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

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

Optimae Lifeservices, Inc (NPI 1508955485)

Field	Value
Entity Type	Organization
Organization	Optimae Lifeservices, Inc
Address	301 W Burlington Ave
City	Fairfield
State	IA
ZIP	52556
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	October 11, 2006

Payer Source	Total Paid
Medicaid	$111.5M
Medicare	$0

Key Findings

OPTIMAE LIFESERVICES, INC is effectively a single-payer Medicaid provider: Total Medicare revenue is none (no Medicare billing on file) while total Medicaid revenue equals $111.5M, indicating its operations and revenue base are almost entirely Medicaid-driven rather than split across Medicare and Medicaid. This concentration has material implications for payer negotiations and program reliance.

Revenue is highly concentrated in a very small set of codes: the top 3 Medicaid codes by revenue account for 93.5% of this provider's total Medicaid revenue, with H2016 contributing $54.2M revenue (48.6% of this provider's total Medicaid revenue), S5136 contributing $43M revenue (38.6% of this provider's total Medicaid revenue), and H2015 contributing $7M revenue (6.3% of this provider's total Medicaid revenue). That level of concentration signals that changes in payment policy or utilization for just these codes would disproportionately affect overall revenue.

The code mix points to community-based behavioral health and long-term supports as the core business: large volumes of H2016 (comprehensive community support services, per diem), H2015 (comprehensive community support services, per 15 minutes), and S5136 (companion care, adult; per diem) indicate the provider delivers ongoing community support, companion/adl assistance, and time-based therapy or support services rather than episodic medical procedures. Smaller but present codes such as H2025, T2020, and T2021 further indicate day habilitation and employment-support services are part of their service portfolio.

OPTIMAE is a significant statewide competitor on its two largest codes: H2016 ranks #7 of 176 providers in-state (97th percentile; notably above typical state volume for this code) and S5136 ranks #5 of 82 providers in-state (95th percentile; notably above typical state volume for this code). These rankings position the provider as a major player in Iowa for per-diem community support and companion care services.

H2015 is a statistical standout: it records 112.9K claims with $62 avg paid/claim and $7M revenue (6.3% of this provider's total Medicaid revenue) and ranks #2 of 95 providers in-state (99th percentile; extreme outlier, far above typical state volume for this code). The extreme outlier label for H2015 suggests unusually intensive use of the per-15-minute billing modality relative to peers, which has operational and audit-focus implications.

Other service lines are present but materially smaller or mixed in prominence: H2025 ($3.3M, 3.0% of Medicaid revenue) ranks #6 of 65 (92th percentile; typical, unremarkable volume), T2020 ($2.7M, 2.4%) ranks #27 of 101 (74th percentile; typical), and T2021 ($1.1M, 1.0%) ranks #8 of 103 (93th percentile; notably above typical state volume for this code). These entries indicate meaningful but secondary contributions from employment supports and day habilitation, with T2021 showing elevated state-level presence relative to peers.

Lower-revenue codes such as S5150 (1.8K claims, $136.1K revenue, 0.1% of Medicaid revenue; rank #23 of 41, 45th percentile) and H0036 (129 claims, $9.5K revenue, 0.0% of Medicaid revenue; rank #3 of 3, 0th percentile) appear in the mix but represent marginal revenue lines and typical or unremarkable volumes in-state. These small-line services are unlikely to be material revenue drivers but can reflect breadth of offered community supports.

The organization has been enumerated for a long time (NPI enumerated 2006-10-11 (~20 years ago)), indicating an established operational presence in the state Medicaid market; combined with the high rankings on core codes, this tenure suggests entrenched delivery capacity in community/behavioral health services rather than a new market entrant.

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2016	Comprehensive community support services, per diem	198,380	$270	$54.2M
S5136	Companion care, adult (e.g., iadl/adl); per diem	178,470	$240	$43M
H2015	Comprehensive community support services, per 15 minutes	112,870	$60	$7M
H2025	Ongoing support to maintain employment, per 15 minutes	14,700	$220	$3.3M
T2020	Day habilitation, waiver; per diem	32,710	$80	$2.7M
T2021	Day habilitation, waiver; per 15 minutes	24,830	$50	$1.1M
S5150	Unskilled respite care, not hospice; per 15 minutes	1,820	$80	$136.1K
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	130	$70	$9.5K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Iowa Distribution

Optimae Lifeservices, Inc — 3 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Iowa

Full comparison — all codes billed, vs. Iowa median

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5136	Companion care, adult (e.g., iadl/adl); per diem	5	80	9,410	$490	$17.9M
H2016	Comprehensive community support services, per diem	7	180	10,790	$390	$15.2M
T2020	Day habilitation, waiver; per diem	27	100	10,960	$110	$3M
H2025	Ongoing support to maintain employment, per 15 minutes	6	70	2,970	$300	$1.9M
H2015	Comprehensive community support services, per 15 minutes	2	100	4,130	$160	$1.9M
S5150	Unskilled respite care, not hospice; per 15 minutes	23	40	2,200	$240	$1.6M
T2021	Day habilitation, waiver; per 15 minutes	8	100	2,780	$60	$386.9K
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	3	10	150	$100	$17.6K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rescare, Inc	IA	Community/Behavioral Health Agency	$0	$170.8M
Optimae Lifeservices Inc	IA	Community/Behavioral Health Agency	$0	$40.4M
Jefferson County Hospital	IA	Rural Health Clinic/Center	$0	$15.5M
Optimae Lifeservices, Inc,	IA	Community/Behavioral Health Agency	$0	$9.5M
Jefferson County Hospital	IA	Critical Access Hospital	$0	$3.9M
Fairfield C.s.d.	IA	Local Education Agency (LEA)	$0	$2.2M
Nurse In The House Inc.	IA	Home Health Agency	$0	$1.3M
Mason Ellis	IA	Physical Therapist	$92.7K	$0
Summit Pharmacy Of Iowa, Inc	IA	Community/Retail Pharmacy	$75.1K	$2.3K

Optimae Lifeservices, Inc — Billing Profile & Reimbursement Data

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Optimae Lifeservices, 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