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

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

Quality Life Concepts Inc. (NPI 1437223518)

Field	Value
Entity Type	Organization
Organization	Quality Life Concepts Inc.
Address	215 Smelter Ave Ne
City	Great Falls
State	MT
ZIP	59404
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	November 20, 2006

Payer Source	Total Paid
Medicaid	$26M
Medicare	$0

Key Findings

QUALITY LIFE CONCEPTS INC. is effectively a single‑payer Medicaid provider with no Medicare billing on file; the profile shows Total Medicaid revenue of $26M and explicitly notes there is no Medicare revenue recorded, indicating the organization’s operations and reimbursement exposure are concentrated entirely in state Medicaid programs. This payer concentration suggests contract and regulatory risk is largely tied to Medicaid policy and rates rather than to Medicare-driven volume.

Revenue concentration is highly focused: the precomputed top three Medicaid codes account for 91.4% of the provider’s total Medicaid revenue. That degree of concentration implies the business model centers on a narrow set of habilitation and day‑program services rather than a broad mix of service lines, so any changes to reimbursement or utilization for those codes would meaningfully affect overall revenue.

The largest single revenue driver is T2017 (Habilitation, residential, waiver; 15 minutes), which produced $14.1M or 54.2% of this provider’s Medicaid revenue and represents the dominant service line. Coupled with T2013 (Habilitation, educational, waiver; per hour) at $5.6M (21.4%) and T2021 (Day habilitation, waiver; per 15 minutes) at $4.1M (15.8%), the billing mix indicates a core emphasis on residential habilitation and day habilitation programs for waiver populations. Operationally this suggests facility- or program‑based care with significant recurring time‑based services billed in 15‑minute and hourly increments.

Competitive standing within Montana is modest-to-strong for its top habilitation services: the provider ranks #4 of 21 for T2017 (85th percentile) and #4 of 17 for T2013 (81st percentile), reflecting above‑median but not dominant statewide volume for those codes. For T2021 the provider ranks #9 of 45 (82nd percentile), which also signals a stronger than typical presence among peers for day habilitation, but not a top one or two statewide operator. Overall these ranks portray QUALITY LIFE CONCEPTS as a meaningful regional player in waiver habilitation services rather than an outlier market leader.

Several secondary codes show limited or routine engagement in complementary services: T2032 (residential care, nos, waiver) contributes $1.8M (7.1%) and ranks #5 of 20 (79th percentile), while non‑emergency transportation codes T2002 and T2003 appear with relatively small revenue shares ($183.8K and $127.2K respectively) and mid‑to‑upper percentile ranks. These patterns are consistent with an organization that delivers core habilitation programming and also bills ancillary transportation and residential supports typical of waiver providers.

The provider has long-established NPI enumeration dating to 2006-11-20 (approximately 20 years ago), indicating sustained operation in the market and experience operating under Medicaid waiver billing structures. That tenure, combined with concentrated revenue in long‑standing waiver codes, suggests institutional familiarity with program requirements and billing workflows for these services.

Smaller volume codes (for example H0046, S5130, T1999 and others) account for negligible portions of Medicaid revenue and generally rank at the low end of in‑state provider lists (many at 0th percentile or only a few providers reporting). These items appear ancillary to the provider’s primary habilitation business and do not materially change the revenue or competitive profile established by the top three codes.

Medicaid: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2017	Habilitation, residential, waiver; 15 minutes	3,910	$3,600	$14.1M
T2013	Habilitation, educational, waiver; per hour	2,030	$2,740	$5.6M
T2021	Day habilitation, waiver; per 15 minutes	4,020	$1,020	$4.1M
T2032	Residential care, not otherwise specified (nos), waiver; per month	2,230	$830	$1.8M
T2002	Non-emergency transportation; per diem	1,720	$110	$183.8K
T2003	Non-emergency transportation; encounter/trip	3,530	$40	$127.2K
H0046	Mental health services, not otherwise specified	70	$560	$36.7K
S5130	Homemaker service, nos; per 15 minutes	160	$200	$30.4K
T1999	Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks"	10	$360	$5.1K
T2028	Specialized supply, not otherwise specified, waiver	220	$20	$3.5K

Showing 1–10 of 13

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Montana Distribution

Quality Life Concepts Inc. — 0 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. Montana median

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2017	Habilitation, residential, waiver; 15 minutes	4	20	2,530	$4,970	$13.2M
T2013	Habilitation, educational, waiver; per hour	4	20	770	$2,020	$5.2M
T2021	Day habilitation, waiver; per 15 minutes	9	50	1,630	$1,010	$2.6M
T2032	Residential care, not otherwise specified (nos), waiver; per month	5	20	1,120	$830	$1M
H2019	Therapeutic behavioral services, per 15 minutes	36	40	3,280	$50	$759.9K
H0046	Mental health services, not otherwise specified	3	10	1,060	$220	$589.3K
S5130	Homemaker service, nos; per 15 minutes	9	10	1,560	$30	$143.8K
T2002	Non-emergency transportation; per diem	12	30	1,440	$110	$141.5K
T2003	Non-emergency transportation; encounter/trip	8	40	2,180	$30	$78K
T2028	Specialized supply, not otherwise specified, waiver	25	40	570	$40	$58.4K

Showing 1–10 of 13

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Central Montana Eyecare PC	MT	Optometrist	$0	$1.8M
Martha Morgan	MT	Clinical Social Worker	$15.9K	$546.9K
Tanya Richem	MT	Professional Counselor	$0	$546.5K
Lisa Anderson Mangan	MT	Professional Counselor	$0	$500.6K
Pacific Cataract And Laser Institute Inc PC	MT	Ambulatory Surgical Clinic/Center	$379.3K	$0
Rays Of Light, LLC	MT	Community/Behavioral Health Agency	$0	$367.2K
Sharon Altschwager	MT	Counselor	$0	$327K
Elisabeth Purdy	MT	Professional Counselor	$0	$246.4K
Carey Welsh	MT	Family Medicine Physician	$116.1K	$0
Anthony Turk	MT	Optometrist	$40.6K	$60.2K

Quality Life Concepts Inc. — Billing Profile & Reimbursement Data

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Quality Life Concepts 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