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

Why is the Medicaid comparison limited to New Jersey 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. New Jersey (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 Arc Ocean County Chapter, Inc (NPI 1386023976)

Field	Value
Entity Type	Organization
Organization	The Arc Ocean County Chapter, Inc
Address	815 Cedar Bridge Ave
City	Lakewood
State	NJ
ZIP	08701
Taxonomy	In Home Supportive Care Agency
NPI Enumerated	May 28, 2015

Payer Source	Total Paid
Medicaid	$147.4M
Medicare	$0

Key Findings

THE ARC OCEAN COUNTY CHAPTER, INC shows effectively single-payer activity: there is no Medicare billing on file and its lifetime Medicaid revenue totals $147.4M, indicating the organization’s entire documented public reimbursement footprint is Medicaid-driven. This concentration in one program should be a primary lens for any payer/provider analysis of scale and risk.

Revenue is extremely concentrated in a very small set of services: the precomputed top three Medicaid codes account for 99.0% of the provider’s total Medicaid revenue, with H2016 alone representing $127.9M (86.8% of total Medicaid revenue). That degree of concentration means changes in reimbursement policy or utilization for H2016 would materially affect overall revenue.

The code mix points to an operation focused on long-duration community support and habilitation services: H2016 (Comprehensive community support services, per diem) is the dominant line, supported by high-volume habilitation and care-planning activity in T2021 (Day habilitation, waiver; per 15 minutes) and T2024 (Service assessment/plan of care development, waiver). These codes are consistent with an in-home/supportive care agency delivering recurring, programmatic supports for beneficiaries with ongoing community habilitation needs.

H2016 performance indicates a strong competitive standing in-state: H2016 ranks #8 of 206 providers (97th percentile) and is described as notably above typical state volume for this code, which positions the provider as a major state participant for comprehensive community support services. By contrast, T2021 and T2024 rank in the mid-to-high percentiles (#32 of 218 at the 86th percentile and #21 of 181 at the 89th percentile respectively) and are labeled as typical or unremarkable in volume, reflecting a solid but less dominant presence for those supplementary service lines.

Operational scale is substantial on utilization metrics: H2016 accounts for 394.6K claims at an average paid amount of $324 per claim yielding $127.9M, while T2021 and T2024 account for 102.5K claims ($120 avg, $12.3M) and 18.8K claims ($303 avg, $5.7M) respectively. These claim counts and per-claim averages underscore a high-throughput model for per-diem community supports combined with frequent short-interval habilitation services.

The provider’s tenure is established but not long-standing by some market standards: the NPI was enumerated 2015-05-28 (~11 years ago), indicating roughly a decade of recorded participation in Medicaid billing, which aligns with the observed high cumulative volumes and suggests stable operations over multiple contract cycles. This longevity supports credibility when assessing historical utilization trends.

Smaller, ancillary service lines exist but contribute minimally to revenue and indicate service breadth rather than core dependence: codes such as T2015 ($593.8K, ranked #7 of 70, 91th percentile), H2021 ($535.7K), T1005 ($109.1K), A0090 ($82.5K), H2015 ($68.7K), H2014 ($68.1K) and H0004 ($62.6K) each represent a small fraction of total Medicaid revenue. These line items point to offerings like prevocational habilitation, wrap-around services, respite, transportation, skills training and behavioral counseling, but none approach the revenue concentration driven by H2016.

From a strategic risk and contracting perspective, the provider’s dependence on a single dominant code and a single payer creates both vulnerability and clarity: nearly all Medicaid revenue is tied to H2016 and to Medicaid overall, so payers and analysts should focus contract, compliance, and utilization reviews on Comprehensive community support services and related care-planning workflows. Any policy, audit, or rate change affecting H2016 reimbursement or utilization would disproportionately impact the provider’s financial performance.

Medicaid: Complete Services Breakdown

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2016	Comprehensive community support services, per diem	394,640	$320	$127.9M
T2021	Day habilitation, waiver; per 15 minutes	102,500	$120	$12.3M
T2024	Service assessment/plan of care development, waiver	18,840	$300	$5.7M
T2015	Habilitation, prevocational, waiver; per hour	17,460	$30	$593.8K
H2021	Community-based wrap-around services, per 15 minutes	6,020	$90	$535.7K
T1005	Respite care services, up to 15 minutes	2,140	$50	$109.1K
A0090	Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest	4,130	$20	$82.5K
H2015	Comprehensive community support services, per 15 minutes	1,860	$40	$68.7K
H2014	Skills training and development, per 15 minutes	1,700	$40	$68.1K
H0004	Behavioral health counseling and therapy, per 15 minutes	990	$60	$62.6K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Jersey Distribution

The Arc Ocean County Chapter, Inc — 1 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Jersey

Full comparison — all codes billed, vs. New Jersey median

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2016	Comprehensive community support services, per diem	8	210	23,310	$490	$41.9M
T2021	Day habilitation, waiver; per 15 minutes	32	220	14,500	$170	$7.7M
H2021	Community-based wrap-around services, per 15 minutes	66	190	3,010	$260	$3.1M
T2024	Service assessment/plan of care development, waiver	21	180	3,700	$300	$2.7M
H2015	Comprehensive community support services, per 15 minutes	58	110	1,860	$140	$1.1M
T2015	Habilitation, prevocational, waiver; per hour	7	70	2,810	$100	$671.2K
H2014	Skills training and development, per 15 minutes	60	160	990	$120	$462.7K
T1005	Respite care services, up to 15 minutes	17	40	830	$100	$313.7K
H0004	Behavioral health counseling and therapy, per 15 minutes	37	60	1,570	$70	$253.4K
A0090	Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest	141	230	7,800	$10	$218.8K

Nearby Providers

Other providers in the same ZIP code as The Arc Ocean County Chapter, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Monmouth Medical Center Inc	NJ	General Acute Care Hospital	$0	$60.1M
Lakewood Resource And Referral Center Inc	NJ	Federally Qualified Health Center (FQHC)	$0	$46.8M
Lakewood Board Of Education	NJ	Local Education Agency (LEA)	$0	$43.9M
Teamcare LLC	NJ	In Home Supportive Care Agency	$0	$38.8M
I.m.e.m. Clinical Associates LLC	NJ	Specialist	$0	$27.8M
Eviancare LLC	NJ	In Home Supportive Care Agency	$0	$23.4M
Nj Dentistry For Children, P.A.	NJ	Pediatric Dentistry	$0	$21.9M
The Special Children Center	NJ	Developmentally Disabled Services Day Training Agency	$0	$17.4M
Precious Health Of Lakewood, PC	NJ	Pediatrics Physician	$0	$15.6M
Preferred Behavioral Health Of New Jersey, Inc.	NJ	Community/Behavioral Health Agency	$0	$13M

The Arc Ocean County Chapter, Inc — Billing Profile & Reimbursement Data

Sign up for The Arc Ocean County Chapter, Inc — Billing Profile & Reimbursement Data policy alerts

The Arc Ocean County Chapter, Inc — Billing Profile & Reimbursement Data

Sign up for The Arc Ocean County Chapter, 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