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

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

Living Alternatives For The Developmentally Disabled, Inc. (NPI 1598000549)

Field	Value
Entity Type	Organization
Organization	Living Alternatives For The Developmentally Disabled, Inc.
Address	300 Whitney St
City	Dowagiac
State	MI
ZIP	49047
Taxonomy	Intellectual and/or Developmental Disabilities Residential Treatment Facility
NPI Enumerated	December 3, 2012

Payer Source	Total Paid
Medicaid	$135.4M
Medicare	$0

Key Findings

This provider is effectively a single‑payer Medicaid operator: there is no Medicare billing on file while lifetime Medicaid revenue totals $135.4M. The absence of Medicare activity indicates the entity’s services and reimbursement footprint are concentrated entirely in state Medicaid programs rather than fee‑for‑service Medicare lines.

A very large share of Medicaid revenue is concentrated in a small set of service types: the top three Medicaid codes account for 79.7% of this provider’s total Medicaid revenue. Those top three are H2015 ($58.6M, 43.3% of Medicaid revenue), H0043 ($35.4M, 26.2%), and T2027 ($13.8M, 10.2%), which together dominate billing and should drive management focus.

The code mix and descriptions point to a core operational model centered on community‑based supports and residential services: H2015 and H2016 are comprehensive community support services (per 15 minutes and per diem), H0043 is supported housing (per diem), and T2027 is specialized childcare under waiver programs (per 15 minutes). High claim counts for time‑based community supports (e.g., H2015 with 396.1K claims and T2027 with 121.1K claims) plus substantial per‑diem revenue in H0043 imply a blended operation providing both intensive hourly community habilitation and ongoing residential housing.

Competitive standing varies by service line within the state. For H2015 the provider ranks #16 of 614 (98th percentile; notably above typical state volume), marking it as a leading statewide provider of comprehensive community support services; T2027 ranks #4 of 39 (92th percentile; typical, unremarkable volume), reflecting strong placement among specialized childcare waiver providers; by contrast, H0043 ranks #59 of 130 (55th percentile; typical, unremarkable volume), indicating only a mid‑range statewide position in supported housing per diem.

Several secondary codes further illustrate the operating footprint and capacity. H2016 (53.3K claims, $249 avg paid/claim, $13.3M revenue; 9.8% of Medicaid revenue) and T1020 (53.3K claims, $242 avg paid/claim, $12.9M revenue; 9.5% of Medicaid revenue) each represent meaningful per‑diem/time‑based business lines and rank in higher percentiles in‑state (H2016 at 88th, T1020 at 87th), supporting the view that the provider delivers steady volumes of both community supports and personal care.

The distribution of per‑claim reimbursement highlights operational heterogeneity: H0043’s high average paid/claim ($2926) contrasts with lower unit values for time‑based community services (H2015 $148 avg paid/claim, T2027 $114 avg paid/claim). This mix of high‑value per‑diem housing payments and very high volumes of low‑unit community support encounters implies the organization must manage both occupancy and workforce/time intensity to sustain margins.

Revenue concentration in three codes (79.7% of Medicaid revenue) presents both risk and leverage: the provider is vulnerable to changes in policy, rate setting, or utilization patterns affecting H2015, H0043, or T2027, but its leading statewide position in H2015 and strong standing in T2027 provide negotiating and scaling advantages within those service lines. Strategic attention to diversifying payor mix or service mix could reduce concentration exposure.

The provider shows an established operational tenure: the NPI was enumerated on 2012-12-03 (~14 years ago), indicating a sustained presence in Michigan’s Medicaid market, and the cumulative Medicaid revenue of $135.4M reflects significant, long‑running engagement with state waiver and community support programs.

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
H2015	Comprehensive community support services, per 15 minutes	396,070	$150	$58.6M
H0043	Supported housing, per diem	12,110	$2,930	$35.4M
T2027	Specialized childcare, waiver; per 15 minutes	121,070	$110	$13.8M
H2016	Comprehensive community support services, per diem	53,310	$250	$13.3M
T1020	Personal care services, per diem, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	53,350	$240	$12.9M
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	470	$1,730	$805.4K
T1005	Respite care services, up to 15 minutes	5,430	$90	$499.9K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Michigan Distribution

Living Alternatives For The Developmentally Disabled, Inc. — 1 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	54	60	2,340	$70	$19.6M
H2016	Comprehensive community support services, per diem	38	300	6,660	$310	$8.7M
H2015	Comprehensive community support services, per 15 minutes	16	610	14,740	$90	$6M
T2027	Specialized childcare, waiver; per 15 minutes	4	40	23,640	$70	$4.8M
T1020	Personal care services, per diem, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	30	220	7,030	$170	$4.6M
H0043	Supported housing, per diem	59	130	10,330	$210	$4.5M
T1005	Respite care services, up to 15 minutes	51	110	4,910	$80	$2.2M

Nearby Providers

Other providers in the same ZIP code as Living Alternatives For The Developmentally Disabled, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pokagon Band Of Potawatomi Indians	MI	Federally Qualified Health Center (FQHC)	$0	$11.5M
Ascension Borgess Lee Hospital	MI	Critical Access Hospital	$0	$6.9M
Living Alternatives For The Developmentally Disabled, Inc.	MI	In Home Supportive Care Agency	$0	$5.7M
Michelle Cockey	MI	Family Nurse Practitioner	$11.5K	$0
Marcy Parisi	MI	Family Nurse Practitioner	$8.4K	$0

Living Alternatives For The Developmentally Disabled, Inc. — Billing Profile & Reimbursement Data

Sign up for Living Alternatives For The Developmentally Disabled, Inc. — Billing Profile & Reimbursement Data policy alerts

Living Alternatives For The Developmentally Disabled, Inc. — Billing Profile & Reimbursement Data

Sign up for Living Alternatives For The Developmentally Disabled, Inc. — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References