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

Why is the Medicaid comparison limited to North Carolina 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 Carolina (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 Of North Carolina (NPI 1396811618)

Field	Value
Entity Type	Organization
Organization	The Arc Of North Carolina
Address	353 E. Six Forks Road Suite 300
City	Raleigh
State	NC
ZIP	27609
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	November 28, 2006

Payer Source	Total Paid
Medicaid	$77.5M
Medicare	$0

Key Findings

THE ARC OF NORTH CAROLINA is effectively a single-payer Medicaid provider: there is no Medicare billing on file while total Medicaid revenue is $77.5M, indicating its operations and revenue base are concentrated exclusively in Medicaid-funded community and behavioral health services. This payer concentration suggests organizational focus on Medicaid programs and waiver-based service delivery rather than Medicare populations.

Revenue concentration is heavily skewed to a narrow set of services: the top 3 Medicaid codes by revenue account for 80.8% of the provider's total Medicaid revenue. The dominance of these three codes (T2013, T2041, T2012) indicates that a small number of service lines generate the vast majority of Medicaid billings and financial inflows for this provider.

The largest single revenue driver is T2013 (Habilitation, educational, waiver; per hour), which produced $34.2M and represents 44.2% of the provider's Medicaid revenue. This high share signals that individualized habilitation and educational waiver services are the core of the organization’s program mix and billing model.

T2041 (Supports brokerage, self-directed, waiver; per 15 minutes) is an organizational outlier: it generated $14.3M (18.5% of Medicaid revenue) and the provider ranks #1 of 124 in-state, described as an "extreme outlier, far above typical state volume for this code." That ranking indicates THE ARC of NC is a dominant statewide provider for supports brokerage and self-directed waiver administration compared with peers.

T2012 (Habilitation, educational; waiver, per diem) contributed $14.1M (18.2% of Medicaid revenue) and ranks in the 92nd percentile in-state (#10 of 110), which is described as typical/unremarkable volume relative to the state distribution for that code. Together with T2013, this confirms a programmatic emphasis on habilitation services delivered under waiver arrangements, with both per-hour and per-diem billing modalities present.

Beyond the top three, targeted case management (T1017) and comprehensive community support (H2015) are material but smaller contributors, producing $9.1M (11.7%) and $2.3M (2.9%) respectively; both sit at typical in-state volume percentiles (94th and 77th). This mix shows the provider also performs care coordination and community support services alongside its habilitation and brokerage focus.

Competitive standing across Medicaid codes is mixed: the provider is a clear statewide leader for T2041 (100th percentile, #1 of 124), notably above typical state volume for T2013 (95th percentile, #11 of 185), and otherwise occupies strong but not dominant positions for other codes. Overall, the data portray an organization with exceptional strength in supports brokerage and unusually high utilization of habilitation services compared with most in-state peers.

The provider’s NPI was enumerated ~20 years ago (2006-11-28), indicating long tenure in the market. This multi-decade presence combined with concentrated Medicaid revenue and leading state rank for select codes suggests an established operational footprint in North Carolina’s waiver and community support ecosystem.

Medicaid: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2013	Habilitation, educational, waiver; per hour	215,300	$160	$34.2M
T2041	Supports brokerage, self-directed, waiver; per 15 minutes	97,370	$150	$14.3M
T2012	Habilitation, educational; waiver, per diem	84,880	$170	$14.1M
T1017	Targeted case management, each 15 minutes	36,380	$250	$9.1M
H2015	Comprehensive community support services, per 15 minutes	26,350	$90	$2.3M
S5150	Unskilled respite care, not hospice; per 15 minutes	27,800	$70	$1.9M
H0045	Respite care services, not in the home, per diem	13,070	$90	$1.1M
H2025	Ongoing support to maintain employment, per 15 minutes	4,210	$110	$445.9K
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	150	$190	$27.3K
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	130	$150	$19.2K

Showing 1–10 of 12

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Carolina Distribution

The Arc Of North Carolina — 1 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

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

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2013	Habilitation, educational, waiver; per hour	11	190	29,090	$150	$9.1M
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	6	10	130	$90	$6.9M
T2012	Habilitation, educational; waiver, per diem	10	110	21,340	$180	$6.1M
H2015	Comprehensive community support services, per 15 minutes	59	250	10,060	$130	$2.4M
99509	A home health provider, such as a registered nurse, or a non nursing practitioner, visits a patient to provide help with activities of daily living, or ADLs, and self care.	1,444	1,450	23,320	$50	$2.3M
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	76	80	2,380	$160	$1.8M
H2025	Ongoing support to maintain employment, per 15 minutes	36	60	6,380	$120	$1.3M
T1017	Targeted case management, each 15 minutes	14	220	1,700	$150	$1.3M
H0045	Respite care services, not in the home, per diem	17	80	4,450	$100	$993.7K
T2041	Supports brokerage, self-directed, waiver; per 15 minutes	1	120	2,780	$150	$966.8K

Showing 1–10 of 12

Nearby Providers

Other providers in the same ZIP code as The Arc Of North Carolina, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Voca Corp Of North Carolina	NC	Community/Behavioral Health Agency	$0	$62.8M
Easter Seals Ucp North Carolina & Virginia, Inc.	NC	Community/Behavioral Health Agency	$0	$58.3M
Fastmed Urgent Care PC	NC	Urgent Care Clinic/Center	$0	$40.4M
Easter Seals Ucp North Carolina & Virginia, Inc.	NC	Community/Behavioral Health Agency	$0	$29.3M
Carter Clinic, P A	NC	Psychiatry Physician	$0	$19.4M
Professional Healthcare, LLC	NC	Nursing Care Agency	$0	$17.6M
Healing Interventions, Inc	NC	Community/Behavioral Health Agency	$0	$15.3M
Kids First Pediatrics Of Raleigh, PLLC	NC	Pediatrics Physician	$0	$12M
Raleigh Best Medical Supply And Home Health Care Services, LLC	NC	Home Health Agency	$0	$11.9M
Resources For Seniors, Inc	NC	Case Manager/Care Coordinator	$0	$11.3M

The Arc Of North Carolina — Billing Profile & Reimbursement Data

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The Arc Of North Carolina — 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