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.

The Easter Seal Society Of Iowa, Inc. (NPI 1295739951)

Field	Value
Entity Type	Organization
Organization	The Easter Seal Society Of Iowa, Inc.
Address	401 Ne 66th Ave
City	Des Moines
State	IA
ZIP	50313
Taxonomy	Voluntary or Charitable Agency
NPI Enumerated	June 10, 2005

Payer Source	Total Paid
Medicaid	$26.1M
Medicare	$0

Key Findings

This provider is effectively single-payer at the federal/state split: there is no Medicare billing on file while lifetime Medicaid revenue totals $26.1M, indicating the organization’s operations and reimbursement footprint are concentrated entirely in the Medicaid program rather than Medicare.

Revenue concentration is high: the precomputed top three Medicaid codes (H2016, T2020, H2015) together account for 78.9% of the provider’s total Medicaid revenue, showing that a small set of community- and habilitation-focused services drive the bulk of payments.

Service-line profile and operations are clearly focused on community support and day habilitation: H2016 (Comprehensive community support services, per diem) produces $8.7M (33.3% of Medicaid revenue), T2020 (Day habilitation, waiver; per diem) produces $7.7M (29.4%), and H2015 (Comprehensive community support services, per 15 minutes) produces $4.2M (16.2%), together indicating primary operations deliver intensive community-based support and habilitation services rather than medical or acute-care procedures.

Competitive standing by code is mixed but generally modest-to-strong in specific service lines: for T2020 the provider ranks #17 of 101 in-state (84th percentile), which signals above-average market share in day habilitation within Iowa; by contrast H2016 ranks #107 of 176 (39th percentile), indicating typical, unremarkable volume relative to peers for that comprehensive community support per-diem code.

The provider is a clear local leader in a couple of niche codes: it ranks #1 of 3 for T2036 (Therapeutic camping, overnight, waiver) and #1 of 6 for T2037 (Therapeutic camping, day, waiver), each with revenues of $2.6M (9.9%) and $192.9K (0.7%) respectively, suggesting a unique or differentiated capacity to deliver therapeutic camping services in-state even though overall dollar impact varies by code.

Several ancillary behavioral-health codes are present but account for small shares of revenue: psychotherapy codes 90834 and 90832 together produce under $212K (roughly 0.8% combined) and rank in the mid-to-upper percentiles statewide, indicating the provider offers some clinical behavioral services but these are secondary to its habilitation and community-support business lines.

Volume and payment characteristics show a mix of high-claim-count, low-unit-value services and lower-frequency, higher-paid claims: T2020 has 45.8K claims at $167 average paid/claim driving $7.7M, while H2015 has 7.4K claims at $571 average paid/claim for $4.2M, reflecting operational scale in per-diem/day services plus meaningful revenue from time-based community support billing.

Organizational tenure: the NPI was enumerated on 2005-06-10 (about 21 years ago), indicating long-standing presence in the state Medicaid market and likely established program relationships and operational experience delivering waiver and community support services.

Competitive weaknesses appear in some service lines where the provider sits low in statewide rank: codes like S5136 (Companion care) and several habilitation support codes rank near the bottom percentiles (e.g., S5136 at the 10th percentile), suggesting limited market penetration or capacity in those specific offerings compared with other Iowa providers.

Medicaid: Complete Services Breakdown

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

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2016	Comprehensive community support services, per diem	6,010	$1,450	$8.7M
T2020	Day habilitation, waiver; per diem	45,840	$170	$7.7M
H2015	Comprehensive community support services, per 15 minutes	7,410	$570	$4.2M
T2036	Therapeutic camping, overnight, waiver; each session	6,050	$430	$2.6M
S5136	Companion care, adult (e.g., iadl/adl); per diem	300	$3,400	$1M
H2025	Ongoing support to maintain employment, per 15 minutes	2,970	$330	$966.6K
T2015	Habilitation, prevocational, waiver; per hour	450	$570	$253.4K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	2,910	$70	$194.8K
T2037	Therapeutic camping, day, waiver; each session	1,290	$150	$192.9K
T1017	Targeted case management, each 15 minutes	1,720	$110	$185.4K

Showing 1–10 of 17

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

The Easter Seal Society Of Iowa, Inc. — 2 of 17 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

17 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5136	Companion care, adult (e.g., iadl/adl); per diem	74	80	9,410	$490	$17.9M
H2016	Comprehensive community support services, per diem	107	180	10,790	$390	$15.2M
T2020	Day habilitation, waiver; per diem	17	100	10,960	$110	$3M
H2025	Ongoing support to maintain employment, per 15 minutes	33	70	2,970	$300	$1.9M
H2015	Comprehensive community support services, per 15 minutes	42	100	4,130	$160	$1.9M
T1017	Targeted case management, each 15 minutes	13	20	3,950	$160	$1.8M
T2036	Therapeutic camping, overnight, waiver; each session	1	10	3,140	$380	$1.2M
S9485	Crisis intervention mental health services, per diem	10	10	470	$370	$572.7K
T2015	Habilitation, prevocational, waiver; per hour	25	30	1,920	$70	$425.6K
T2021	Day habilitation, waiver; per 15 minutes	86	100	2,780	$60	$386.9K

Showing 1–10 of 17

Nearby Providers

Other providers in the same ZIP code as The Easter Seal Society Of Iowa, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bridges Of Iowa	IA	Substance Abuse Rehabilitation Facility	$0	$12.7M
Al Home Health Care LLC	IA	Home Health Agency	$0	$1.1M
Robert Weissinger	IA	Family Medicine Physician	$27.9K	$0
Dianne Cooper	IA	Certified Registered Nurse Anesthetist	$1.7K	$0

The Easter Seal Society Of Iowa, Inc. — Billing Profile & Reimbursement Data

Sign up for The Easter Seal Society Of Iowa, Inc. — Billing Profile & Reimbursement Data policy alerts

The Easter Seal Society Of Iowa, Inc. — Billing Profile & Reimbursement Data

Sign up for The Easter Seal Society Of Iowa, Inc. — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References