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

Why is the Medicaid comparison limited to North 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. North 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.

Community Options For Residential And Employment Services, Inc (NPI 1356951503)

Field	Value
Entity Type	Organization
Organization	Community Options For Residential And Employment Services, Inc
Address	4909 Shelburne St
City	Bismarck
State	ND
ZIP	58503
Taxonomy	Case Manager/Care Coordinator
NPI Enumerated	August 3, 2020

Payer Source	Total Paid
Medicaid	$84.4M
Medicare	$0

Key Findings

COMMUNITY OPTIONS FOR RESIDENTIAL AND EMPLOYMENT SERVICES, INC has no Medicare billing on file and is effectively a single-payer Medicaid provider; its lifetime Medicaid revenue is $84.4M with zero reported Medicare revenue, indicating the organization’s operations and revenue risk are highly concentrated in state Medicaid programs rather than fee-for-service Medicare.

Revenue concentration is high: the precomputed top three Medicaid codes account for 70.2% of the provider’s total Medicaid revenue. The single largest code is T2016 (Habilitation, residential, waiver; per diem) at $23.2M (27.5% of Medicaid revenue), followed by T2021 (Day habilitation, waiver; per 15 minutes) at $18.7M (22.2%), and W0725 at $17.3M (20.5%), together driving the majority of cash flow.

The code mix (T2016, T2021, and W0725) signals core service lines centered on habilitation and day habilitation services for waiver populations and high-dollar service units associated with specialized waiver billing. Substantial volumes in per-diem residential habilitation and frequent 15-minute habilitation units suggest the organization runs both residential group settings and intensive day-program services rather than primarily episodic clinical care.

On competitive standing within North Dakota, the provider shows both typical and dominant positions depending on code: it ranks #6 of 29 for T2016 (82nd percentile), which is a typical statewide volume; it ranks #2 of 26 for T2021 (96th percentile), indicating a notably above-typical state presence in day habilitation; and it ranks #2 of 25 for W0725 (96th percentile), also notably above typical state volume. These ranks imply the organization is a leading provider for certain waiver services in-state while remaining one of several sizeable operators for residential habilitation.

There are several code-level outliers that further differentiate the provider’s scope: W0715 (28.6K claims, $13.8M) ranks #1 of 25 providers in-state (100th percentile), which the source labels as notably above typical — this underlines market leadership in that specific service line. H2015 (Comprehensive community support services, per 15 minutes) also ranks #1 of 7 providers in-state (100th percentile), showing dominance in that smaller but specialized service category. Conversely, multiple codes (e.g., T2019, W0300, S5150) are described as typical, unremarkable volumes, indicating a mixed profile of strengths and routine service offerings.

Claim counts and average paid-per-claim values show a mix of labor-intensive, high-frequency services and fewer high-dollar claims: T2021 has 105.1K claims at $178 avg paid/claim, reflecting many short-unit billings typical of 15-minute habilitation services, while W0725 has only 5.5K claims but $3170 avg paid/claim, indicating fewer encounters with much higher per-claim payments. This mix suggests operational capacity both to deliver frequent, minute-based supports and to manage resource-intensive services that generate large single-claim reimbursements.

The provider’s NPI was enumerated on 2020-08-03 (~6 years ago), establishing a relatively recent tenure in the regulatory/claims system. Given the concentration of Medicaid revenue into a few waiver and habilitation codes over that period, the organization appears to have scaled quickly in Medicaid waiver service lines since its enumeration.

Medicaid: Complete Services Breakdown

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	64,910	$360	$23.2M
T2021	Day habilitation, waiver; per 15 minutes	105,050	$180	$18.7M
W0725	N/A	5,470	$3,170	$17.3M
W0715	N/A	28,570	$480	$13.8M
W0300	N/A	2,130	$1,400	$3M
S5125	Attendant care services; per 15 minutes	15,040	$140	$2M
W0260	N/A	240	$5,290	$1.3M
W0200	N/A	630	$1,960	$1.2M
T2017	Habilitation, residential, waiver; 15 minutes	10,790	$110	$1.2M
W0720	N/A	3,090	$220	$669.7K

Showing 1–10 of 19

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Dakota Distribution

Community Options For Residential And Employment Services, Inc — 5 of 19 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Dakota

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

19 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	6	30	21,220	$400	$14.1M
W0725	N/A	2	30	1,380	$2,520	$9.9M
T2021	Day habilitation, waiver; per 15 minutes	2	30	32,410	$170	$6.6M
W0300	N/A	8	10	2,370	$630	$4M
W0715	N/A	1	30	6,250	$450	$3.8M
S5125	Attendant care services; per 15 minutes	6	20	10,750	$180	$2.7M
T2019	Habilitation, supported employment, waiver; per 15 minutes	15	20	11,310	$80	$1.2M
W0260	N/A	4	20	150	$4,920	$1M
T2017	Habilitation, residential, waiver; 15 minutes	4	10	4,870	$100	$1M
W0720	N/A	5	10	2,730	$190	$847.3K

Showing 1–10 of 19

Nearby Providers

Other providers in the same ZIP code as Community Options For Residential And Employment Services, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Metro Area Ambulance Service, Inc	ND	Land Ambulance	$1.5M	$11.7M
Red Door Pediatric Therapy, Inc	ND	Speech-Language Pathologist	$0	$5.6M
New Freedom Center	ND	Substance Abuse Rehabilitation Facility	$0	$4.5M
Bismarck Surgical Associates, LLC	ND	Ambulatory Surgical Clinic/Center	$2.2M	$0
Maple View Ii East Inc	ND	Alzheimer Center (Dementia Center)	$0	$1.7M
Good Road Recovery Center	ND	Substance Abuse Rehabilitation Facility	$0	$1.1M
Bismarck Transportation Services	ND	Taxi	$0	$1.1M
Daniel J. Keith, Dds, Ms, PC	ND	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$1.1M
Sanford Healthcare Accessories, LLC	ND	Durable Medical Equipment & Medical Supplies	$0	$1.1M
Pathology Consultants, PC	ND	Anatomic Pathology & Clinical Pathology Physician	$0	$1M

Community Options For Residential And Employment Services, Inc — Billing Profile & Reimbursement Data

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Community Options For Residential And Employment Services, Inc — 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