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.

Granite Bay Care, Inc (NPI 1518022763)

Field	Value
Entity Type	Organization
Organization	Granite Bay Care, Inc
Address	1037 Forest Ave
City	Portland
State	ME
ZIP	04103
Taxonomy	Intellectual and/or Developmental Disabilities Residential Treatment Facility
NPI Enumerated	December 27, 2006

Payer Source	Total Paid
Medicaid	$281.6M
Medicare	$0

Key Findings

This provider is effectively single-payer in its public reimbursement footprint: there is no Medicare billing on file while Medicaid lifetime revenue is reported at $281.6M, indicating the organization’s operations and scale are financed almost entirely through Medicaid. Analysts should treat Medicaid payment policy and state waiver rules as the primary financial levers for this entity.

Revenue is highly concentrated in a single service line: the top 3 Medicaid codes account for 100.0% of this provider's total Medicaid revenue, with T2016 alone representing 99.6% of Medicaid revenue. This concentration implies high financial sensitivity to changes in that code’s reimbursement, eligibility, or utilization controls.

The code mix and taxonomy point to a residential habilitation business model: T2016 (Habilitation, residential, waiver; per diem) as the dominant code indicates the provider operates as a census-driven residential habilitation/IDD treatment facility rather than an outpatient clinic. The per-diem nature of T2016 suggests revenue scales with daily census and length-of-stay rather than episodic visit volume.

Operational scale for the dominant code is large: T2016 shows 222.2K claims at a $1262 avg paid/claim for $280.4M in revenue, and the provider ranks #1 of 75 in-state (100th percentile; extreme outlier). That ranking and volume position the provider as the leading statewide participant for residential habilitation services reported under T2016.

Ancillary Medicaid services are minimal and not a meaningful diversification: G9012 (3.1K claims, $311 avg, $949.8K revenue) and H0004 (714 claims, $212 avg, $151.4K revenue) together comprise a trivial share of total Medicaid revenue (0.3% and 0.1% respectively) and rank at common state percentiles (#47/50 for G9012, 6th percentile; #156/290 for H0004, 46th percentile). These codes appear to represent supportive case management and therapy services rather than alternate revenue pillars.

An additional minor code, G9007, is present at very low volume (132 claims, $54 avg paid/claim, $7.1K revenue) and ranks #22 of 25 providers in-state (13th percentile); it contributes a de minimis portion of revenue but indicates occasional billing for scheduled team conferences. This pattern reinforces that the organization’s billing footprint is overwhelmingly centered on per-diem residential habilitation.

The provider has an established presence given its NPI enumeration date of 2006-12-27 (~20 years ago), which combined with its T2016 dominance suggests a long-tenured operational footprint in the state’s IDD residential market. For payers and network analysts, that tenure plus the provider’s extreme outlier status on T2016 implies both negotiation leverage for capacity-based services and systemic exposure to policy or rate changes affecting per-diem habilitation payments.

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	222,220	$1,260	$280.4M
G9012	Other specified case management service not elsewhere classified	3,050	$310	$949.8K
H0004	Behavioral health counseling and therapy, per 15 minutes	710	$210	$151.4K
G9007	Coordinated care fee, scheduled team conference	130	$50	$7.1K

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

Granite Bay Care, Inc — 1 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

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	1	80	7,300	$1,670	$30.8M
G9012	Other specified case management service not elsewhere classified	47	50	25,820	$80	$3M
H0004	Behavioral health counseling and therapy, per 15 minutes	156	290	860	$80	$805.1K
G9007	Coordinated care fee, scheduled team conference	22	30	950	$60	$258.2K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Spurwink Services	ME	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$112.7M
Cor Health Services LLC	ME	Home Health Agency	$0	$55.9M
Spurwink Services Incorporated	ME	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$52.9M
Casa, Inc.	ME	Adult Care Home Facility	$0	$50.1M
Gateway Community Services, LLC	ME	Community/Behavioral Health Agency	$0	$30.2M
Peregrine Corporation	ME	Case Management Agency	$0	$30M
Ubuntu Care	ME	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$27.3M
New England Integrated Living Support	ME	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$22.3M
Affinity	ME	Developmentally Disabled Services Day Training Agency	$0	$9.7M
Ocean Home Care LLC	ME	Personal Care Attendant	$0	$9M

Granite Bay Care, Inc — Billing Profile & Reimbursement Data

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Granite Bay Care, 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