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.

Area Residential Care Inc. (NPI 1275674749)

Field	Value
Entity Type	Organization
Organization	Area Residential Care Inc.
Address	1170 Roosevelt St Ext
City	Dubuque
State	IA
ZIP	52001
Taxonomy	Intellectual Disabilities Intermediate Care Facility
NPI Enumerated	February 9, 2007

Payer Source	Total Paid
Medicaid	$32.8M
Medicare	$0

Key Findings

AREA RESIDENTIAL CARE INC. has no Medicare billing on file and reports $32.8M in lifetime Medicaid revenue, making it effectively a single-payer (Medicaid) operator in the Medicare/Medicaid mix. Analysts should treat Medicaid reimbursement policy and state waiver changes as the primary external drivers of this provider’s revenue profile.

Revenue is highly concentrated: the precomputed top 3 Medicaid codes by revenue account for 96.7% of the provider’s total Medicaid revenue. In particular, S5136 alone represents 76.4% of Medicaid revenue ($25.1M), with T2020 at 15.4% ($5.1M) and H2015 at 4.9% ($1.6M), indicating a narrow set of service lines account for nearly all receipts.

The code mix—S5136 (companion care, adult; per diem), T2020 (day habilitation, waiver; per diem), and H2015 (comprehensive community support services, per 15 minutes)—points to a business model built around residential/supportive services and day habilitation for individuals with intellectual disabilities. This mix aligns with the provider’s taxonomy (Intellectual Disabilities Intermediate Care Facility) and suggests operations are organized around per-diem staffing and day-program delivery.

Claim counts and average paid-per-claim reveal operational dynamics: S5136 shows 104.8K claims at $239 avg paid/claim, T2020 shows 54.9K claims at $92 avg paid/claim, and H2015 shows 3.8K claims at $424 avg paid/claim. The large claim volumes on per-diem codes (S5136, T2020) indicate a volume-driven, day/residential service footprint, while the relatively high avg paid/claim for H2015 suggests more intensive or higher-unit services billed in smaller volumes.

State competitive standing is mixed but not extreme: S5136 ranks #11 of 82 in-state (88th percentile) and T2020 ranks #14 of 101 (87th percentile), which places the provider in the upper range of statewide activity for those per-diem services; H2015 is more middle-of-market at #49 of 95 (49th percentile). Despite these rank positions, each code is explicitly labeled as having "typical, unremarkable volume," indicating the provider is a significant but not an anomalous statewide participant for its top services.

The provider’s heavy dependence on S5136 (76.4% of Medicaid revenue) and the top-three concentration of 96.7% create a material concentration risk: any changes in companion care utilization, state reimbursement rates, or waiver authorization for per-diem day habilitation could disproportionately impact overall revenue. Analysts should prioritize monitoring state policy and rate updates affecting S5136 and T2020.

AREA RESIDENTIAL CARE INC. has an established enrollment history, with its NPI enumerated on 2007-02-09 (~19 years ago), suggesting long-tenured operations and likely entrenched relationships with state Medicaid programs and referral sources. This tenure can support stable utilization patterns but does not mitigate the identified revenue concentration risk.

Medicaid: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5136	Companion care, adult (e.g., iadl/adl); per diem	104,850	$240	$25.1M
T2020	Day habilitation, waiver; per diem	54,950	$90	$5.1M
H2015	Comprehensive community support services, per 15 minutes	3,790	$420	$1.6M
H2025	Ongoing support to maintain employment, per 15 minutes	2,110	$410	$861.7K
S5102	Day care services, adult; per diem	1,340	$100	$138.8K
T2021	Day habilitation, waiver; per 15 minutes	3,540	$20	$70.8K

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

Area Residential Care Inc. — 0 of 6 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

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5136	Companion care, adult (e.g., iadl/adl); per diem	11	80	9,410	$490	$17.9M
T2020	Day habilitation, waiver; per diem	14	100	10,960	$110	$3M
H2025	Ongoing support to maintain employment, per 15 minutes	40	70	2,970	$300	$1.9M
H2015	Comprehensive community support services, per 15 minutes	49	100	4,130	$160	$1.9M
S5102	Day care services, adult; per diem	15	20	3,060	$90	$1.1M
T2021	Day habilitation, waiver; per 15 minutes	45	100	2,780	$60	$386.9K

Nearby Providers

Other providers in the same ZIP code as Area Residential Care Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hills And Dales Child Development Center	IA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$68.5M
Hillcrest Family Services	IA	Child & Adolescent Psychiatry Physician	$0	$32.5M
Crescent Community Health Center	IA	Federally Qualified Health Center (FQHC)	$0	$29.5M
Dubuque Community School District	IA	Local Education Agency (LEA)	$0	$26.6M
The Finley Hospital	IA	General Acute Care Hospital	$0	$14.1M
City Of Dubuque	IA	Land Ambulance	$690.9K	$8.9M
Hillcrest Family Services	IA	Social Worker	$0	$7.1M
Mercy Medical Center-dubuque	IA	General Acute Care Hospital	$0	$5.2M
Hills And Dales Child Development Center	IA	Intellectual Disabilities Intermediate Care Facility	$0	$4.7M
Dubuque Internal Medicine PC	IA	Internal Medicine Physician	$0	$3.9M

Area Residential Care Inc. — Billing Profile & Reimbursement Data

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Area Residential Care 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