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

Why is the Medicaid comparison limited to South Dakota 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. South Dakota (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.

Oahe, Inc. (NPI 1336292754)

Field	Value
Entity Type	Organization
Organization	Oahe, Inc.
Address	125 W Pleasant Dr
City	Pierre
State	SD
ZIP	57501
Taxonomy	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NPI Enumerated	January 19, 2007

Payer Source	Total Paid
Medicaid	$4.4M
Medicare	$0

Key Findings

OAHE, INC. operates as an Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in PIERRE, SD and is effectively single-payer at scale: there is no Medicare billing on file and lifetime Medicaid revenue is $4.4M. This billing profile signals the organization’s revenue is concentrated entirely in Medicaid-funded IDD services rather than Medicare-covered care.

Revenue concentration is extremely high among a small set of service codes: the top three Medicaid codes (T2016, T2020, S0281) together account for 94.2% of the provider’s total Medicaid revenue. In particular, T2016 alone represents $2.7M (61.1% of Medicaid revenue), making residential habilitation per diem the primary revenue driver.

The provider’s code mix points to a service model centered on residential and day habilitation plus care coordination: T2016 (Habilitation, residential, waiver; per diem), T2020 (Day habilitation, waiver; per diem), and S0281 (Medical home program, comprehensive care coordination and planning, maintenance of plan) are the dominant codes, suggesting on-site residential supports and structured day programs with formal care planning. Claims and payment patterns for these codes reinforce that operational focus rather than episodic clinical services.

Top-code operational intensity is reflected in claims and average paid per claim: T2016 has 1.2K claims with $2175 avg paid/claim ($2.7M revenue), T2020 has 1.5K claims with $718 avg paid/claim ($1.1M revenue), and S0281 has 1.5K claims with $284 avg paid/claim ($412.7K revenue). These volumes indicate recurring per-diem billing and ongoing care-management activity rather than one-time procedures.

Competitive standing within the state is modest to low for the largest codes: T2016 ranks #20 of 21 providers in-state (5th percentile) and is described as "typical, unremarkable volume for this code," T2020 ranks #20 of 20 (0th percentile) and is also "typical, unremarkable volume for this code," and S0281 ranks #19 of 21 (10th percentile) with the same "typical, unremarkable" descriptor. Collectively, these ranks indicate OAHE is not a dominant in-state provider for these waiver services.

Secondary Medicaid codes contribute only small shares of revenue and likewise sit at low to mid percentiles: T2014 ($148.5K, 3.4% of revenue) ranks #13 of 17 (25th percentile), T2025 ($50K, 1.1%) ranks #18 of 19 (6th percentile), and T2018 ($47.8K, 1.1%) ranks #16 of 17 (6th percentile). This pattern suggests limited diversification beyond the core residential and day habilitation offerings.

From a payer-mix and risk perspective, the absence of Medicare billing plus the concentration of $4.4M in Medicaid revenue creates operational dependence on state waiver programs and Medicaid reimbursement rates; changes in waiver policy or rates could materially affect the provider given that the top three codes account for 94.2% of Medicaid revenue. Analysts should view OAHE as Medicaid-centric with minimal exposure to Medicare populations.

OAHE’s NPI was enumerated 2007-01-19 (~19 years ago), indicating an established presence in the market. Despite this tenure, the provider’s in-state rankings and the narrow revenue base suggest a stable but modest-scale operator focused on core IDD residential and day habilitation services rather than a large regional or statewide competitor.

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	1,250	$2,180	$2.7M
T2020	Day habilitation, waiver; per diem	1,470	$720	$1.1M
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	1,450	$280	$412.7K
T2014	Habilitation, prevocational, waiver; per diem	740	$200	$148.5K
T2025	Waiver services; not otherwise specified (nos)	1,020	$50	$50K
T2018	Habilitation, supported employment, waiver; per diem	560	$90	$47.8K
T2028	Specialized supply, not otherwise specified, waiver	460	$20	$10.5K
A0100	Non-emergency transportation; taxi	250	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Dakota Distribution

Oahe, Inc. — 0 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. South Dakota median

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	20	20	6,880	$1,660	$31.6M
T2020	Day habilitation, waiver; per diem	20	20	7,340	$500	$8.9M
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	19	20	6,090	$420	$3M
T2025	Waiver services; not otherwise specified (nos)	18	20	5,410	$180	$1.9M
T2018	Habilitation, supported employment, waiver; per diem	16	20	1,510	$80	$433.9K
T2014	Habilitation, prevocational, waiver; per diem	13	20	1,210	$130	$410.3K
T2028	Specialized supply, not otherwise specified, waiver	24	30	910	$50	$169.8K
A0100	Non-emergency transportation; taxi	7	10	280	$1	$1.2K

Nearby Providers

Other providers in the same ZIP code as Oahe, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Homecare Services Of South Dakota, Inc.	SD	Home Health Agency	$0	$20.1M
Resources For Human Development	SD	Case Management Agency	$0	$8.5M
Capital Area Counseling Service, Inc	SD	Clinical Social Worker	$0	$7.6M
Avera St Marys	SD	Multi-Specialty Clinic/Center	$0	$4.6M
Rising Hope Counseling, LLC	SD	Mental Health Counselor	$0	$4M
Central Dakota Eyecare, LLP	SD	Optometrist	$0	$1.8M
Avera St Marys	SD	General Acute Care Hospital	$0	$1.7M
Delta Dental Of South Dakota Foundation	SD	Dental Clinic/Center	$0	$1.2M
Delta Dental Of South Dakota Foundation	SD	Dental Clinic/Center	$0	$1M
Delta Dental Of South Dakota Foundation	SD	Dental Clinic/Center	$0	$594K

Oahe, Inc. — Billing Profile & Reimbursement Data

Sign up for Oahe, Inc. — Billing Profile & Reimbursement Data policy alerts

Oahe, Inc. — Billing Profile & Reimbursement Data

Sign up for Oahe, 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