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

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

Employment Solutions Inc (NPI 1447392923)

Field	Value
Entity Type	Organization
Organization	Employment Solutions Inc
Address	1084 Whipple Ct
City	Lexington
State	KY
ZIP	40511
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	February 13, 2007

Payer Source	Total Paid
Medicaid	$62.6M
Medicare	$0

Key Findings

EMPLOYMENT SOLUTIONS INC is effectively a single-payer provider: there is no Medicare billing on file while total Medicaid revenue is $62.6M. This payer mix means the organization’s financial performance and operational decisions appear to be driven almost exclusively by Medicaid policy and reimbursement trends.

The provider has long-tenure in federal enrollment, with an NPI enumerated on 2007-02-13 (~19 years ago), indicating sustained participation in public programs and an established footprint in its service market. That longevity supports its ability to accumulate the large claim volumes reported below.

Revenue is highly concentrated: the precomputed top three Medicaid codes (T2016, T2021, H0004) together account for 87.3% of this provider’s Medicaid revenue. Individually those codes are T2016 ($35.8M, 57.2% of Medicaid revenue), T2021 ($13.4M, 21.3%), and H0004 ($5.5M, 8.7%), signaling heavy dependence on a small set of service lines.

Code mix and descriptions indicate the operation is primarily centered on habilitation and waiver services: T2016 (residential habilitation, waiver; per diem) and T2021 (day habilitation, waiver; per 15 minutes) are the dominant revenue drivers, while H0004 (behavioral health counseling and therapy, per 15 minutes) supplies a behavioral-health counseling component. This combination is consistent with a Developmentally Disabled Services Day Training Agency model that delivers both residential/day habilitation and associated behavioral therapy.

Competitive standing in-state is strong for the top habilitation codes: T2021 ranks #1 of 150 providers in Kentucky (100th percentile) and is labelled an extreme outlier, while T2016 ranks #5 of 146 (97th percentile) and is described as notably above typical state volume. H0004 also ranks highly at #10 of 175 (95th percentile), so the provider is a major, above-typical participant in the services that generate most of its revenue.

Utilization patterns show very large volumes: T2016 has 215.9K claims and T2021 has 193.6K claims, with H0004 accounting for 41.4K claims. The combination of very high claim counts and per-diem/per-15-minute billing units suggests operations structured around sustained day- and residential-level service delivery rather than episodic acute care.

The provider shows some service diversification beyond its top three codes but at much smaller scale: 97535 ($5.2M, 8.4% of Medicaid revenue) ranks #29 of 305 (91th percentile) and is described as typical/unremarkable, while T1019 ($2.6M, 4.1%) and T1005 ($159.2K, 0.3%) have more modest volumes and lower percentiles (T1019 rank #29 of 51, 44th percentile; T1005 rank #56 of 81, 31th percentile). These secondary lines provide therapy and personal-care elements but do not materially change the firm’s Medicaid concentration profile.

Operational and reimbursement risk is concentrated: because 87.3% of Medicaid revenue derives from three codes and there is no Medicare exposure, any changes to waiver rules, per-diem or per-15-minute rates, or state-level authorization for T2016/T2021/H0004 could materially affect cash flow. From a payer or policy review perspective, monitoring state waiver policy and utilization authorizations for these specific codes should be a priority when assessing this provider.

Medicaid: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	215,880	$170	$35.8M
T2021	Day habilitation, waiver; per 15 minutes	193,560	$70	$13.4M
H0004	Behavioral health counseling and therapy, per 15 minutes	41,440	$130	$5.5M
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	32,790	$160	$5.2M
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…	11,480	$220	$2.6M
T1005	Respite care services, up to 15 minutes	1,000	$160	$159.2K
E1399	Durable medical equipment, miscellaneous	20	$270	$4.9K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Employment Solutions Inc — 2 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	5	150	42,680	$190	$11.3M
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…	29	50	13,600	$140	$11.1M
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	29	310	830	$120	$3.7M
H0004	Behavioral health counseling and therapy, per 15 minutes	10	180	1,320	$220	$1.9M
T2021	Day habilitation, waiver; per 15 minutes	1	150	16,130	$70	$1.7M
E1399	Durable medical equipment, miscellaneous	19	30	170	$600	$996.7K
T1005	Respite care services, up to 15 minutes	56	80	2,880	$70	$799.2K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bhg Xxxv, LLC	KY	Substance Use Disorder Rehabilitation Clinic/Center	$268.7K	$14.4M
Impactlex, LLC	KY	Developmentally Disabled Services Day Training Agency	$0	$12.9M
New Vista Behavioral Healthcare Inc.	KY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$12.3M
Lexar Laboratories & Analysis LLC	KY	Clinical Medical Laboratory	$328.7K	$11.6M
Crossroads Counseling Services, Inc.	KY	Mental Health Counselor	$0	$3.3M
Mercy Ambulance Of Evansville Inc	KY	Ambulance	$494.1K	$2.1M
Peter Roumanos	KY	Physical Medicine & Rehabilitation Physician	$394.1K	$0
Kelly Huynh	KY	Optometrist	$29.1K	$0
Namrata Donthamsetti	KY	Optometrist	$10.5K	$0
Timothy Ainger	KY	Clinical Neuropsychologist	$9.6K	$0

Employment Solutions Inc — Billing Profile & Reimbursement Data

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Employment Solutions 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