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

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

Easter Seals Delaware & Marylands Eastern Shore, Inc (NPI 1437156635)

Field	Value
Entity Type	Organization
Organization	Easter Seals Delaware & Marylands Eastern Shore, Inc
Address	61 Corporate Cir
City	New Castle
State	DE
ZIP	19720
Taxonomy	Intellectual & Developmental Disabilities Psychologist
NPI Enumerated	July 1, 2005

Payer Source	Total Paid
Medicaid	$315.9M
Medicare	$0

Key Findings

EASTER SEALS DELAWARE & MARYLANDS EASTERN SHORE, INC shows an effectively single-payer footprint: there is no Medicare billing on file while lifetime Medicaid revenue totals $315.9M, indicating the organization's scale is driven almost entirely by Medicaid-funded programs. Analysts should treat Medicaid policy and waiver payment changes as primary drivers of this entity's financial performance.

Revenue is highly concentrated: the precomputed top 3 Medicaid codes by revenue account for 84.8% of total Medicaid revenue, driven by S5130 ($174M, 55.1%), T1019 ($69.2M, 21.9%), and T2040 ($24.6M, 7.8%). This concentration implies that a small set of waiver and home-care services underpins most receipts and that changes to reimbursement or utilization for these codes would materially affect overall revenue.

The provider’s code mix points to a large waiver/home-and-community-based services operation: S5130 (homemaker service), T1019 (personal care services), and T2040 (financial management, self-directed waiver) together dominate revenue, and additional high-volume codes such as T2020 (day habilitation, per diem) and S5105 (day care services, center-based) reinforce a service model centered on personal care, day habilitation, and self-directed waiver supports rather than institutional care. This profile aligns with an Intellectual & Developmental Disabilities–focused provider delivering both in-home and center-based habilitation and support functions.

Competitive standing by code is mixed but includes several strong statewide positions: S5130 ranks #3 of 62 providers in-state (97th percentile; notably above typical state volume), T1019 is listed as #1 of 1 providers in-state (0th percentile; no state peer volume comparison available) suggesting unique in-state reporting for that code, and T2040 ranks #1 of 2 providers in-state (100th percentile; typical, unremarkable volume). Those rankings indicate the organization is among the leading in-state suppliers for homemaker and several waiver-related services while some code comparisons are limited by lack of peers.

Beyond the top three, the provider also leads statewide for other waiver-day services: T2020 (215.6K claims, $19.4M revenue, 6.1%) ranks #1 of 11 providers in-state (100th percentile; notably above typical state volume), and S5105 (63.2K claims, $5.1M revenue, 1.6%) ranks #1 of 11 providers in-state (100th percentile; notably above typical state volume). These additional #1 positions for day habilitation and center-based day services reinforce a multi-channel delivery footprint across both in-home and center settings.

The billing mix includes a substantive block of in-home clinical therapies and support services that broaden the care offering beyond hands-on personal care: S9128 (speech therapy in the home) generated $3.4M (1.1%) and 92507 accounted for $1.8M (0.6%), while S9131 and S9129 (in-home PT and OT) also appear on the top-25 list. This suggests the provider offers integrated therapy and habilitation supports alongside personal care and day services, supporting a comprehensive IDD services model.

Operational scale is reflected in very high claim volumes for core codes: S5130 has 293.5K claims, T1019 has 152.8K claims, and T2040 has 139.7K claims, demonstrating a large, recurring-service workforce and administrative throughput to support frequent, time-based billing. Analysts should interpret these claim counts as evidence of high-utilization, per-15-minute or per-diem service delivery rather than episodic or procedure-based care.

The organization’s NPI has been enumerated since 2005-07-01 (~21 years ago), indicating an established presence in the market; combined with top-rank positions on several waiver-related codes and the large Medicaid revenue base, this tenure is consistent with a longstanding, major Medicaid waiver services operator in Delaware. Historical footing plus code-level dominance suggests scale and operational maturity within the state’s IDD service network.

Medicaid: Complete Services Breakdown

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

33 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5130	Homemaker service, nos; per 15 minutes	293,450	$590	$174M
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…	152,750	$450	$69.2M
T2040	Financial management, self-directed, waiver; per 15 minutes	139,690	$180	$24.6M
T2020	Day habilitation, waiver; per diem	215,640	$90	$19.4M
S5105	Day care services, center-based; services not included in program fee, per diem	63,200	$80	$5.1M
S9128	Speech therapy, in the home, per diem	32,850	$110	$3.4M
S5150	Unskilled respite care, not hospice; per 15 minutes	11,440	$260	$3M
T2014	Habilitation, prevocational, waiver; per diem	37,700	$70	$2.6M
T2019	Habilitation, supported employment, waiver; per 15 minutes	13,780	$180	$2.5M
S9131	Physical therapy; in the home, per diem	22,970	$100	$2.3M

Showing 1–10 of 33

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Delaware Distribution

Easter Seals Delaware & Marylands Eastern Shore, Inc — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. Delaware median

33 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	1	10	152,750	$450	$69.2M
T2040	Financial management, self-directed, waiver; per 15 minutes	1	10	92,230	$180	$16.5M
S5130	Homemaker service, nos; per 15 minutes	3	60	18,620	$130	$8.6M
T2020	Day habilitation, waiver; per diem	1	10	19,250	$120	$6.3M
T2014	Habilitation, prevocational, waiver; per diem	3	10	46,520	$70	$3.4M
S9131	Physical therapy; in the home, per diem	1	10	22,970	$100	$2.2M
T2019	Habilitation, supported employment, waiver; per 15 minutes	3	10	8,540	$160	$2.1M
S9128	Speech therapy, in the home, per diem	1	10	16,490	$110	$1.7M
S9129	Occupational therapy, in the home, per diem	1	10	16,960	$100	$1.7M
T1005	Respite care services, up to 15 minutes	1	10	9,290	$160	$1.5M

Showing 1–10 of 33

Nearby Providers

Other providers in the same ZIP code as Easter Seals Delaware & Marylands Eastern Shore, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bayada Home Health Care, Inc.	DE	Home Health Agency	$0	$61.2M
Conexio Care, Inc.	DE	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$15.8M
Nurses 'n Kids, Inc.	DE	Medically Fragile Infants and Children Day Care	$0	$14.3M
Delaware Diagnostic Labs, LLC	DE	Clinical Medical Laboratory	$3.1M	$8.5M
Point Of Hope Inc.	DE	Intellectual & Developmental Disabilities Psychologist	$0	$10M
Anesthesia Services PA	DE	Anesthesiology Physician	$0	$6.3M
Collaborative Effort To Reinforce Transition Success, Inc	DE	Intellectual & Developmental Disabilities Psychologist	$0	$4M
Abundant Life Community Development Corporation	DE	Intellectual & Developmental Disabilities Psychologist	$0	$2M
State Of Delaware	DE	Local Education Agency (LEA)	$0	$2M
Family Care Associates, Inc	DE	Family Medicine Physician	$0	$1.6M

Easter Seals Delaware & Marylands Eastern Shore, Inc — Billing Profile & Reimbursement Data

Sign up for Easter Seals Delaware & Marylands Eastern Shore, Inc — Billing Profile & Reimbursement Data policy alerts

Easter Seals Delaware & Marylands Eastern Shore, Inc — Billing Profile & Reimbursement Data

Sign up for Easter Seals Delaware & Marylands Eastern Shore, 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