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

Why is the Medicaid comparison limited to South Carolina 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. South Carolina (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.

York County Board Of Disabilities And Special Needs (NPI 1437587243)

Field	Value
Entity Type	Organization
Organization	York County Board Of Disabilities And Special Needs
Address	7900 Park Place Rd
City	York
State	SC
ZIP	29745
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	October 15, 2013

Payer Source	Total Paid
Medicaid	$40.2M
Medicare	$0

Key Findings

This provider is effectively single-payer in its current footprint: Medicare revenue is listed as none (no Medicare billing on file) while total Medicaid revenue is $40.2M, indicating nearly all documented reimbursement flows through Medicaid programs. The absence of Medicare activity means analyses of competitiveness and revenue exposure should focus on Medicaid program and rate dynamics rather than dual-eligibility or Medicare-Medicaid interactions.

Medicaid revenue is highly concentrated: the precomputed top three Medicaid codes (T2016, T2020, T2014) account for 92.6% of the provider's total Medicaid revenue. Specifically, T2016 generates $31.2M (77.7% of Medicaid revenue), T2020 $3.8M (9.4%), and T2014 $2.2M (5.5%), so changes in reimbursement or utilization for these three per-diem habilitation codes would materially affect total revenue.

The code mix aligns with a residential and habilitation service model consistent with the provider taxonomy (Developmentally Disabled Services Day Training Agency): T2016 (Habilitation, residential, waiver; per diem) is the dominant revenue driver, supplemented by day habilitation (T2020) and prevocational habilitation (T2014). Large claim volumes with per-diem payment patterns (e.g., 129.1K claims for T2016 at $242 avg paid/claim) suggest ongoing program-based placements and regular, sustained service delivery rather than episodic clinical encounters.

State-level competitive standing for the largest code is relatively high but described as in-range: the provider ranks #7 of 52 for T2016 (88th percentile) and this usage is labeled as "typical, unremarkable volume" for that code. Similar patterns appear for T2020 (rank #6 of 40, 87th percentile; "typical, unremarkable volume") and T2014 (rank #12 of 34, 67th percentile; "typical, unremarkable volume"), indicating a sizeable in-state presence that is not characterized as anomalous or exceptionally outsized within the service category.

Operational intensity is visible in claims and unit economics: T2016 shows 129.1K claims with a $242 avg paid/claim, while T2020 and T2014 show 49.1K and 28.7K claims respectively with $77 avg paid/claim each. These figures reinforce a business model built on per-diem/day habilitation encounters and sustained client enrollment, implying staffing, facility, and program capacity geared toward long-term habilitation and day services.

Ancillary supports and care coordination appear as secondary revenue streams: T1017 (Targeted case management) contributes $1.3M (3.3% of Medicaid revenue) with 32.7K claims and ranks #9 of 57 in-state (86th percentile; "typical, unremarkable volume"). Additional smaller lines—H2026 (employment supports, $857K), T1005 (respite, $408.6K), and T1027 (family training, $185.5K)—indicate the provider offers a broader package of supports beyond core residential/day habilitation.

The provider has an established operational tenure: NPI enumerated 2013-10-15 (~13 years ago), suggesting multi-year engagement with state Medicaid systems and likely long-standing contractual relationships. Given the heavy concentration in a few Medicaid per-diem codes, this tenure supports operational experience but also implies revenue sensitivity to state policy, rate adjustments, or changes in waiver authorizations affecting those dominant codes.

From a risk/portfolio perspective for payers and network planners, the provider represents a focused habilitation/residential services supplier with most Medicaid dollars tied to a small set of per-diem codes. That concentration makes it an important in-state supplier for residential/day habilitation (noted by upper-percentile ranks) while also creating potential exposure if utilization patterns or per-diem payments for T2016/T2020/T2014 are altered.

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
T2016	Habilitation, residential, waiver; per diem	129,070	$240	$31.2M
T2020	Day habilitation, waiver; per diem	49,150	$80	$3.8M
T2014	Habilitation, prevocational, waiver; per diem	28,690	$80	$2.2M
T1017	Targeted case management, each 15 minutes	32,680	$40	$1.3M
H2026	Ongoing support to maintain employment, per diem	10,990	$80	$857K
T1005	Respite care services, up to 15 minutes	4,390	$90	$408.6K
T1027	Family training and counseling for child development, per 15 minutes	1,950	$100	$185.5K
T1016	Case management, each 15 minutes	1,180	$100	$117.6K
H2025	Ongoing support to maintain employment, per 15 minutes	1,260	$60	$72.8K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Carolina Distribution

York County Board Of Disabilities And Special Needs — 0 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

Full comparison — all codes billed, vs. South Carolina median

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	7	50	42,240	$250	$15.4M
T2014	Habilitation, prevocational, waiver; per diem	12	30	17,930	$70	$1.9M
T2020	Day habilitation, waiver; per diem	6	40	18,120	$70	$1.8M
T1017	Targeted case management, each 15 minutes	9	60	7,610	$50	$1.2M
H2026	Ongoing support to maintain employment, per diem	15	30	10,980	$70	$939.8K
T1005	Respite care services, up to 15 minutes	13	20	4,860	$90	$892.9K
T1027	Family training and counseling for child development, per 15 minutes	56	80	3,560	$100	$857.8K
T1016	Case management, each 15 minutes	75	100	4,210	$50	$614.8K
H2025	Ongoing support to maintain employment, per 15 minutes	16	20	2,240	$90	$241.7K

Nearby Providers

Other providers in the same ZIP code as York County Board Of Disabilities And Special Needs, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Piedmont Physician Network LLC	SC	Internal Medicine Physician	$0	$7.4M
York School District One	SC	Local Education Agency (LEA)	$0	$2.3M
Tri-county Pediatrics LLC	SC	Rural Health Clinic/Center	$0	$1.8M
York County Adult Day Care Services, Inc.	SC	Adult Day Care Clinic/Center	$0	$1.7M
Romin Shah	SC	Internal Medicine Physician	$78.9K	$0

York County Board Of Disabilities And Special Needs — Billing Profile & Reimbursement Data

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York County Board Of Disabilities And Special Needs — 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