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.

Spectrum For Living Development, Inc. (NPI 1407998842)

Field	Value
Entity Type	Organization
Organization	Spectrum For Living Development, Inc.
Address	210 Rivervale Road, Suite 3
City	River Vale
State	NJ
ZIP	07675
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	February 13, 2007

Payer Source	Total Paid
Medicaid	$161.6M
Medicare	$0

Key Findings

SPECTRUM FOR LIVING DEVELOPMENT, INC. reports $161.6M in lifetime Medicaid revenue and has no Medicare billing on file, making it effectively a single-payer Medicaid provider at this scale. The absence of Medicare revenue means payer strategy, financial exposure, and growth opportunities are concentrated entirely in Medicaid-funded services.

Revenue is extremely concentrated: the top three Medicaid codes (H2016, T2021, H2021) together account for 99.8% of the provider's total Medicaid revenue. This concentration creates operational dependence on a narrow set of service lines and reimbursement rules tied to those codes.

H2016 (Comprehensive community support services, per diem) is the dominant revenue driver with 322.7K claims, $403 avg paid/claim, and $130.1M in revenue, representing 80.5% of the provider's Medicaid revenue; coupled with heavy T2021 volume (203.5K claims, $152 avg paid/claim, $30.9M, 19.1%), the code mix indicates the organization primarily operates high-volume day habilitation and comprehensive community support programs for developmentally disabled populations. The billing pattern — large per-diem H2016 volumes alongside per-15-minute T2021 services — is consistent with operating day programs and intensive community support models.

Competitive standing in-state is strong for the two main codes: H2016 ranks #11 of 206 providers (95th percentile) and T2021 ranks #9 of 218 providers (96th percentile), both described as notably above typical state volume. Those ranks indicate SPECTRUM FOR LIVING is a major regional provider for these Medicaid-funded services rather than a modest participant.

Secondary codes generate negligible revenue relative to the top two: H2021 accounts for 0.2% ($269.7K) and H0004 accounts for 0.1% ($173K) of Medicaid revenue, with H2021 ranked #87 of 194 (55th percentile) and H0004 ranked #17 of 64 (75th percentile). These entries suggest the provider offers some wrap-around and behavioral health supports, but they are not material to its overall revenue base.

Operational scale is reflected in claims and unit rates: 322.7K claims billed for H2016 at $403 avg paid/claim and 203.5K claims for T2021 at $152 avg paid/claim demonstrate both high utilization and substantial per-claim reimbursement for the core services. This combination of high claim counts and meaningful avg paid/claim values underpins the large Medicaid revenue totals reported.

The provider has an established presence, with its NPI enumerated on 2007-02-13 (~19 years ago), indicating long-tenured participation in Medicaid service delivery. Tenure combined with its high ranks on core codes suggests institutional experience and scale in delivering developmental disability day and community support services.

Smaller therapy and ancillary codes (examples include 92507, 97535, S8990 and A0090) contribute trivial revenue relative to the top two codes and generally rank in low-to-median percentiles statewide; this pattern reinforces that revenue and competitive strength are concentrated in H2016 and T2021 rather than a broad mix of clinical 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
H2016	Comprehensive community support services, per diem	322,750	$400	$130.1M
T2021	Day habilitation, waiver; per 15 minutes	203,480	$150	$30.9M
H2021	Community-based wrap-around services, per 15 minutes	3,850	$70	$269.7K
H0004	Behavioral health counseling and therapy, per 15 minutes	4,940	$40	$173K
H2015	Comprehensive community support services, per 15 minutes	1,040	$70	$72.5K
A0090	Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest	1,650	$10	$23.1K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	500	$30	$15K
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	140	$40	$4.9K
S8990	Physical or manipulative therapy performed for maintenance rather than restoration	20	$70	$1.3K

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

Spectrum For Living Development, Inc. — 2 of 9 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

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2016	Comprehensive community support services, per diem	11	210	23,310	$490	$41.9M
T2021	Day habilitation, waiver; per 15 minutes	9	220	14,500	$170	$7.7M
H2021	Community-based wrap-around services, per 15 minutes	87	190	3,010	$260	$3.1M
H2015	Comprehensive community support services, per 15 minutes	70	110	1,860	$140	$1.1M
S8990	Physical or manipulative therapy performed for maintenance rather than restoration	22	20	2,470	$120	$639K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	138	190	860	$100	$534.8K
H0004	Behavioral health counseling and therapy, per 15 minutes	17	60	1,570	$70	$253.4K
A0090	Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest	163	230	7,800	$10	$218.8K
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	152	220	350	$60	$95.3K

Nearby Providers

Other providers in the same ZIP code as Spectrum For Living Development, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Donna Dephillips	NJ	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$544.8K	$603.2K
Stephen Nychay	NJ	MOHS-Micrographic Surgery Physician	$956.4K	$0
Jonathan Blume	NJ	Dermatology Physician	$474.5K	$0
Robert Tassan	NJ	Hematology (Internal Medicine) Physician	$421.8K	$0
Patrick Chin	NJ	Ophthalmology Physician	$399.1K	$0
Martha Maso	NJ	Dermatology Physician	$367.9K	$0
Michael Molinaro	NJ	Dermatology Physician	$346.5K	$0
Pamela Muscara	NJ	Physical Therapist	$340.7K	$0
Richard Garden	NJ	Urology Physician	$291.5K	$0
Michael Scherl	NJ	Otolaryngology Physician	$277K	$0

Spectrum For Living Development, Inc. — Billing Profile & Reimbursement Data

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Spectrum For Living Development, 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