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

Why is the Medicaid comparison limited to New Mexico 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. New Mexico (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.

Ramah Care Services, Inc. (NPI 1497800106)

Field	Value
Entity Type	Organization
Organization	Ramah Care Services, Inc.
Address	2405 Fuhs Ave Bldg 7
City	Gallup
State	NM
ZIP	87301
Taxonomy	Assisted Living Facility
NPI Enumerated	January 24, 2007

Payer Source	Total Paid
Medicaid	$33.4M
Medicare	$0

Key Findings

This provider is effectively single-payer: RAMAH CARE SERVICES, INC. has no Medicare billing on file and reports $33.4M in lifetime Medicaid revenue, so its operations and financial exposure are concentrated in Medicaid-funded services. Any analysis of growth, risk, or reimbursement sensitivity should be framed primarily around Medicaid waiver programs and state-level policy changes.

The organization has been enumerated for a long time: NPI registered 2007-01-24 (~19 years ago), indicating an established presence in Gallup, NM. That tenure supports the interpretation that current billing patterns reflect an operational model that has been in place for many years rather than a recent shift.

Revenue is highly concentrated in a very small set of Medicaid codes: the top three Medicaid codes account for 95.7% of the provider's total Medicaid revenue. The dominant code is T2016 (75.7%, $25.3M), followed by T2031 (13.0%, $4.3M) and T2021 (7.0%, $2.3M), so most financial activity is compressed into a few waiver-related per-diem and habilitation lines.

The code mix aligns with an assisted-living/residential habilitation business model: T2016 (Habilitation, residential, waiver; per diem) and T2031 (Assisted living; waiver, per diem) together drive the majority of revenue, supplemented by T2021 (Day habilitation, waiver; per 15 minutes) and H2021 (Community-based wrap-around services, per 15 minutes). This pattern is consistent with an Assisted Living Facility taxonomy focused on waiver-funded residential placement and day habilitation services, suggesting the provider operates both long-term residential and day-program components.

Competitive standing is mixed by service line: for the largest driver T2016 the provider posts $25.3M in revenue and 67.3K claims but ranks #16 of 40 in-state, indicating substantial scale for the practice but a middle-tier statewide position on this specific code. In other words, T2016 is the firm’s dominant internal revenue source even though it is not a clear statewide leader for that line.

The provider holds relatively stronger statewide positions in assisted-living and day habilitation per-diem services: T2031 (13.9K claims, $312 avg paid/claim, $4.3M) ranks #4 of 20 in-state, indicating above-average strength in assisted living per-diem billing, while T2021 (18.2K claims, $128 avg paid/claim, $2.3M) ranks #13 of 52, showing an above-median but still typical presence in day habilitation. These ranks imply the provider competes well in assisted living waiver slots and has solid utilization for day habilitation compared with peers.

Claims and unit-rate dynamics underline how revenue is produced: T2016 generates 67.3K claims at $376 avg paid/claim and accounts for $25.3M in revenue, so a combination of high claim volume and a relatively higher per-diem rate drives aggregate dollars. By contrast, T2021 has a lower avg paid/claim ($128) but sizable claim volume (18.2K), and H2021 contributes $1.4M from 8.1K claims at $176 avg paid/claim; these differences show revenue is sensitive to both per-diem rates and utilization patterns across the waiver services.

The heavy dependence on Medicaid waivers and a very small number of codes (top 3 = 95.7% of Medicaid revenue) creates both operational leverage and concentration risk: payor or rate changes to T2016/T2031/T2021 reimbursement or waiver eligibility would materially affect revenue. Given the provider’s established tenure and stronger rank in assisted-living per-diem (T2031), strategic opportunities exist to expand or defend assisted-living capacity, but diversification outside Medicaid waiver per-diem and habilitation lines appears limited based on current billing.

Medicaid: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	67,340	$380	$25.3M
T2031	Assisted living; waiver, per diem	13,930	$310	$4.3M
T2021	Day habilitation, waiver; per 15 minutes	18,190	$130	$2.3M
H2021	Community-based wrap-around services, per 15 minutes	8,140	$180	$1.4M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Mexico Distribution

Ramah Care Services, Inc. — 0 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Mexico

Full comparison — all codes billed, vs. New Mexico median

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	16	40	54,080	$360	$22.1M
H2021	Community-based wrap-around services, per 15 minutes	26	60	6,750	$340	$4.4M
T2031	Assisted living; waiver, per diem	4	20	3,730	$310	$2.1M
T2021	Day habilitation, waiver; per 15 minutes	13	50	6,810	$120	$1.6M

Nearby Providers

Other providers in the same ZIP code as Ramah Care Services, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dhhs,phs,naihs, Gallup Indian Medical Center	NM	General Acute Care Hospital	$0	$32.6M
Rehoboth Mckinley Christian Health Care Services, Inc.	NM	Critical Access Hospital	$0	$31.9M
Red Rocks Dialysis, LLC	NM	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$17M
Native Resource Development Company Inc.	NM	In Home Supportive Care Agency	$0	$14.7M
Guardian Flight LLC	NM	Air Ambulance	$2.1M	$11M
Special Care At Home, Inc	NM	In Home Supportive Care Agency	$0	$11M
Tohatchi Area Of Opportunity & Services	NM	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$10.3M
Jjdac, LLC	NM	Land Ambulance	$544.5K	$9.6M
Rehoboth Mckinley Christian Health Care Services, Inc	NM	Rural Health Clinic/Center	$0	$9.9M
Zhon Home Care Corporation	NM	In Home Supportive Care Agency	$0	$8.7M

Ramah Care Services, Inc. — Billing Profile & Reimbursement Data

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Ramah Care Services, 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