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

Why is the Medicaid comparison limited to Wisconsin 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. Wisconsin (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.

Ablelight Inc. (NPI 1417010604)

Field	Value
Entity Type	Organization
Organization	Ablelight Inc.
Address	600 Hoffmann Dr
City	Watertown
State	WI
ZIP	53094
Taxonomy	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NPI Enumerated	December 18, 2006

Payer Source	Total Paid
Medicaid	$125.1M
Medicare	$0

Key Findings

ABLELIGHT INC. has no Medicare billing on file and reported Total Medicaid revenue of $125.1M, so its operations are effectively single-payer Medicaid-focused at scale. Analysts should treat Medicare as absent for this entity and concentrate competitive and utilization analysis on Medicaid claims and waiver programs.

Revenue is highly concentrated: the precomputed top 3 Medicaid codes by revenue account for 87.9% of this provider's total Medicaid revenue. Those three codes are dominated by T2016, which alone contributes $82.7M (66.1%), with S5140 and H2016 together making up most of the remainder, signaling a very narrow revenue base tied to a few service lines.

T2016 (Habilitation, residential, waiver; per diem) is the single largest revenue driver with 180.1K claims, $459 avg paid/claim, and $82.7M revenue (66.1% of Medicaid revenue). This code profile indicates the provider’s core business is residential habilitation under waiver programs, consistent with its Intellectual and/or Developmental Disabilities community-based residential treatment taxonomy.

S5140 (Foster care, adult; per diem) and H2016 (Comprehensive community support services, per diem) are the other top revenue codes, with S5140 at 55.9K claims, $267 avg paid/claim, $14.9M revenue (11.9%) and H2016 at 32.6K claims, $381 avg paid/claim, $12.4M revenue (9.9%). The mix of foster-care per diem and community support per diem suggests a blended model of residential foster-care placements combined with structured community supports rather than primarily outpatient clinical services.

ABLELIGHT ranks at or near the top of state peers for multiple Medicaid codes, reflecting strong in-state positioning for waiver and habilitation services. It ranks #1 of 4 providers for T2016 (100th percentile, described as typical, unremarkable volume for this code), #1 of 2 for H2016 (100th percentile), and #1 of 38 for T2021, among other #1 placements; several of these #1 rankings occur in contexts with few listed peers or no peer-volume comparison available, so leadership should be interpreted with that caveat.

The provider shows statistical outlier behavior on several specialized habilitation and supportive-service codes: T2021 (Day habilitation, waiver; per 15 minutes) is reported as an extreme outlier (38.9K claims, $74 avg paid/claim, $2.9M revenue, 2.3% of Medicaid revenue, #1 of 38, 100th percentile) and T2019 (Habilitation, supported employment, waiver; per 15 minutes) is also an extreme outlier (#1 of 20, 100th percentile). These outlier labels indicate utilization far above typical state volumes for per‑15‑minute habilitation services and suggest a pronounced operational emphasis on time-based habilitation in addition to per-diem residential care.

ABLELIGHT also generates meaningful revenue from infrequent, high-paid services: A0429 (Ambulance service, basic life support, emergency transport (bls-emergency)) shows 1K claims, $3298 avg paid/claim and $3.5M revenue (2.8% of Medicaid revenue) and ranks #51 of 153 providers in-state (67th percentile). The presence of this relatively high-cost transport revenue line indicates the provider occasionally bills emergency transport services that, while not a top revenue driver, contribute nontrivial dollars due to high per-claim payments.

The provider’s NPI was enumerated on 2006-12-18 (~20 years ago), reflecting long tenure in the market. Combined with a concentrated Medicaid revenue base and repeated #1 in-state rankings on core waiver and habilitation codes, this tenure supports the interpretation of ABLELIGHT as an established, specialized Medicaid waiver/residential habilitation provider in Wisconsin.

Medicaid: Complete Services Breakdown

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

21 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	180,070	$460	$82.7M
S5140	Foster care, adult; per diem	55,860	$270	$14.9M
H2016	Comprehensive community support services, per diem	32,640	$380	$12.4M
A0429	Ambulance service, basic life support, emergency transport (bls-emergency)	1,050	$3,300	$3.5M
T2021	Day habilitation, waiver; per 15 minutes	38,910	$70	$2.9M
0169	N/A	4,070	$360	$1.5M
T2020	Day habilitation, waiver; per diem	4,240	$270	$1.1M
S5151	Unskilled respite care, not hospice; per diem	2,450	$430	$1.1M
T2019	Habilitation, supported employment, waiver; per 15 minutes	7,610	$110	$860.3K
T2033	Residential care, not otherwise specified (nos), waiver; per diem	2,020	$430	$860.2K

Showing 1–10 of 21

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wisconsin Distribution

Ablelight Inc. — 5 of 19 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

21 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	1	10	33,230	$460	$28.6M
S5140	Foster care, adult; per diem	1	10	55,860	$270	$14.9M
H2016	Comprehensive community support services, per diem	1	10	18,630	$500	$9.3M
0169	N/A	1	10	4,070	$360	$1.5M
S5151	Unskilled respite care, not hospice; per diem	7	20	2,030	$280	$1.1M
T2020	Day habilitation, waiver; per diem	2	10	590	$650	$949.6K
T2033	Residential care, not otherwise specified (nos), waiver; per diem	1	10	2,020	$420	$860.1K
A0429	Ambulance service, basic life support, emergency transport (bls-emergency)	51	150	450	$150	$480.6K
0101	N/A	1	10	320	$1,520	$477.8K
T2021	Day habilitation, waiver; per 15 minutes	1	40	340	$200	$441.5K

Showing 1–10 of 21

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bethesda Lutheran Communities	WI	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$14.2M
Watertown Unified School District	WI	Local Education Agency (LEA)	$0	$1.6M
City Of Watertown	WI	Land Ambulance	$221K	$289.8K
Walgreen Co	WI	Pharmacy	$141K	$22.1K
Gwen Herzog	WI	Family Nurse Practitioner	$63.7K	$0
Brent Yaeggi	WI	Podiatrist	$63.4K	$0
Michael Grajewski	WI	Family Medicine Physician	$57.6K	$0
Elizabeth Albanese	WI	Podiatrist	$49.6K	$0

Ablelight Inc. — Billing Profile & Reimbursement Data

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Ablelight 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