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

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

Autumn Springs Assisted Living (NPI 1528199395)

Field	Value
Entity Type	Organization
Organization	Autumn Springs Assisted Living
Address	3758 Avenue B
City	Billings
State	MT
ZIP	59102
Taxonomy	Assisted Living Facility
NPI Enumerated	March 7, 2007

Payer Source	Total Paid
Medicaid	$8.2M
Medicare	$0

Key Findings

This provider is effectively a single-payer Medicaid operation: Total Medicare revenue is none (no Medicare billing on file) while total Medicaid revenue is $8.2M, so all reported legacy revenue comes from Medicaid-funded services. Analysts should treat Medicare-related comparisons as inapplicable when evaluating this entity’s billing footprint.

Revenue is highly concentrated in a single service line: the precomputed top 3 Medicaid codes by revenue account for 100.0% of this provider’s total Medicaid revenue, indicating near-total dependence on a very small set of Medicaid billing categories. That concentration means changes in Medicaid coverage or rate-setting for those codes would have an outsized impact on the provider’s topline.

The dominant Medicaid code is T2031 (Assisted living; waiver, per diem): it accounts for $8.2M in revenue from 3.5K claims with a $2370 avg paid/claim, and represents 100.0% of the provider’s Medicaid revenue. This profile is consistent with a facility delivering waiver-based per-diem assisted living services rather than episodic medical procedures, emphasizing residential and custodial supports billed to Medicaid waivers.

Operational implications from the T2031 mix: routinely billing T2031 at $2370 avg paid/claim and 3.5K claims signals a steady caseload of waiver-funded residents and a business model centered on long-stay, per-diem reimbursement. Staffing, facility capacity, and payer authorization processes are likely the primary operational levers for revenue management rather than procedure throughput or acute-care referrals.

Competitive standing within Montana for the T2031 code is notable but not anomalous: the provider ranks #4 of 42 in-state (93th percentile) for this code, which places it among the larger billers in the state. At the same time, the dataset labels its volume as “typical, unremarkable volume for this code,” suggesting that high rank reflects the commonality of this service line statewide rather than unusually aggressive billing patterns.

Tenure and market presence are established: the NPI was enumerated on 2007-03-07 (~19 years ago), indicating a long-standing participation in Medicaid programs and likely sustained relationships with waiver administrators and case managers. That longevity can support continuity of census and payer enrollment flows, but it also means historical practice patterns may be entrenched.

From a risk and strategic perspective, the provider’s complete dependence on T2031 means payer mix shifts, waiver policy changes, or rate adjustments for assisted living per-diems would materially affect revenue stability. Given $8.2M in Medicaid revenue tied to 3.5K claims at a $2370 avg paid/claim, analysts reviewing network contracting or rate negotiations should prioritize monitoring T2031 policy developments and utilization trends for this entity.

Medicaid: Complete Services Breakdown

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

1 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2031	Assisted living; waiver, per diem	3,480	$2,370	$8.2M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Montana Distribution

Autumn Springs Assisted Living — 0 of 1 code billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. Montana median

1 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2031	Assisted living; waiver, per diem	4	40	690	$1,470	$2.1M

Nearby Providers

Other providers in the same ZIP code as Autumn Springs Assisted Living, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Youth Dynamics, Inc.	MT	Mental Illness Community Based Residential Treatment Facility	$0	$65.4M
New Day, Inc.	MT	Mental Illness Community Based Residential Treatment Facility	$0	$27.7M
Youth Dynamics, Inc.	MT	Professional Counselor	$0	$24.6M
Resource, Support, & Development, Inc.	MT	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$21.3M
Brittany Curl	MT	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$17.5M
Rimrock Pediatric Dentistry	MT	Pediatric Dentistry	$0	$15.2M
Bridges Of Montana	MT	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$12.7M
The Childrens Clinic Of Billings, PC	MT	Pediatrics Physician	$0	$10.9M
Community Option Resource Enterprises, Inc.	MT	Developmentally Disabled Services Day Training Agency	$0	$9.8M
Ryan K. Larsen Dmd & Associates	MT	Dental Anesthesiology	$0	$8.3M

Autumn Springs Assisted Living — Billing Profile & Reimbursement Data

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Autumn Springs Assisted Living — 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