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

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

The Lilypad, LLC (NPI 1447557335)

Field	Value
Entity Type	Organization
Organization	The Lilypad, LLC
Address	2010 W Rosten Ave
City	Nampa
State	ID
ZIP	83686
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	February 11, 2011

Payer Source	Total Paid
Medicaid	$8.3M
Medicare	$0

Key Findings

THE LILYPAD, LLC is effectively a single-payer Medicaid provider: it reports $8.3M in lifetime Medicaid revenue and has no Medicare billing on file. Its NPI was enumerated on 2011-02-11 (~15 years ago), indicating roughly a decade and a half of enrollment and operational tenure in the state.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 90.6% of this provider's total Medicaid revenue. Those top contributors are H0004 ($5.4M, 64.5%), H2019 ($1.6M, 19.8%), and 96152 ($518.1K, 6.2%), signalling a narrow set of code drivers for overall income.

The code mix points to an intensive, unit-based behavioral health and developmental support operation: H0004 (behavioral health counseling and therapy, per 15 minutes) and H2019 (therapeutic behavioral services, per 15 minutes) together dominate revenue and imply frequent, short-interval therapy sessions typical of community-based day training and behavioral support. 96152 has no description available on file, but its position as the third-largest revenue source suggests an important ancillary clinical or assessment role within the provider's service mix.

Competitive positioning on core codes is strong in-state: H0004 ranks #7 of 157 providers in Idaho (96th percentile; notably above typical state volume) and H2019 ranks #4 of 60 providers (95th percentile; notably above typical state volume). These ranks indicate THE LILYPAD is a major regional provider for high-volume Medicaid behavioral health units relative to peers.

The provider also shows niche leadership on specific lower-revenue codes: T2024 (Service assessment/plan of care development, waiver) ranks #1 of 15 providers in-state (100th percentile; notably above typical state volume) despite contributing $18.9K (0.2% of Medicaid revenue), and T1027 (family training and counseling for child development) ranks #6 of 44 (88th percentile) with $136.7K (1.6%). These rankings suggest operational strengths in waiver plan development and family training beyond the primary therapy codes.

Operational scale is driven by volume and short-unit billing: H0004 has 50.5K claims at $106 avg paid/claim and H2019 has 19.4K claims at $85 avg paid/claim, while 96152 shows 6.2K claims at $84 avg paid/claim. The combination of very high claim counts and per-15-minute unit codes underscores a care model built around frequent, brief encounters rather than low-frequency, high-dollar procedures.

The concentration of revenue in a few Medicaid codes creates exposure to policy or rate changes affecting those specific service lines: with 90.6% of Medicaid revenue tied to the top three codes and no Medicare offset, payment or coverage shifts for H0004 or H2019 would disproportionately affect the provider's financial profile. This payer and code concentration elevates sensitivity to state Medicaid policy, rate-setting, and utilization-management actions.

Taken together, THE LILYPAD presents as a substantial, Medicaid-focused day-training and behavioral-service operator in Idaho: $8.3M in Medicaid revenue paired with top-decile ranks on its primary therapy codes indicate a solid in-state footprint concentrated on frequent behavioral health and developmental support services, with limited diversification across other payers or unrelated service lines.

Medicaid: Complete Services Breakdown

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0004	Behavioral health counseling and therapy, per 15 minutes	50,480	$110	$5.4M
H2019	Therapeutic behavioral services, per 15 minutes	19,380	$90	$1.6M
96152	N/A	6,170	$80	$518.1K
G9002	Coordinated care fee, maintenance rate	13,420	$20	$308.8K
T1027	Family training and counseling for child development, per 15 minutes	4,140	$30	$136.7K
H2015	Comprehensive community support services, per 15 minutes	2,390	$50	$129.1K
H0032	Mental health service plan development by non-physician	850	$120	$97.8K
G9007	Coordinated care fee, scheduled team conference	670	$70	$43.4K
99368	A nonphysician qualified health care professional joins a medical team in a meeting to discuss a treatment plan for a patient who requires attention from more than one medical specialty.	990	$40	$36.4K
T2024	Service assessment/plan of care development, waiver	1,580	$10	$18.9K

Showing 1–10 of 11

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Idaho Distribution

The Lilypad, LLC — 2 of 11 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. Idaho median

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0004	Behavioral health counseling and therapy, per 15 minutes	7	160	4,020	$140	$1.6M
G9002	Coordinated care fee, maintenance rate	19	40	11,630	$40	$913.2K
H2019	Therapeutic behavioral services, per 15 minutes	4	60	2,960	$120	$609.8K
96152	N/A	20	70	2,270	$80	$608.8K
H2015	Comprehensive community support services, per 15 minutes	28	50	2,960	$100	$570.3K
G9007	Coordinated care fee, scheduled team conference	21	30	1,140	$110	$294K
T1027	Family training and counseling for child development, per 15 minutes	6	40	1,050	$40	$66.8K
T2024	Service assessment/plan of care development, waiver	1	20	270	$120	$42.3K
H0032	Mental health service plan development by non-physician	19	110	150	$70	$37.3K
99368	A nonphysician qualified health care professional joins a medical team in a meeting to discuss a treatment plan for a patient who requires attention from more than one medical specialty.	3	10	130	$30	$25.7K

Showing 1–10 of 11

Nearby Providers

Other providers in the same ZIP code as The Lilypad, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
A&r Case Management	ID	Case Management Agency	$0	$18.1M
High Valley Developmental	ID	Developmentally Disabled Services Day Training Agency	$0	$15.5M
Nampa School District #131	ID	Local Education Agency (LEA)	$0	$15.2M
Witco, Inc.	ID	Developmentally Disabled Services Day Training Agency	$0	$8.3M
Allegiant Health LLC	ID	In Home Supportive Care Agency	$0	$6.9M
Vics Family Pharmacy Inc	ID	Pharmacy	$28.2K	$4.9M
Children's Dentistry Of Idaho, PLLC	ID	Pediatric Dentistry	$0	$3.9M
Idaho Dental Aid PLLC	ID	Dentist	$0	$3.6M
All For One, LLC	ID	Case Management Agency	$0	$2.5M
Another Choice Virtual Charter School, Inc	ID	Local Education Agency (LEA)	$0	$2.3M

The Lilypad, LLC — Billing Profile & Reimbursement Data

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The Lilypad, 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