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

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

Department Of Intellectual And Developmental Disabilities, State Of Tn (NPI 1447618061)

Field	Value
Entity Type	Organization
Organization	Department Of Intellectual And Developmental Disabilities, State Of Tn
Address	400 Deaderick St
City	Nashville
State	TN
ZIP	37243
Taxonomy	Public Health or Welfare Agency
NPI Enumerated	February 10, 2016

Payer Source	Total Paid
Medicaid	$147.5M
Medicare	$0

Key Findings

This provider is effectively single-payer: there is no Medicare billing on file and lifetime Medicaid revenue totals $147.5M, indicating that all reported public-program billing for this entity flows through Medicaid rather than Medicare. The absence of Medicare activity means analyses of payer mix and financial exposure should focus exclusively on Medicaid payment policies and waiver program dynamics in Tennessee.

Revenue is highly concentrated in a very small set of service lines: the precomputed top three Medicaid codes account for 95.3% of the provider's total Medicaid revenue. Those three codes are T1019 ($120.4M, 81.6% of Medicaid revenue), T2020 ($12.4M, 8.4%), and T2021 ($7.8M, 5.3%), so the provider’s financial profile depends overwhelmingly on these specific billing categories.

T1019 (personal care services, per 15 minutes) is the dominant revenue driver with 926.1K claims, a $130 avg paid/claim and $120.4M in revenue; this activity represents 81.6% of the provider's Medicaid revenue and the provider ranks #2 of 208 in-state, described as an extreme outlier and sitting at the 100th percentile. That positioning signals the provider is a major statewide executor of personal care services under the waiver/IDD-related benefit and operates at volumes far above typical state peers.

The mix of top codes indicates an operational focus on personal care and habilitation services for individuals with intellectual and developmental disabilities: T1019 (personal care), T2020 (day habilitation, per diem), and T2021 (day habilitation, per 15 minutes) together form the core service lines. Secondary codes such as T2019 (supported employment), T2033 (residential care, waiver), and T2002 (non-emergency transportation) show complementary waiver and support services consistent with a public health/welfare agency providing comprehensive IDD support rather than episodic clinical care.

Competitive standing varies by service line: for T1019 the provider is a statewide dominant outlier (rank #2 of 208, 100th percentile), while for T2021 the provider ranks #4 of 104 (97th percentile) indicating consistently high volume in day habilitation per-15-minute billing. In contrast, T2020 shows rank #3 of 3 (0th percentile) which reflects a small peer set and unremarkable per-provider volume for that specific per-diem billing category.

There is notable operational exposure from revenue concentration: because T1019, T2020, and T2021 account for 95.3% of Medicaid revenue, changes in reimbursement policy, eligibility, or utilization for these specific codes would materially affect the provider’s overall Medicaid revenue. Stakeholders should treat the provider’s financial stability as dependent on continued funding and utilization of personal care and day habilitation waiver services.

The provider has an established presence in the state market, with NPI enumeration dated 2016-02-10 (~10 years ago), suggesting multiple years of operating history under current program structures. That tenure combined with very high volumes on T1019 implies an operational scale and embedded role in Tennessee’s IDD waiver network rather than a recent entrant.

A range of ancillary services and smaller revenue lines are present but individually represent tiny shares of total revenue: examples include T2019 ($4.1M, 2.8%), T2033 ($985.2K, 0.7%), T2002 ($929.1K, 0.6%), and smaller claims for codes such as H2025, S9125, G0153, and a few dental codes. These lines reflect complementary residential, transportation, employment support, respite, and therapy services but do not materially diversify the provider’s revenue base away from the dominant personal-care and day-habilitation 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
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…	926,150	$130	$120.4M
T2020	Day habilitation, waiver; per diem	177,270	$70	$12.4M
T2021	Day habilitation, waiver; per 15 minutes	105,240	$70	$7.8M
T2019	Habilitation, supported employment, waiver; per 15 minutes	67,260	$60	$4.1M
T2033	Residential care, not otherwise specified (nos), waiver; per diem	24,030	$40	$985.2K
T2002	Non-emergency transportation; per diem	132,730	$10	$929.1K
H2025	Ongoing support to maintain employment, per 15 minutes	5,080	$60	$310K
S9125	Respite care, in the home, per diem	1,330	$200	$266.3K
T2025	Waiver services; not otherwise specified (nos)	1,300	$200	$260.9K
G0153	Services performed by a qualified speech‑language pathologist in the home health or hospice setting, each 15 minutes.	500	$100	$48.9K

Showing 1–10 of 13

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Department Of Intellectual And Developmental Disabilities, State Of Tn — 3 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2020	Day habilitation, waiver; per diem	3	10	540,460	$80	$69.8M
T2033	Residential care, not otherwise specified (nos), waiver; per diem	12	100	4,520	$320	$31.6M
H2025	Ongoing support to maintain employment, per 15 minutes	3	10	510	$90	$17.5M
T2025	Waiver services; not otherwise specified (nos)	7	20	1,030	$570	$13.3M
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…	2	210	10,880	$90	$3.7M
T2021	Day habilitation, waiver; per 15 minutes	4	100	3,920	$80	$3.4M
T2019	Habilitation, supported employment, waiver; per 15 minutes	2	20	1,770	$70	$1.1M
G0153	Services performed by a qualified speech‑language pathologist in the home health or hospice setting, each 15 minutes.	10	20	550	$100	$638.6K
D4341	Periodontal scaling and root planing - four or more teeth per quadrant	10	20	80	$340	$522.6K
S9125	Respite care, in the home, per diem	2	10	1,890	$210	$390.9K

Showing 1–10 of 13

Nearby Providers

Other providers in the same ZIP code as Department Of Intellectual And Developmental Disabilities, State Of Tn, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Department Of Intellectual And Developmental Disabilities, State Of Tn	TN	Public Health or Welfare Agency	$0	$2.6B
Department Of Intellectual And Developmental Disabilities, State Of Tn	TN	Public Health or Welfare Agency	$0	$1.5B
Tennessee Department Of Children's Services	TN	Public Health or Welfare Agency	$0	$780.6M
State Of Tennessee	TN	Clinical Medical Laboratory	$0	$2.4M

Department Of Intellectual And Developmental Disabilities, State Of Tn — 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