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

Why is the Medicaid comparison limited to North Carolina 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. North Carolina (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.

The Kids Workshop Inc (NPI 1558420018)

Field	Value
Entity Type	Organization
Organization	The Kids Workshop Inc
Address	The Kids Workshop Inc
City	Charlotte
State	NC
ZIP	28216
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	December 8, 2006

Payer Source	Total Paid
Medicaid	$70.9M
Medicare	$0

Key Findings

THE KIDS WORKSHOP INC is effectively a single-payer provider: there is no Medicare billing on file and its entire reported federal revenue runs through Medicaid, totaling $70.9M. This concentrated payer mix indicates the organization operates predominantly within Medicaid waiver and community-support funding streams rather than through Medicare fee-for-service.

Revenue is highly concentrated in a small set of Medicaid service lines: the precomputed top three Medicaid codes (H2016, T2021, T2013) account for 68.4% of the provider's total Medicaid revenue. Individually those codes generate $19.7M (H2016, 27.8%), $17.3M (T2021, 24.4%), and $11.5M (T2013, 16.3%) respectively, so most of the business is driven by a narrow set of habilitation and community-support services.

The code mix and payment units point to sustained, time-based service delivery: H2016 is billed per diem for comprehensive community support services, T2021 is day habilitation billed per 15 minutes, and T2013 is habilitation educational billed per hour. Together these suggest the provider runs high-volume day programs, continuous community-support services, and hour/segment-based habilitation services consistent with a Community/Behavioral Health Agency focused on developmental and long-duration supports.

Operational scale is large in claims volume for the top services: H2016 shows 102.5K claims, T2021 shows 121.8K claims, and T2013 shows 79.6K claims. Those high claim counts, combined with per-diem and per-15-minute billing structures, imply a sizable client-facing footprint with many recurring sessions or daily enrollments rather than predominantly one-off visits.

Competitive standing is strong for several core codes within North Carolina: H2016 ranks #7 of 65 providers and is in the 91th percentile (characterized as notably above typical state volume), T2021 ranks #8 of 199 providers in the 96th percentile (also notably above typical state volume), and H2015 ranks #7 of 251 providers in the 98th percentile (notably above typical state volume). At the same time, T2013 ranks #35 of 185 providers in the 82th percentile and is described as typical/unremarkable, indicating the provider is a leading player for some community-support and day habilitation services but not uniformly dominant across every habilitation code.

Several ancillary Medicaid codes also contribute meaningfully to revenue and underscore a broader service array: H2015 contributes $7.2M (10.1%), T2012 contributes $6.7M (9.5%), and S5150 contributes $4.2M (5.9%). The presence of both per-diem community support codes and respite/unskilled care (S5150) shows the organization bills across complementary service types common to waiver and ongoing-support models.

The provider has an established operating history, with its NPI enumerated on 2006-12-08 (~20 years ago), which supports the idea of long-term relationships with Medicaid payers and stability in delivering waiver-based services. This tenure, combined with high percentiles on multiple codes, suggests institutional scale and experience in the state's Medicaid ecosystem.

The concentration of revenue in a few time-based habilitation and community-support codes presents both leverage and exposure: specialization in H2016, T2021, and T2013 likely gives THE KIDS WORKSHOP bargaining relevance for those service lines within networks, but it also concentrates reimbursement risk if state waiver policies, per-unit rates, or utilization controls change for these specific codes. Monitoring payer policy and waiver adjustments for per-diem and per-15-minute habilitation services should be a priority for analysts assessing future revenue stability.

Medicaid: Complete Services Breakdown

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2016	Comprehensive community support services, per diem	102,490	$190	$19.7M
T2021	Day habilitation, waiver; per 15 minutes	121,800	$140	$17.3M
T2013	Habilitation, educational, waiver; per hour	79,580	$150	$11.5M
H2015	Comprehensive community support services, per 15 minutes	80,350	$90	$7.2M
T2012	Habilitation, educational; waiver, per diem	34,670	$190	$6.7M
S5150	Unskilled respite care, not hospice; per 15 minutes	44,200	$90	$4.2M
T2027	Specialized childcare, waiver; per 15 minutes	15,250	$120	$1.9M
H2025	Ongoing support to maintain employment, per 15 minutes	10,970	$120	$1.3M
H0045	Respite care services, not in the home, per diem	5,620	$150	$836.6K
T2020	Day habilitation, waiver; per diem	1,900	$160	$296.7K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Carolina Distribution

The Kids Workshop Inc — 3 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. North Carolina median

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2013	Habilitation, educational, waiver; per hour	35	190	29,090	$150	$9.1M
H2016	Comprehensive community support services, per diem	7	70	28,040	$220	$8.2M
T2020	Day habilitation, waiver; per diem	40	50	22,570	$180	$6.2M
T2012	Habilitation, educational; waiver, per diem	31	110	21,340	$180	$6.1M
T2021	Day habilitation, waiver; per 15 minutes	8	200	25,740	$130	$4.6M
T2027	Specialized childcare, waiver; per 15 minutes	2	10	4,050	$90	$2.5M
H2015	Comprehensive community support services, per 15 minutes	7	250	10,060	$130	$2.4M
H2025	Ongoing support to maintain employment, per 15 minutes	24	60	6,380	$120	$1.3M
H0045	Respite care services, not in the home, per diem	33	80	4,450	$100	$993.7K
S5150	Unskilled respite care, not hospice; per 15 minutes	8	170	4,310	$80	$958.4K

Nearby Providers

Other providers in the same ZIP code as The Kids Workshop Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kci Usa, Inc.	NC	Durable Medical Equipment & Medical Supplies	$0	$10.6M
Tom Judy	NC	Medical Physician Assistant	$128.8K	$0
Masood Khan	NC	Cardiovascular Disease Physician	$13.3K	$940

The Kids Workshop Inc — Billing Profile & Reimbursement Data

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The Kids Workshop 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