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 1295869428)

Field	Value
Entity Type	Organization
Organization	Commonwealth Of Massachusetts
Address	21 Spring Street
City	Taunton
State	MA
ZIP	02780
Taxonomy	Case Management Agency
NPI Enumerated	March 16, 2007

Payer Source	Total Paid
Medicaid	$326.7M
Medicare	$0

Key Findings

COMMONWEALTH OF MASSACHUSETTS (Case Management Agency) is an established NPI-listed entity enumerated since 2007-03-16 (~19 years ago) and is based in TAUNTON, MA. Its public billing footprint is effectively single-payer: there is no Medicare billing on file and all documented federal revenue activity is Medicaid-based totaling $326.7M.

Revenue is extremely concentrated: the top three Medicaid codes (T2016, S5100, T2023) together account for 93.3% of the provider's total Medicaid revenue. Those top codes break down as T2016 $276.7M (84.7% of Medicaid revenue), S5100 $17M (5.2%), and T2023 $11.2M (3.4%), showing that a very large share of Medicaid dollars flow through a small set of service lines.

The provider’s service mix and billing modalities indicate a community-based long-term services and supports operator: T2016 (Habilitation, residential, waiver; per diem) is the dominant revenue driver, while S5100 (Day care services, adult; per 15 minutes) and T2023 (Targeted case management; per month) indicate complementary day program and case management offerings. The presence of per-diem residential habilitation plus per-15-minute day services and monthly case management payments suggests integrated residential and outpatient/ancillary service delivery for waiver populations.

Operational scale and unit economics differ sharply across top codes: T2016 shows 29.9K claims with a very high average paid/claim of $9247, reflecting high-dollar residential per-diem billing; by contrast S5100 shows 67.3K claims at $252 avg paid/claim and T2023 shows 33.1K claims at $339 avg paid/claim, indicating S5100 and T2023 are higher-volume, lower-unit-value services supporting the residential business.

Competitive standing is mixed across services within the state. For T2016 the provider ranks #13 of 25 (50th percentile) and is described as typical/unremarkable statewide despite that code producing $276.7M of this provider’s revenue; S5100 is a relative area of strength, ranking #17 of 189 (91st percentile) and labeled notably above typical state volume, suggesting above-average scale in adult day care compared with in-state peers; T2023 ranks #14 of 70 (81st percentile) and is typical/unremarkable for that code class.

Beyond the top three, the provider bills a range of supportive community services at smaller scale—H2015 $8.3M (2.5%), T2021 $6.8M (2.1%), H2023 $3.6M (1.1%)—which indicates offerings in comprehensive community support, day habilitation, and supported employment. Ranks and percentiles for these codes (for example T2021 ranks #5 of 24 at the 83rd percentile and H2015 ranks #53 of 147 at the 64th percentile) show a portfolio that includes some higher-ranked niche services alongside many typical statewide volumes.

The combination of a Medicaid-only revenue base ($326.7M) and extreme concentration in a single per-diem waiver code (T2016 at 84.7% of Medicaid revenue) creates a concentrated payer-service exposure: policy, rate, or program changes affecting waiver residential habilitation or day-program reimbursement could materially affect the provider’s revenue. This profile also implies limited Medicare diversification and a high dependence on state Medicaid program stability.

For downstream analysis or monitoring, the most material signals are the heavy reliance on T2016 (high-dollar residential habilitation) and the anomalously strong statewide position in S5100 (adult day care, 91st percentile, notably above typical). Given the provider’s ~19-year tenure and the mix of residential and non-residential codes, analysts should treat this entity as an established Medicaid waiver services operator with concentrated revenue drivers and moderate breadth of ancillary community support services.

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	29,930	$9,250	$276.7M
S5100	Day care services, adult; per 15 minutes	67,310	$250	$17M
T2023	Targeted case management; per month	33,090	$340	$11.2M
H2015	Comprehensive community support services, per 15 minutes	23,310	$360	$8.3M
T2021	Day habilitation, waiver; per 15 minutes	30,770	$220	$6.8M
H2023	Supported employment, per 15 minutes	19,130	$190	$3.6M
T2003	Non-emergency transportation; encounter/trip	58,200	$30	$1.6M
T2019	Habilitation, supported employment, waiver; per 15 minutes	12,310	$100	$1.2M
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	3,160	$80	$246.5K

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 — 0 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	13	30	29,930	$10,070	$358.9M
T2023	Targeted case management; per month	14	70	8,210	$510	$8.6M
H2023	Supported employment, per 15 minutes	18	20	28,450	$190	$5.6M
H2015	Comprehensive community support services, per 15 minutes	53	150	7,770	$140	$4.8M
T2021	Day habilitation, waiver; per 15 minutes	5	20	20,590	$210	$4.5M
S5100	Day care services, adult; per 15 minutes	17	190	2,000	$230	$3.1M
T2019	Habilitation, supported employment, waiver; per 15 minutes	21	20	24,690	$120	$3.1M
T2003	Non-emergency transportation; encounter/trip	100	250	40,490	$30	$2.2M
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	35	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
Northeast Health Services, LLC	MA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$121.1M
Community Counseling Of Bristol County, Inc.	MA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$77.9M
Morton Hospital, A Steward Family Hospital, Inc.	MA	General Acute Care Hospital	$0	$41.7M
Associates For Human Services, Inc.	MA	Adult Day Care Clinic/Center	$0	$20M
Preparatory Rehabilitation For Individual Development & Employment, In	MA	Adult Care Home Facility	$0	$16.9M
Nightingale Home Healthcare Of Massachusetts, Inc.	MA	Home Health Agency	$0	$14.5M
Northeast Dental Anesthesia Associates, PLLC	MA	Dental Clinic/Center	$0	$9.5M
Community Counseling Of Bristol County, Inc.	MA	Community/Behavioral Health Agency	$0	$9.1M
Atg Massachusetts Inc	MA	Customized Equipment (DME)	$0	$8.8M
Department Of Mental Health	MA	Substance Abuse Rehabilitation Facility	$0	$7.3M

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