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

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

Daybreak Community Services Texas LLC (NPI 1437534559)

Field	Value
Entity Type	Organization
Organization	Daybreak Community Services Texas LLC
Address	4150 International Plz Ste 820
City	Fort Worth
State	TX
ZIP	76109
Taxonomy	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NPI Enumerated	July 30, 2015

Payer Source	Total Paid
Medicaid	$242.8M
Medicare	$0

Key Findings

DAYBREAK COMMUNITY SERVICES TEXAS LLC is effectively a single-payer Medicaid provider: there is no Medicare billing on file and the provider reports $242.8M in lifetime Medicaid revenue. This concentration means the organization’s financial footprint and payer exposure are driven almost entirely by state Medicaid policies and reimbursement for developmental/intellectual disability services.

Revenue concentration is very high: the precomputed top three Medicaid codes account for 68.1% of the provider’s total Medicaid revenue. The single largest code is H2016 ($133.2M, 55.5% of total Medicaid revenue), followed by M0150 ($16.3M, 6.8%) and H2014 ($13.9M, 5.8%), indicating a heavy dependence on a small set of service lines.

The codes billed point to a community-based intellectual/developmental disability operating model: H2016 (Comprehensive community support services, per diem), H2014 (Skills training and development, per 15 minutes), and T2020 (Day habilitation, waiver; per diem) dominate the mix. This combination of per-diem community supports and time-based habilitation codes is consistent with residential or day habilitation programs and intensive community support services rather than traditional medical or acute-care activity.

DAYBREAK is a statewide outlier on multiple measures: H2016 ranks #1 of 430 providers in-state (100th percentile; extreme outlier, far above typical state volume for this code), and several other high-revenue codes similarly rank at the top of their peer groups. That pattern—multiple codes with #1 statewide ranks and 100th-percentile designations—characterizes the organization as a dominant provider of several Medicaid IDD service lines within Texas.

Beyond H2016, the provider posts unusually large claim volumes across a range of M0xx and T1xxx procedure codes, with several labeled as extreme outliers. Examples include M0150 (101.3K claims, $16.3M; rank #1 of 79, 100th percentile; extreme outlier), M0152 (56.1K claims, $9.8M; rank #1 of 41, 100th percentile; extreme outlier), and T1002 (77.9K claims, $3M; rank #1 of 433, 100th percentile; extreme outlier), indicating breadth as well as depth in the provider’s Medicaid activity.

Operational throughput is large: H2016 alone shows 564.3K claims and H2014 shows 272.3K claims, while other high-frequency codes include M0116 (250.7K claims) and T1003 (89.9K claims). These claim totals align with a high-volume service operation delivering frequent, recurring per-diem and unit-based services to a substantial client population.

The provider’s NPI was enumerated on 2015-07-30 (~11 years ago), indicating an established presence in the Texas Medicaid market; that tenure plausibly supports the scale and multiple top-rank positions observed across in-state peers. The combination of near-decade-plus enrollment and large, concentrated revenue lines suggests an organization that has grown or specialized into specific Medicaid-funded IDD service niches.

Concentration risk is material given that H2016 alone accounts for $133.2M (55.5% of Medicaid revenue) and the top three codes make up 68.1% of Medicaid revenue; any material policy, rate, or authorization change for per-diem community support or habilitation services could disproportionately affect the provider’s revenue. From an analytic perspective, payers and competitor analysts should treat changes to H2016/H2014/T2020 reimbursement or utilization rules as high-impact levers for this provider.

Medicaid: Complete Services Breakdown

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

42 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2016	Comprehensive community support services, per diem	564,340	$240	$133.2M
M0150	N/A	101,300	$160	$16.3M
H2014	Skills training and development, per 15 minutes	272,290	$50	$13.9M
M0152	N/A	56,110	$180	$9.8M
M0123	N/A	112,750	$80	$8.6M
M0167	N/A	35,380	$160	$5.7M
M0122	N/A	76,140	$70	$5.6M
T2020	Day habilitation, waiver; per diem	67,980	$80	$5.5M
M0116	N/A	250,650	$20	$5.3M
M0166	N/A	32,200	$150	$4.9M

Showing 1–10 of 42

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Texas Distribution

Daybreak Community Services Texas LLC — 24 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. Texas median

42 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	34	110	6,810	$200	$8.1M
H2016	Comprehensive community support services, per diem	1	430	5,020	$270	$5.6M
M0150	N/A	1	80	6,450	$160	$1.4M
H2014	Skills training and development, per 15 minutes	1	560	9,630	$80	$1.4M
M0151	N/A	1	10	6,170	$200	$1.4M
M0152	N/A	1	40	5,390	$170	$1.3M
T1016	Case management, each 15 minutes	14	20	940	$60	$1.2M
M0166	N/A	1	20	5,660	$150	$1.2M
M0149	N/A	1	10	5,440	$150	$1M
M0167	N/A	1	40	5,570	$150	$1M

Showing 1–10 of 42

Nearby Providers

Other providers in the same ZIP code as Daybreak Community Services Texas LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. Giles Living Centers, Inc.	TX	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$64.2M
Pediatric Services Of America, LLC	TX	Nursing Care Agency	$0	$11.4M
Heart To Heart Hospice Of Fort Worth, LLC	TX	Community Based Hospice Care Agency	$0	$11.3M
Todd Young	TX	Urology Physician	$1.3M	$0
Molly Warthan	TX	Dermatology Physician	$823.4K	$0
David Rittenhouse	TX	Urology Physician	$772.6K	$0
Michael Boothby	TX	Sports Medicine (Orthopaedic Surgery) Physician	$632.8K	$0
Michael Waters	TX	Urology Physician	$589.1K	$0
Diego Marra	TX	MOHS-Micrographic Surgery Physician	$544K	$0
James Kelley	TX	Urology Physician	$461K	$0

Daybreak Community Services Texas LLC — Billing Profile & Reimbursement Data

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Daybreak Community Services Texas LLC — 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