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

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

Sweetser (NPI 1487885976)

Field	Value
Entity Type	Organization
Organization	Sweetser
Address	50 Moody St
City	Saco
State	ME
ZIP	04072
Taxonomy	Mental Illness Community Based Residential Treatment Facility
NPI Enumerated	July 31, 2009

Payer Source	Total Paid
Medicaid	$98.1M
Medicare	$0

Key Findings

SWEETSER is a community-based residential treatment facility (taxonomy: Mental Illness Community Based Residential Treatment Facility) located in SACO, ME, with an NPI enumerated (registered) 2009-07-31 (~17 years ago); the tenure indicates it has been operating under this NPI for roughly 17 years. This longevity supports interpretation of its current billing profile as an established, site-based residential services provider rather than a new entrant.

The provider has no Medicare billing on file and reports $98.1M in lifetime Medicaid revenue, making it effectively a single-payer (Medicaid) operation based on available claims data. Analysts should treat Medicaid policy, rate changes, and waiver program rules as the primary levers that will affect SWEETSER’s top-line performance given the absence of Medicare receipts.

Medicaid revenue is highly concentrated: the top three Medicaid codes account for 100.0% of this provider's total Medicaid revenue, led by H0019 at 54.6% and T2016 at 43.6%, with S9484 contributing 1.8%. This concentration indicates that two per-diem residential habilitation codes drive nearly all reported Medicaid payments, leaving little diversification across other Medicaid service lines.

The mix of codes billed (H0019 — long-term residential, per diem; T2016 — habilitation, residential waiver, per diem) points to a business model centered on long-stay, per-diem residential care and waiver-funded habilitation services rather than episodic outpatient or clinician-based services. The predominance of per-diem billing suggests operations are organized around bed-based care and daily habilitation supports rather than time-limited therapy encounters.

Competitive standing varies by code: SWEETSER ranks #3 of 28 in-state for H0019 (93th percentile) which signals a leading position in long-term residential per-diem capacity, although the peer-data label for this code is "typical, unremarkable volume"; for T2016 it ranks #31 of 75 (59th percentile), a middle-tier presence consistent with the same "typical, unremarkable volume" label. For crisis-intervention S9484 it ranks #2 of 3 in-state (50th percentile) and again is described as typical, indicating a modest footprint in hourly crisis services among a very small peer set.

No Medicaid code in SWEETSER’s profile is flagged as an outlier in the provided plain-English labels; each top code is described as "typical, unremarkable volume" relative to state peers despite the high rank for H0019. Ancillary codes report negligible revenue — for example, 99510 shows 260 claims, $29 avg paid/claim, $7.5K revenue (0.0% of total) and ranks #1 of 1 in-state (0th percentile; no peer comparison available), while S9485 lists 832 claims with $0 revenue (0.0% of total) and ranks #2 of 2 (0th percentile) — both indicate minimal financial impact.

From an operational and contracting perspective, SWEETSER’s financial exposure is concentrated in Medicaid per-diem and waiver payments (H0019 and T2016). Any changes in state Medicaid per-diem rates, waiver program enrollment, or eligibility for residential habilitation could materially affect the provider’s revenue base because those two codes together represent the vast majority of reported Medicaid receipts.

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	119,470	$450	$53.5M
T2016	Habilitation, residential, waiver; per diem	11,540	$3,700	$42.7M
S9484	Crisis intervention mental health services, per hour	9,370	$190	$1.8M
99510	A licensed psychologist or social worker visits the patient in his home to provide counseling.	260	$30	$7.5K
S9485	Crisis intervention mental health services, per diem	830	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Maine Distribution

Sweetser — 0 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maine

Full comparison — all codes billed, vs. Maine median

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	31	80	7,300	$1,670	$30.8M
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	3	30	13,990	$560	$23.9M
S9484	Crisis intervention mental health services, per hour	2	10	9,370	$270	$6.9M
S9485	Crisis intervention mental health services, per diem	2	10	6,000	$160	$934.7K
99510	A licensed psychologist or social worker visits the patient in his home to provide counseling.	1	10	260	$30	$7.4K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Sweetser, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sweetser	ME	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$80.6M
Sweetser	ME	Community/Behavioral Health Agency	$0	$8.1M
Sweetser	ME	Substance Use Disorder Rehabilitation Clinic/Center	$0	$2.5M
Wendy Ray	ME	Clinical Social Worker	$3.5K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mainehealth Care At Home	ME	Home Health Agency	$0	$11.3M
Qaisi Homecare Inc	ME	In Home Supportive Care Agency	$0	$9.2M
Everest Recovery Centers - Maine	ME	Substance Use Disorder Rehabilitation Clinic/Center	$147K	$7.9M
Saco School Department	ME	Local Education Agency (LEA)	$0	$1.7M
Island Institute For Trauma Recovery LLC	ME	Community/Behavioral Health Agency	$0	$1.7M
City Of Saco	ME	Ambulance	$269.2K	$1.3M
Maine Medical Partners	ME	Pediatrics Physician	$0	$1.4M
Community Choice Behavioral Health, LLC.	ME	Community/Behavioral Health Agency	$0	$1.3M
Saco Bay Orthopaedic And Sports Physical Therapy, Inc.	ME	Rehabilitation Clinic/Center	$0	$1.3M
Maine Oral Surgery And Dental Implant Center	ME	Oral and Maxillofacial Surgery (Dentist)	$0	$921.8K

Sweetser — Billing Profile & Reimbursement Data

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Sweetser — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References