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.

New Concepts For Living (NPI 1275907826)

Field	Value
Entity Type	Organization
Organization	New Concepts For Living
Address	765 Route 17 South
City	Paramus
State	NJ
ZIP	07652
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	November 19, 2015

Payer Source	Total Paid
Medicaid	$123.8M
Medicare	$0

Key Findings

This provider is effectively single-payer in scale: there is no Medicare billing on file and lifetime Medicaid revenue totals $123.8M, indicating material dependence on Medicaid as the sole recorded public payer for its services. The absence of Medicare activity alongside substantial Medicaid receipts frames the provider as focused on state-covered developmental disability services rather than Medicare-eligible medical care.

Revenue is highly concentrated in a very small set of service lines: the precomputed top 3 Medicaid codes account for 100.0% of this provider's total Medicaid revenue, with H2016 alone representing $103.1M (83.3% of Medicaid revenue). That level of concentration makes overall financial performance closely tied to reimbursement and utilization for H2016.

H2016 (Comprehensive community support services, per diem) is the dominant operational code by volume and dollars: 164.4K claims at an average paid amount of $627 per claim generated $103.1M, and the provider ranks #33 of 206 in-state (84th percentile; typical, unremarkable volume for this code). This profile indicates large-scale delivery of per-diem community support programming as the organization’s core business line.

T2021 (Day habilitation, waiver; per 15 minutes) is the second major revenue source, generating $20.7M from 94.6K claims with an average paid amount of $219 per claim and ranking #35 of 218 in-state (84th percentile; typical, unremarkable volume for this code). The presence of high-volume, time-based habilitation billing alongside H2016 suggests the provider operates both day-program and time-segmented habilitation services for individuals with developmental disabilities.

H0004 (Behavioral health counseling and therapy, per 15 minutes) is negligible in the revenue mix, totaling $2.4K from 44 claims at $54 average paid per claim and ranking #61 of 64 in-state (5th percentile; typical, unremarkable volume for this code). This indicates behavioral therapy billing is not a meaningful part of the provider’s service mix relative to its community support and day habilitation offerings.

Competitive standing by code shows the provider is a significant in-state participant for its top two lines but not a market leader: H2016 and T2021 both fall at the 84th percentile statewide (ranks #33 and #35), which positions the organization above many peers but still within a broad cohort described as typical and not uniquely dominant. The low rank for H0004 confirms limited competitive presence in behavioral counseling within the state.

Operational implications from the code mix: reliance on a per-diem comprehensive support code (H2016) plus time-based habilitation (T2021) is consistent with the provider’s taxonomy as a Developmentally Disabled Services Day Training Agency, indicating programs centered on day services, habilitation, and community supports rather than clinical or Medicare-focused care. Given that the top 3 codes make up 100.0% of Medicaid revenue, programmatic or policy changes affecting these codes could disproportionately affect revenue.

The provider’s tenure is established but not long-standing: the NPI was enumerated on 2015-11-19 (~11 years ago), which suggests the current billing footprint and scale of $123.8M in Medicaid revenue were built over roughly an eleven-year operating window under that NPI record. This timeframe provides context for growth and competitive positioning assessments against longer-tenured peers.

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	164,430	$630	$103.1M
T2021	Day habilitation, waiver; per 15 minutes	94,560	$220	$20.7M
H0004	Behavioral health counseling and therapy, per 15 minutes	40	$50	$2.4K

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

New Concepts For Living — 0 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	33	210	23,310	$490	$41.9M
T2021	Day habilitation, waiver; per 15 minutes	35	220	14,500	$170	$7.7M
H0004	Behavioral health counseling and therapy, per 15 minutes	61	60	1,570	$70	$253.4K

Nearby Providers

Other providers in the same ZIP code as New Concepts For Living, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Aid And Family Services, Inc.	NJ	In Home Supportive Care Agency	$0	$91M
Care Plus Nj, Inc	NJ	Community/Behavioral Health Agency	$0	$38.1M
Bergen County Improvement Authority	NJ	General Acute Care Hospital	$0	$37.5M
Jewish Association For Developmental Disabilities	NJ	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$37.3M
The Valley Hospital Inc.	NJ	General Acute Care Hospital	$0	$31.5M
Bergen County Adult Day Care LLC	NJ	Adult Day Care Clinic/Center	$0	$28.7M
Help At Home Services	NJ	Home Health Agency	$0	$18.8M
Care Plus Nj, Inc	NJ	Community/Behavioral Health Agency	$0	$17.2M
Care Plus Nj, Inc.	NJ	Community/Behavioral Health Agency	$0	$17M
Bergen County Special Services School District	NJ	Local Education Agency (LEA)	$0	$15.4M

New Concepts For Living — Billing Profile & Reimbursement Data

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New Concepts For Living — 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