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.

Elwyn New Jersey (NPI 1265848675)

Field	Value
Entity Type	Organization
Organization	Elwyn New Jersey
Address	228 W Landis Ave Bldg C
City	Vineland
State	NJ
ZIP	08360
Taxonomy	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NPI Enumerated	July 7, 2014

Payer Source	Total Paid
Medicaid	$206.7M
Medicare	$0

Key Findings

This provider reports no Medicare billing on file and a concentrated Medicaid footprint totaling $206.7M in lifetime Medicaid revenue, making its operations effectively single‑payer at the Medicaid level. The absence of Medicare activity means analyses of payer mix should treat ELWYN NEW JERSEY as Medicaid‑dependent rather than balanced between federal payers.

Revenue is extremely concentrated by code: the dataset shows the top three Medicaid codes account for 100.0% of this provider’s Medicaid revenue, with two codes explicitly listed. H2016 alone represents $182.3M (88.2% of Medicaid revenue) while T2021 contributes $24.4M (11.8% of Medicaid revenue), indicating nearly all billed value is generated from a very small set of service lines.

The code mix and taxonomy align with a community‑based residential treatment model: H2016 (Comprehensive community support services, per diem) and T2021 (Day habilitation, waiver; per 15 minutes) point to operations focused on per‑diem residential supports and time‑based habilitation/day programs for individuals with intellectual and developmental disabilities, consistent with the provider’s taxonomy. This suggests the organization’s delivery model emphasizes ongoing daily supports and structured day programming rather than episodic medical services.

Operational scale is high in utilization terms: H2016 shows 254.9K claims with an average paid/claim of $715, and T2021 shows 183.6K claims with an average paid/claim of $133. These volumes and payment levels reflect a mix of higher‑value per‑diem reimbursement for comprehensive supports and high‑frequency, lower‑unit payments for time‑based habilitation services.

Competitive standing for H2016 is mixed: the provider ranks #14 of 206 in‑state and sits in the 94th percentile but the dataset labels that volume as "typical, unremarkable volume." In practical terms, ELWYN NEW JERSEY is among the higher‑volume billers for comprehensive community support services in New Jersey, even if the statewide distribution of billing makes such volumes not unusually extreme.

For T2021 the provider ranks #12 of 218 in‑state and is in the 95th percentile, a position described as "notably above typical state volume." This indicates ELWYN NEW JERSEY is a clearly above‑average participant in the day habilitation market within New Jersey and likely captures meaningful share of waiver‑based habilitation billing.

The NPI was enumerated on 2014-07-07 (~12 years ago), indicating the organization has an established presence and multi‑year billing history in Medicaid. That tenure supports the observed high cumulative Medicaid revenue and the development of sustained programmatic capacity for community support and day habilitation services.

High revenue concentration in a tiny set of codes creates sensitivity to rate, policy, or utilization changes for H2016 and T2021; because the top three codes account for 100.0% of Medicaid revenue, any reimbursement or eligibility changes affecting these codes would materially affect overall revenue. For analysts, this concentration highlights the importance of monitoring state waiver rules, per‑diem rate updates, and utilization management policies tied to these specific service lines.

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
H2016	Comprehensive community support services, per diem	254,930	$720	$182.3M
T2021	Day habilitation, waiver; per 15 minutes	183,590	$130	$24.4M

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

Elwyn New Jersey — 0 of 2 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

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2016	Comprehensive community support services, per diem	14	210	23,310	$490	$41.9M
T2021	Day habilitation, waiver; per 15 minutes	12	220	14,500	$170	$7.7M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Inspira Medical Centers, Inc.	NJ	General Acute Care Hospital	$0	$227M
Arthritis & Rheumatology Associates Of South Jersey PC	NJ	Rheumatology Physician	$0	$53.4M
Winter Enterprises	NJ	Oral and Maxillofacial Surgery (Dentist)	$0	$17M
Comminity Programs Inc.	NJ	Adult Day Care Clinic/Center	$0	$13.7M
City Of Vineland Board Of Education	NJ	Local Education Agency (LEA)	$0	$12.8M
Pinnacle Treatment Centers Nj Iii LLC	NJ	Methadone Clinic	$264.3K	$10.9M
Excelcare Alliance, LLC	NJ	Family Medicine Physician	$0	$11M
Confident Care Corp	NJ	Home Health Agency	$0	$8.2M
Stephen Soloway	NJ	Rheumatology Physician	$2.7M	$0
City Of Vineland	NJ	Ambulance	$798.1K	$1.6M

Elwyn New Jersey — Billing Profile & Reimbursement Data

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Elwyn New Jersey — 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