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

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

Council For Extended Care (NPI 1285755579)

Field	Value
Entity Type	Organization
Organization	Council For Extended Care
Address	5257 Shaw Ave
City	Saint Louis
State	MO
ZIP	63110
Taxonomy	Intellectual and/or Developmental Disabilities Residential Treatment Facility
NPI Enumerated	April 3, 2007

Payer Source	Total Paid
Medicaid	$98.1M
Medicare	$0

Key Findings

This provider is effectively a single-payer Medicaid operation: there is no Medicare billing on file and lifetime Medicaid revenue totals $98.1M. The NPI was enumerated 2007-04-03 (~19 years ago), indicating an established presence in the market but a heavy dependence on Medicaid as the sole public-payer revenue source.

Revenue is extremely concentrated in a single service line: the top 3 Medicaid codes account for 96.9% of this provider’s total Medicaid revenue, with T2016 alone contributing $92.6M (94.4% of total Medicaid revenue). That concentration means overall revenue is dominated by per-diem residential habilitation payments rather than a diversified mix of fee-for-service lines.

T2016 (T2016 – Habilitation, residential, waiver; per diem) profile and volumes indicate the organization operates primarily as a residential habilitation facility: the file shows 213.4K claims at $434 avg paid/claim generating $92.6M revenue and the code is described as notably above typical state volume for this code. The per-diem nature of T2016 implies the provider’s topline is census-driven and tied to residential placements and waiver authorizations.

Behavioral and habilitation therapy services are present but represent a small fraction of revenue: 97155 generated $1.4M (1.4% of Medicaid revenue) across 7.9K claims at $177 avg paid/claim, and 97153 and 97156 together add smaller shares. The presence of 97155 (provider-delivered adaptive behavior treatment) and technician codes signals the provider runs ABA-style or adaptive behavior programs alongside residential habilitation rather than as its primary revenue driver.

Competitive standing is strong for residential habilitation in-state: the provider ranks #8 of 193 providers for T2016 (96th percentile), which positions it as a major residential habilitation participant in Missouri. By contrast, its day habilitation footprint is modest—T2021 generated $1M (1.1% of Medicaid revenue) and ranks #113 of 167 providers in-state (33th percentile), indicating a below-midrange position for day services.

Certain ancillary service lines appear as supportive revenue streams: T1002 (Rn services) produced $665K (0.7% of Medicaid revenue; ranks #15 of 195 providers in-state, 93th percentile) and T2001 (non-emergency transportation; patient attendant/escort) produced $646.2K (0.7% of Medicaid revenue; ranks #12 of 150 providers in-state, 93th percentile). These codes and others such as S5108 and T1019 show the provider bills for nursing, transport, home-care training, and personal care supports, but each contributes only a small share of total Medicaid revenue.

Operational and payer-policy implications stem from the per-diem concentration: because $92.6M (94.4% of Medicaid revenue) is tied to T2016 per-diem habilitation payments, changes in waiver rules, occupancy, or per-diem rates could materially affect revenue. Meanwhile, the existence of higher-percentile rankings for provider-delivered behavior treatment (97155 ranks #8 of 69, 90th percentile) suggests capability to deliver higher-touch clinical services even if those services are not the primary revenue source.

Medicaid: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	213,380	$430	$92.6M
97155	The provider, a physician or other qualified healthcare professional, administers adaptive behavior treatment face–to–face with one patient and makes modifications in the protocol targets and…	7,930	$180	$1.4M
T2021	Day habilitation, waiver; per 15 minutes	10,390	$100	$1M
T1002	Rn services, up to 15 minutes	11,270	$60	$665K
T2001	Non-emergency transportation; patient attendant/escort	5,010	$130	$646.2K
S5108	Home care training to home care client, per 15 minutes	6,040	$90	$561.8K
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	3,540	$140	$503.2K
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	5,410	$70	$351.9K
97156	The provider discusses a patient’s adaptive behavior treatment face–to–face with the guardian(s) or caregiver(s), with or without the patient present. Report this code for each 15 minutes that the…	2,200	$90	$197.7K
0369T	Duodenal mucosal resurfacing, endoscopic	650	$120	$75.7K

Showing 1–10 of 12

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Missouri Distribution

Council For Extended Care — 1 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. Missouri median

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	8	190	38,330	$450	$27M
T2021	Day habilitation, waiver; per 15 minutes	113	170	18,890	$180	$5.4M
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	702	1,330	6,550	$80	$4.6M
S5108	Home care training to home care client, per 15 minutes	20	40	6,430	$70	$794.4K
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	22	60	1,810	$160	$587.2K
A0120	Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems	98	120	730	$60	$585.2K
97155	The provider, a physician or other qualified healthcare professional, administers adaptive behavior treatment face–to–face with one patient and makes modifications in the protocol targets and…	8	70	2,030	$140	$460.6K
T2001	Non-emergency transportation; patient attendant/escort	12	150	1,300	$150	$296.4K
T1002	Rn services, up to 15 minutes	15	200	1,720	$50	$194.4K
97156	The provider discusses a patient’s adaptive behavior treatment face–to–face with the guardian(s) or caregiver(s), with or without the patient present. Report this code for each 15 minutes that the…	4	30	370	$80	$64.3K

Showing 1–10 of 12

Nearby Providers

Other providers in the same ZIP code as Council For Extended Care, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. Louis Children's Hospital	MO	Children's Hospital	$0	$66.9M
Barnes Jewish Hospital	MO	General Acute Care Hospital	$0	$61.4M
Paraquad Inc	MO	Customized Equipment (DME)	$0	$56.3M
Washington University	MO	Multi-Specialty Clinic/Center	$0	$22M
Cooperative Home Care, Inc.	MO	Home Health Agency	$0	$20.6M
Washington University	MO	Multi-Specialty Clinic/Center	$0	$14.8M
New Beginnings In Home Services, LLC	MO	In Home Supportive Care Agency	$0	$11.6M
Washington University	MO	Multi-Specialty Clinic/Center	$0	$10.4M
Washington University	MO	Emergency Care Clinic/Center	$0	$9.1M
Bjc Home Care Services	MO	Durable Medical Equipment & Medical Supplies	$0	$8.2M

Council For Extended Care — Billing Profile & Reimbursement Data

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Council For Extended Care — 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