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

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

Commonwealth Of Massachusets (NPI 1528281532)

Field	Value
Entity Type	Organization
Organization	Commonwealth Of Massachusets
Address	One Federal Street
City	Springfield
State	MA
ZIP	01105
Taxonomy	Case Management Agency
NPI Enumerated	April 10, 2007

Payer Source	Total Paid
Medicaid	$465.2M
Medicare	$0

Key Findings

This provider effectively operates as a Medicaid-only billing entity: there is no Medicare billing on file and its lifetime Medicaid revenue totals $465.2M. With an NPI enumerated on 2007-04-10 (~19 years ago), the organization appears to be a long-standing participant in Massachusetts’ Medicaid waiver and community services network rather than a dual-payer provider.

Revenue is highly concentrated in a small set of waiver and habilitation services: the top 3 Medicaid codes by revenue account for 87.5% of the provider's total Medicaid revenue, and a single code, T2016, represents $356.2M or 76.6% of that Medicaid book. That concentration indicates the business is largely driven by residential habilitation/waiver per-diem services rather than a broad mix of outpatient medical billing.

The service mix implied by the dominant codes points to an operation focused on long-term supports and community-based services: T2016 (Habilitation, residential, waiver; per diem) is the primary revenue engine, while H2015 (Comprehensive community support services, per 15 minutes), T2023 (Targeted case management; per month), and H2023 (Supported employment, per 15 minutes) show complementary investments in case management, community supports, and employment services. This pattern is consistent with a provider that delivers waiver-funded residential care plus bundled community support programs and supported employment for individuals with disabilities.

S5100 (Day care services, adult; per 15 minutes) is a clear statewide strength and statistical outlier for this provider: 112.6K claims produced $31.2M in revenue at an average $277 paid/claim and the code ranks #3 of 189 providers in-state (99th percentile; extreme outlier). That scale in adult day care suggests the organization has either large program capacity or broad enrollment relative to peers, representing a differentiated service line beyond its residential habilitation core.

Several ancillary service lines show above-typical statewide standings that reinforce operational breadth: T2023 (Targeted case management) generated $18.7M from 55.3K claims and ranks #4 of 70 providers (96th percentile; notably above typical), while T2003 (Non-emergency transportation; encounter/trip) produced $9.4M from 361.8K claims and ranks #5 of 245 providers (98th percentile; notably above typical). These patterns indicate the provider not only operates residential and day services but also controls substantial case management and transportation volumes that support its client population.

Not all high-revenue codes indicate statewide dominance: T2016, despite comprising $356.2M in revenue, ranks #8 of 25 providers in-state (71th percentile; typical, unremarkable volume for this code), and H2015 ($19.9M, 51.7K claims) ranks #24 of 147 providers (84th percentile; typical, unremarkable). In other words, the provider’s outsized Medicaid revenue is driven more by the absolute size of its T2016 program than by consistent top-of-market rank across all habilitation and community support codes.

The claim-level economics reflect the service model: T2016 shows 38K claims at $9386 avg paid/claim (per-diem residential payments), S5100 shows high-frequency short-interval billing with 112.6K claims at $277 avg paid/claim, and T2003 shows large trip volumes with 361.8K claims at $26 avg paid/claim. These payment and utilization profiles are consistent with a model that mixes high-cost per-diem residential care with high-volume, lower-unit services (day care and transportation) that support the same client populations.

From a competitive and operational-risk perspective, the provider’s reliance on a single dominant revenue source (T2016 at 76.6% of Medicaid revenue) creates sensitivity to policy, rate, or waiver eligibility changes affecting residential habilitation. At the same time, the provider’s extreme outlier position in S5100 and high percentiles in T2023 and T2003 point to meaningful scale in adult day services, case management, and transportation that could provide diversification and negotiating leverage within the Massachusetts Medicaid market.

Medicaid: Complete Services Breakdown

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	37,960	$9,390	$356.2M
S5100	Day care services, adult; per 15 minutes	112,590	$280	$31.2M
H2015	Comprehensive community support services, per 15 minutes	51,690	$380	$19.9M
T2023	Targeted case management; per month	55,310	$340	$18.7M
H2023	Supported employment, per 15 minutes	53,550	$250	$13.2M
T2003	Non-emergency transportation; encounter/trip	361,760	$30	$9.4M
T2021	Day habilitation, waiver; per 15 minutes	17,070	$320	$5.5M
T2019	Habilitation, supported employment, waiver; per 15 minutes	41,450	$130	$5.3M
S5125	Attendant care services; per 15 minutes	12,540	$380	$4.8M
T1005	Respite care services, up to 15 minutes	5,550	$170	$933.1K

Showing 1–10 of 11

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

Commonwealth Of Massachusets — 4 of 11 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	8	30	29,930	$10,070	$358.9M
T2023	Targeted case management; per month	4	70	8,210	$510	$8.6M
H2023	Supported employment, per 15 minutes	4	20	28,450	$190	$5.6M
H2015	Comprehensive community support services, per 15 minutes	24	150	7,770	$140	$4.8M
S5125	Attendant care services; per 15 minutes	11	40	3,390	$300	$4.7M
T2021	Day habilitation, waiver; per 15 minutes	15	20	20,590	$210	$4.5M
S5100	Day care services, adult; per 15 minutes	3	190	2,000	$230	$3.1M
T2019	Habilitation, supported employment, waiver; per 15 minutes	4	20	24,690	$120	$3.1M
T2003	Non-emergency transportation; encounter/trip	5	250	40,490	$30	$2.2M
H0038	Self‑help/peer services, per 15 minutes	26	40	4,420	$80	$471.4K

Showing 1–10 of 11

Nearby Providers

Other providers in the same ZIP code as Commonwealth Of Massachusets, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Habit Opco, LLC	MA	Methadone Clinic	$11M	$224.1M
Mental Health Association, Inc.	MA	Community/Behavioral Health Agency	$0	$18.8M
Depatment Of Mental Health	MA	Case Management Agency	$0	$14.2M
Colony Care Senior Living, Inc.	MA	Home Health Agency	$0	$12.1M
Western Mass Home Health Services Inc	MA	Home Health Agency	$0	$7.6M
Mitchell Clionsky	MA	Clinical Neuropsychologist	$294.4K	$0
Colleen Calvanese	MA	Physical Therapist	$120.5K	$0
Nicolas Cal	MA	Gastroenterology Physician	$91.1K	$11.4K
Ibelis Buzzetta	MA	Clinical Psychologist	$21.7K	$0

Commonwealth Of Massachusets — 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