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

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

Restoring Hope, LLC (NPI 1558528463)

Field	Value
Entity Type	Organization
Organization	Restoring Hope, LLC
Address	306 Davis Dr Ste 200
City	West Plains
State	MO
ZIP	65775
Taxonomy	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NPI Enumerated	May 19, 2008

Payer Source	Total Paid
Medicaid	$73M
Medicare	$0

Key Findings

RESTORING HOPE, LLC is effectively a Medicaid-focused provider with no Medicare billing on file and $73M in lifetime Medicaid revenue; this makes its operating footprint overwhelmingly concentrated in state Medicaid programs rather than a mixed Medicare/Medicaid delivery model.

Revenue concentration is extreme: the precomputed top 3 Medicaid codes account for 100.0% of the provider's Medicaid revenue, with S5136 representing $63.8M (87.4%), T2021 $8.1M (11.1%), and T1002 $1M (1.4%). This indicates a very narrow set of billable services that drive nearly all cash flow from Medicaid.

The code mix and descriptions indicate the facility operates primarily as a community-based residential habilitation and support operation: S5136 (companion care, adult; per diem) dominates, while T2021 (day habilitation, waiver; per 15 minutes) and T1002 (RN services, up to 15 minutes) suggest bundled daily companion supports with associated day-program habilitation and nursing oversight. Together these codes are consistent with an intellectual/developmental disabilities residential and habilitation service line rather than acute medical or procedure-based care.

On competitive standing for its largest code, S5136 the provider ranks #2 of 14 in-state and sits in the 92th percentile, characterized as notably above typical state volume for this code; this places RESTORING HOPE as a leading statewide provider of companion care per diem services. By contrast, its T2021 activity (32.8K claims, $248 avg paid/claim) ranks #54 of 167 (68th percentile) and is described as typical/unremarkable volume, indicating a middling position in day habilitation capacity.

T1002 nursing services (10.8K claims, $95 avg paid/claim) accounts for only $1M (1.4%) of Medicaid revenue but ranks #17 of 195 in-state (92th percentile) and is also labeled typical/unremarkable volume; this suggests that while nursing is a consistent billed component, it is not a major revenue driver relative to companion care.

Operational implications: heavy reliance on per-diem companion care (S5136: 255.3K claims, $250 avg paid/claim) creates sensitivity to reimbursement rate changes or policy shifts affecting per-diem waiver services, and expansion or contraction in day habilitation demand would meaningfully alter the provider's revenue mix given T2021's 11.1% share.

Tenure and stability: the NPI was enumerated on 2008-05-19 (~18 years ago), indicating long-standing participation in Medicaid programs which may reflect established referral relationships and operational experience in the state waiver and residential care ecosystem.

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5136	Companion care, adult (e.g., iadl/adl); per diem	255,270	$250	$63.8M
T2021	Day habilitation, waiver; per 15 minutes	32,780	$250	$8.1M
T1002	Rn services, up to 15 minutes	10,850	$100	$1M
T2041	Supports brokerage, self-directed, waiver; per 15 minutes	1,260	$20	$21.4K
T2003	Non-emergency transportation; encounter/trip	140	$60	$8.6K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Missouri Distribution

Restoring Hope, LLC — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. Missouri median

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5136	Companion care, adult (e.g., iadl/adl); per diem	2	10	18,080	$240	$15.9M
T2021	Day habilitation, waiver; per 15 minutes	54	170	18,890	$180	$5.4M
T2003	Non-emergency transportation; encounter/trip	23	20	2,300	$20	$1.3M
T1002	Rn services, up to 15 minutes	17	200	1,720	$50	$194.4K
T2041	Supports brokerage, self-directed, waiver; per 15 minutes	7	10	1,400	$30	$66.7K

Nearby Providers

Other providers in the same ZIP code as Restoring Hope, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ozarks Medical Center	MO	General Acute Care Hospital	$0	$35.8M
Calstar Air Medical Services LLC	MO	Air Ambulance	$5M	$23.6M
Ozark Independent Living	MO	Personal Care Attendant	$0	$27.6M
Newton's Group Home Of West Plains -isl	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$23.5M
Ozarks Medical Center	MO	Adult Mental Health Clinic/Center	$0	$18.5M
Cal-ore Life Flight LLC	MO	Air Ambulance	$3.6M	$14.1M
Perfect Partners, LLC	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$13.4M
Lets Go Inc	MO	Community/Behavioral Health Agency	$0	$9.8M
Howell County Sheltered Workshop Board	MO	Case Management Agency	$0	$6.5M
South Howell County Ambulance District	MO	Land Ambulance	$657.9K	$4.6M

Restoring Hope, LLC — Billing Profile & Reimbursement Data

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Restoring Hope, LLC — 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