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

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

Commonwealth Of Massachusetts (NPI 1285758300)

Field	Value
Entity Type	Organization
Organization	Commonwealth Of Massachusetts
Address	1740 Purchase St
City	New Bedford
State	MA
ZIP	02740
Taxonomy	Case Management Agency
NPI Enumerated	March 16, 2007

Payer Source	Total Paid
Medicaid	$226M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-centric operator: total Medicaid revenue on file is $226M while there is no Medicare billing on file (none), indicating near-total exposure to Medicaid reimbursement and program-level policy changes rather than a balanced payer mix. That concentration means shifts in state Medicaid policy or rates would disproportionately affect the provider’s topline.

Revenue is highly concentrated in a very small set of services: the precomputed top three Medicaid codes by revenue (T2016, H2015, S5100) account for 89.7% of this provider’s Medicaid revenue. The single largest line, T2016, generates $178.6M (79.0% of Medicaid revenue) with 19.1K claims and an average paid/claim of $9334, making it the primary revenue engine for the organization.

Service-line mix and operational footprint align with residential habilitation and community supports: the dominant code T2016 (Habilitation, residential, waiver; per diem) together with H2015 (Comprehensive community support services, per 15 minutes) and S5100 (Day care services, adult; per 15 minutes) indicate the provider operates residential waiver habilitation, community-based support services, and adult day programs consistent with a Case Management Agency taxonomy. Additional codes present—such as T2023 (Targeted case management; per month) with $9.4M revenue and T2019 (Habilitation, supported employment, waiver; per 15 minutes) with $7.4M revenue—further reinforce a mix of day/residential habilitation plus case management and employment support.

Competitive standing is mixed across codes: for its largest revenue driver, T2016, the provider ranks #21 of 25 in-state (17th percentile) and is described as typical/unremarkable volume for that code, suggesting it is not a statewide leader in residential per-diem habilitation despite that code producing the bulk of its revenue. By contrast, S5100 (Day care services) ranks #22 of 189 (89th percentile), indicating relatively strong state presence in adult day services, and H2015 ranks #45 of 147 (70th percentile), reflecting a solid but not dominant position in comprehensive community support.

There are notable statistical outliers within the Medicaid portfolio: T2019 (Habilitation, supported employment, waiver; per 15 minutes) is reported as rank #1 of 24 providers in-state (100th percentile; notably above typical state volume), which signals a market-leading position in supported employment services even though that code represents a smaller share of total Medicaid revenue (3.3%, $7.4M). This suggests specialized strength in supported employment that is not the primary revenue driver but could represent a strategic niche.

Operational scale characteristics show a mix of high-dollar-per-claim and high-volume, low-unit-pay services: T2016 has a high average paid/claim ($9334) accounting for $178.6M in revenue, while T2003 (Non-emergency transportation; encounter/trip) records 188.7K claims at $26 avg paid/claim for $4.9M revenue (2.2%), indicating the provider also runs large-volume transportation and low-margin encounter programs alongside higher-paid residential services. That dual profile implies the organization manages both resource-intensive residential care and high-frequency ancillary services.

Tenure in the market is long-standing: the NPI was enumerated on 2007-03-16 (~19 years ago), indicating the provider has maintained an active Medicaid billing presence for nearly two decades, which supports operational experience and institutional relationships with state Medicaid programs. This longevity may help explain their ability to capture both large residential payments and specialized supported-employment volume.

From a risk and strategic perspective, concentration is a key vulnerability: T2016 alone represents 79.0% of Medicaid revenue and the top three codes account for 89.7% of Medicaid revenue overall, exposing the provider to material revenue volatility if reimbursement, utilization rules, or waiver structures change for those specific service lines. Analysts evaluating partnership, payment reform, or contracting should prioritize review of residential waiver and community support reimbursement drivers given this narrow revenue base.

Medicaid: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	19,130	$9,330	$178.6M
H2015	Comprehensive community support services, per 15 minutes	29,360	$450	$13.2M
S5100	Day care services, adult; per 15 minutes	53,960	$200	$10.8M
T2023	Targeted case management; per month	27,760	$340	$9.4M
T2019	Habilitation, supported employment, waiver; per 15 minutes	50,050	$150	$7.4M
T2003	Non-emergency transportation; encounter/trip	188,670	$30	$4.9M
T2021	Day habilitation, waiver; per 15 minutes	5,460	$250	$1.4M
S5125	Attendant care services; per 15 minutes	1,890	$80	$153.1K
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	430	$100	$45.1K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

Commonwealth Of Massachusetts — 1 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	21	30	29,930	$10,070	$358.9M
T2023	Targeted case management; per month	20	70	8,210	$510	$8.6M
H2015	Comprehensive community support services, per 15 minutes	45	150	7,770	$140	$4.8M
S5125	Attendant care services; per 15 minutes	25	40	3,390	$300	$4.7M
T2021	Day habilitation, waiver; per 15 minutes	23	20	20,590	$210	$4.5M
S5100	Day care services, adult; per 15 minutes	22	190	2,000	$230	$3.1M
T2019	Habilitation, supported employment, waiver; per 15 minutes	1	20	24,690	$120	$3.1M
T2003	Non-emergency transportation; encounter/trip	17	250	40,490	$30	$2.2M
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	63	70	2,890	$90	$1.4M

Nearby Providers

Other providers in the same ZIP code as Commonwealth Of Massachusetts, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southcoast Hospitals Group, Inc	MA	General Acute Care Hospital	$0	$172.9M
Child & Family Services, Inc.	MA	Mental Health Counselor	$0	$169.5M
High Point Treatment Center Inc.	MA	Counselor	$516K	$98.4M
Greater New Bedford Community Health Center, Inc.	MA	Community Health Clinic/Center	$0	$42.5M
Boston Neurobehavioral Associates, LLC	MA	Psychiatry Physician	$0	$17.1M
City Of New Bedford	MA	Land Ambulance	$1.7M	$11.7M
Shokoohi & Vakili LLC	MA	Pediatric Dentistry	$0	$12M
Anchor Medical Group And Wellness Center PC	MA	Addiction Medicine (Internal Medicine) Physician	$0	$10.6M
Commonwealth Of Massachusetts-dmh	MA	Case Management Agency	$0	$9.4M
Kennedy Donovan Center, Inc	MA	Developmentally Disabled Services Day Training Agency	$0	$7.6M

Commonwealth Of Massachusetts — Billing Profile & Reimbursement Data

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Commonwealth Of Massachusetts — 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