H0004	Behavioral health counseling and therapy, per 15 minutes	34	60	1,570	$70	$253.4K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rwjbh Emergency Medicine Associates, LLC	NJ	Emergency Medicine Physician	$0	$117.8M
Everas Community Services, Inc.	NJ	Developmentally Disabled Services Day Training Agency	$0	$114.2M
Premier Supports, LLC	NJ	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$71.4M
Forever Young Medical Day Care	NJ	Adult Day Care Clinic/Center	$0	$35.8M
Audiology Services Company Usa, LLC	NJ	Hearing and Speech Clinic/Center	$0	$33.3M
Paradise Adult Day Healthcare LLC	NJ	Adult Day Care Clinic/Center	$0	$27M
National Mentor Healthcare, LLC	NJ	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$10.7M
Franklin Township Publc Schools	NJ	Local Education Agency (LEA)	$0	$9.3M
Jersey Behavioral Care LLC	NJ	Mental Health Counselor	$0	$8.7M
Rainbow Healthcare Inc.	NJ	Adult Day Care Clinic/Center	$0	$7.3M

Rem New Jersey, Inc. — Billing Profile & Reimbursement Data

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Rem New Jersey, 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