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

Why is the Medicaid comparison limited to Colorado 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. Colorado (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 Resource Exchange Inc. (NPI 1568093359)

Field	Value
Entity Type	Organization
Organization	The Resource Exchange Inc.
Address	6385 Corporate Dr Ste 301
City	Colorado Springs
State	CO
ZIP	80919
Taxonomy	Case Management Agency
NPI Enumerated	January 30, 2020

Payer Source	Total Paid
Medicaid	$40M
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 $40M, indicating the organization's scale and revenue base are concentrated entirely in Medicaid programs. The NPI was enumerated on 2020-01-30 (~6 years ago), so the entity has been active under this identifier for several years but shows no Medicare participation in available records.

Revenue concentration is extreme: the precomputed top 3 Medicaid codes by revenue account for 100.0% of this provider's total Medicaid revenue, with T2023 alone generating $31.3M (78.3% of Medicaid revenue). This means the provider's financial performance depends heavily on a small set of recurring case-management services rather than a diversified procedure mix.

T2023 patterns indicate a high-volume monthly case-management model: T2023 (Targeted case management; per month) shows 284.5K claims at an $110 avg paid/claim totaling $31.3M and ranks #1 of 38 providers in-state (100th percentile; extreme outlier, far above typical state volume for this code). Such concentrated monthly billing is consistent with a large caseload or centralized administration of targeted case management services across many beneficiaries.

T2024 and T1017 further define the service mix as waiver and time-based case management: T2024 (Service assessment/plan of care development, waiver) has 70.8K claims at a $79 avg paid/claim for $5.6M and ranks #1 of 68 providers in-state (100th percentile; extreme outlier), while T1017 (Targeted case management, each 15 minutes) has 118.2K claims at a $26 avg paid/claim for $3.1M and ranks #2 of 309 providers in-state (100th percentile; extreme outlier). Together these codes show the organization performs both monthly bundled case management and detailed time-based interactions, suggesting operational emphasis on both recurring oversight and documented minute-level service delivery.

Competitive standing in-state is dominant for its primary services: the provider ranks #1 for both T2023 and T2024 and #2 for T1017, each at the 100th percentile and labeled an extreme outlier, which positions it as a major provider of targeted case management and waiver planning in Colorado relative to peers. For payers and network planners, this profile identifies a key statewide vendor for these specific case-management lines rather than a broad multi-service competitor.

The presence of T1016 with 1.4K claims but $0 avg paid/claim and $0 revenue is notable: while this code (Case management, each 15 minutes) appears in the activity log, it contributes 0.0% of Medicaid revenue and ranks #16 of 24 providers in-state (35th percentile; typical, unremarkable volume for this code). This suggests either that T1016 activity is not a revenue driver for this entity or that the code is being recorded in contexts that do not generate direct Medicaid payments in the available data.

From a service-line implication perspective, the code mix (T2023, T2024, T1017) aligns tightly with a Case Management Agency model focused on targeted case management, waiver plan development, and time-based client contact. The heavy reliance on recurring monthly and per-15-minute billing practices implies operational systems designed for high-volume, repetitive case-management workflows and documentation rather than episodic clinical procedures.

For payers evaluating risk exposure and contracting, the provider’s Medicaid-only revenue footprint and the fact that top three codes constitute 100.0% of Medicaid revenue mean any changes to reimbursement policy or authorization for T2023/T2024/T1017 could materially affect the provider’s revenue. The provider’s extreme outlier status in multiple codes signals that it is a critical counterparty for Medicaid case-management capacity in Colorado Springs and likely a focal point for statewide network planning for these services.

Medicaid: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2023	Targeted case management; per month	284,530	$110	$31.3M
T2024	Service assessment/plan of care development, waiver	70,830	$80	$5.6M
T1017	Targeted case management, each 15 minutes	118,170	$30	$3.1M
T1016	Case management, each 15 minutes	1,350	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

The Resource Exchange Inc. — 3 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2023	Targeted case management; per month	1	40	6,060	$130	$3.9M
T1017	Targeted case management, each 15 minutes	2	310	640	$80	$494.3K
T2024	Service assessment/plan of care development, waiver	1	70	880	$90	$455.1K
T1016	Case management, each 15 minutes	16	20	3,070	$40	$296.9K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Centennial State Lab, LLC	CO	Clinical Medical Laboratory	$1.4M	$33.1M
Mosaic	CO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$23.7M
The Resource Exchange Inc	CO	Developmentally Disabled Services Day Training Agency	$0	$18.4M
Simply Kids Dental	CO	Pediatric Dentistry	$0	$14.5M
Apria Healthcare LLC	CO	Durable Medical Equipment & Medical Supplies	$0	$7.3M
Alpine Autism Center	CO	Specialist	$0	$6.2M
Colorado Springs Imaging LLC	CO	Diagnostic Radiology Physician	$337.4K	$5.3M
A Rise Above Home Care	CO	Case Manager/Care Coordinator	$0	$3.7M
Ascent Surgery Center, LLC	CO	Ambulatory Surgical Clinic/Center	$411.2K	$0
Kimberly Wagner	CO	Neurology Physician	$353.4K	$0

The Resource Exchange Inc. — Billing Profile & Reimbursement Data

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The Resource Exchange 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