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

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

Tbi Residential And Community Services, Inc. (NPI 1518560580)

Field	Value
Entity Type	Organization
Organization	Tbi Residential And Community Services, Inc.
Address	2016 W Superior St
City	Duluth
State	MN
ZIP	55806
Taxonomy	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NPI Enumerated	November 20, 2020

Payer Source	Total Paid
Medicaid	$51.6M
Medicare	$0

Key Findings

This entity is effectively a single-payer Medicaid provider: there is no Medicare billing on file and total Medicaid revenue is $51.6M, indicating the organization’s entire billed footprint in the dataset is Medicaid-funded. The absence of Medicare activity suggests its operations and reimbursement dependencies are concentrated on state Medicaid programs rather than dual-payer clinical billing.

Medicaid revenue is highly concentrated: the precomputed top-3 Medicaid codes account for 100.0% of the provider’s Medicaid revenue, with a single code, S5140, representing the lion’s share at $50.5M or 97.9% of total Medicaid revenue. This concentration implies material business risk tied to reimbursement or utilization changes affecting that code.

The top revenue-driving codes define the service model: S5140 (Foster care, adult; per diem) dominance combined with a secondary line of H2019 (Therapeutic behavioral services, per 15 minutes) is consistent with a residential foster-care operation providing ongoing, per-diem adult residency plus billed behavioral treatment sessions. These code types and the provider taxonomy (Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility) align with a facility focused on long-term residential supports and adjunctive behavioral therapies.

S5140 operational profile: the provider reported 173.1K S5140 claims at a $292 avg paid/claim totaling $50.5M in revenue, and it ranks #18 of 59 providers in-state (71th percentile; typical, unremarkable volume for this code). While the rank signals the provider is not among the very highest-volume in-state S5140 billers, the absolute dollars show S5140 is the dominant revenue driver for this organization.

H2019 operational profile: the provider reported 42.5K H2019 claims at a $26 avg paid/claim totaling $1.1M in revenue, and it ranks #3 of 49 providers in-state (96th percentile; notably above typical state volume for this code). This high percentile position indicates the provider is a significant regional supplier of billed therapeutic behavioral services relative to peers, despite H2019 comprising a small share (2.1%) of total Medicaid revenue.

Competitive standing is mixed: for the core per-diem residential code S5140 the provider is a modest participant statewide (mid-table rank and labeled “typical, unremarkable”), whereas for behavioral therapy billing (H2019) it is a leading in-state performer (top-3 ranking and labeled “notably above typical”). Together these patterns suggest dominance in a specialty service line within a broadly residential-care business model.

Tenure and market implications: the NPI was enumerated on 2020-11-20 (~6 years ago), indicating a relatively recent enrollment period followed by rapid Medicaid revenue accumulation concentrated in residential per-diem services. Given the concentrated Medicaid exposure and the strong H2019 position, analysts should monitor changes to state Medicaid policy or rate-setting for S5140 and utilization trends in behavioral services as primary drivers of future revenue risk and opportunity.

Medicaid: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5140	Foster care, adult; per diem	173,080	$290	$50.5M
H2019	Therapeutic behavioral services, per 15 minutes	42,480	$30	$1.1M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Minnesota Distribution

Tbi Residential And Community Services, Inc. — 1 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. Minnesota median

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5140	Foster care, adult; per diem	18	60	33,770	$300	$37.6M
H2019	Therapeutic behavioral services, per 15 minutes	3	50	5,850	$110	$1.2M

Nearby Providers

Other providers in the same ZIP code as Tbi Residential And Community Services, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Duluth Bethel Society, Inc.	MN	Substance Abuse Rehabilitation Facility	$0	$6M
Lorraine Turner	MN	Family Medicine Physician	$17.1K	$0

Tbi Residential And Community Services, Inc. — Billing Profile & Reimbursement Data

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Tbi Residential And Community Services, Inc. — Billing Profile & Reimbursement Data

Sign up for Tbi Residential And Community Services, Inc. — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References