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

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

Developmental Concepts, Inc. (NPI 1538205935)

Field	Value
Entity Type	Organization
Organization	Developmental Concepts, Inc.
Address	8100 W Emerald St
City	Boise
State	ID
ZIP	83704
Taxonomy	Developmental Disabilities Clinic/Center
NPI Enumerated	January 30, 2007

Payer Source	Total Paid
Medicaid	$13.2M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-only operation: Total Medicare revenue: none (no Medicare billing on file) while Total Medicaid revenue: $13.2M, indicating nearly all billed activity and reimbursement flow through state Medicaid programs rather than fee‑for‑service Medicare. The absence of any Medicare billing on file points to a payer mix concentrated exclusively in Medicaid.

Revenue is extremely concentrated in a single service line: the top 3 Medicaid codes together account for 97.2% of this provider's total Medicaid revenue, with H2022 alone representing $12M and 91.0% of Medicaid revenue. That dominance means a very large share of the provider’s financial performance is driven by one per‑diem community wrap‑around rate.

The code mix signals a focused developmental‑disabilities community support operation rather than a medical or acute care clinic: H2022 (Community-based wrap-around services, per diem), H2015 (Comprehensive community support services, per 15 minutes), and 97537 (community work reintegration training, per 15 minutes) together drive the bulk of billing, which aligns with delivery of day‑programs, habilitation, and community reintegration services for people with developmental disabilities. This suggests the provider’s business model centers on Medicaid-funded community supports.

Unit‑level economics reinforce why H2022 dominates revenue: H2022 shows 5.6K claims at $2141 avg paid/claim for $12M revenue, while the next two top codes are $231 avg paid/claim (H2015) and $21 avg paid/claim (97537) producing $541.2K and $280.2K respectively. The high average payment per H2022 claim, not higher claim counts alone, is the primary revenue driver for the organization.

Competitive standing within the state is modest rather than dominant: H2022 ranks #8 of 14 providers in-state (46th percentile) and is described as typical, unremarkable volume for this code, while H2015 ranks #29 of 45 (36th percentile) and 97537 ranks #28 of 41 (33rd percentile). Those mid‑to‑low percentiles indicate the provider is a regular but not leading participant in each of its top service lines statewide.

Secondary service lines contribute only small shares of revenue and generally low state rankings: for example H0004 (behavioral health counseling and therapy) generated $267.8K (2.0% of Medicaid revenue) and ranks #109 of 157 providers in-state (31st percentile), and H2032 produced $75.7K (0.6%) and ranks #38 of 41 (8th percentile). These figures show ancillary behavioral and activity therapy billing is present but not a major revenue source relative to peers.

The provider has long tenure in the NPI registry (NPI enumerated: 2007-01-30, ~19 years ago), which supports operational stability in state Medicaid networks; combined with the concentrated Medicaid revenue base, this longevity suggests an established Medicaid provider specializing in community developmental services.

High concentration into one Medicaid per‑diem code (H2022 at 91.0% of Medicaid revenue) creates exposure to reimbursement or policy changes affecting that line: given the provider’s reliance on H2022 for the bulk of revenue, any significant rate adjustments or eligibility/coverage changes for community‑based wrap‑around services could materially affect overall revenue. Monitoring H2022 utilization and state program policy is therefore salient for payers and analysts.

Medicaid: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2022	Community-based wrap-around services, per diem	5,590	$2,140	$12M
H2015	Comprehensive community support services, per 15 minutes	2,340	$230	$541.2K
97537	In this procedure, the provider works one on one with a patient to provide community work reintegration training. The training helps the injured or ill patient to return to employment and the…	13,340	$20	$280.2K
H0004	Behavioral health counseling and therapy, per 15 minutes	1,200	$220	$267.8K
H2032	Activity therapy, per 15 minutes	1,850	$40	$75.7K
G9002	Coordinated care fee, maintenance rate	430	$50	$20.5K
S5130	Homemaker service, nos; per 15 minutes	30	$20	$640

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Idaho Distribution

Developmental Concepts, Inc. — 0 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. Idaho median

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2022	Community-based wrap-around services, per diem	8	10	6,010	$820	$8.9M
H0004	Behavioral health counseling and therapy, per 15 minutes	109	160	4,020	$140	$1.6M
H2032	Activity therapy, per 15 minutes	38	40	19,190	$50	$1.6M
97537	In this procedure, the provider works one on one with a patient to provide community work reintegration training. The training helps the injured or ill patient to return to employment and the…	28	40	30,150	$20	$1.2M
G9002	Coordinated care fee, maintenance rate	34	40	11,630	$40	$913.2K
H2015	Comprehensive community support services, per 15 minutes	29	50	2,960	$100	$570.3K
S5130	Homemaker service, nos; per 15 minutes	76	80	12,220	$20	$537.5K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Full Circle Health, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$53.3M
Community Connections, Inc	ID	Case Management Agency	$0	$30M
K A Health Services LLC	ID	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$13.9M
County Of Ada	ID	Land Ambulance	$2M	$11.4M
Pathways Of Idaho, LLC	ID	Community/Behavioral Health Agency	$0	$12M
Havenwood Caregiver Services Of Idaho, LLC	ID	In Home Supportive Care Agency	$0	$10.7M
Living Independently Forever, Inc.	ID	Developmentally Disabled Services Day Training Agency	$0	$9.8M
Community Partnerships Of Idaho, Inc.	ID	Developmental Disabilities Clinic/Center	$0	$7.6M
All Horizons Inc	ID	Mental Health Counselor	$0	$6.7M
Ascent Behavioral Health Services	ID	Community/Behavioral Health Agency	$0	$4.7M

Developmental Concepts, Inc. — Billing Profile & Reimbursement Data

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Developmental Concepts, 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