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

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

Dubuque Community School District (NPI 1598812141)

Field	Value
Entity Type	Organization
Organization	Dubuque Community School District
Address	2300 Chaney Road
City	Dubuque
State	IA
ZIP	52001
Taxonomy	Local Education Agency (LEA)
NPI Enumerated	January 5, 2007

Payer Source	Total Paid
Medicaid	$26.6M
Medicare	$0

Key Findings

DUBUQUE COMMUNITY SCHOOL DISTRICT is effectively a single-payer Medicaid billing entity: it has no Medicare billing on file and reports $26.6M in lifetime Medicaid revenue. The absence of Medicare activity means analyses should focus on Medicaid-dominated operations and competitive dynamics within Iowa.

Revenue is highly concentrated: the top three Medicaid codes (T1020, T1019, 96165) account for 67.3% of the provider's total Medicaid revenue. Those three codes individually generate $10.2M (T1020, 38.4%), $4.8M (T1019, 18.1%), and $2.9M (96165, 10.8%) respectively, indicating a small number of service lines drive the majority of dollars.

The code mix signals a school-based service model that emphasizes personal care and behavioral health: T1020 and T1019 are personal care service codes (per diem and per 15 minutes) with $10.2M and $4.8M in revenue and very large claim counts, while 96165 and several other 96xxx codes reflect high-volume psychologist-led group and individual counseling. Combined, these codes suggest the district bills extensively for in-school personal assistance and structured behavioral interventions.

Dubuque is a dominant statewide provider for several lines: T1019 ranks #1 of 49 providers in-state (100th percentile; extreme outlier) and T1020 ranks #2 of 53 (98th percentile; notably above typical state volume). Similarly, 96165 ranks #2 of 42 (98th percentile; extreme outlier) and 96153 ranks #3 of 33 (94th percentile; notably above typical state volume), marking the district as a major player in both personal care and behavioral health billing within Iowa.

Non-emergency transportation is another significant operating component: A0110 ($1.9M, 91.2K claims) and T2001 ($1.5M, 98.7K claims) both rank #1 in-state (A0110 #1 of 27, 100th percentile; T2001 #1 of 31, 100th percentile) and are labeled extreme outliers. This pattern indicates a large-scale transportation program—wheelchair/bus services and attendant escorts—that materially supports Medicaid revenue and student mobility services.

The district’s behavioral health footprint is broad and high-volume: in addition to 96165, codes such as 96153 ($2.5M, 42K claims), 96164 ($625.1K, 78.1K claims), and 96159 ($880.9K, 14.9K claims) show consistent, above-typical state volumes and strong rank positions. These multiple 96xxx entries imply both group-based and individualized psychological services are standard offerings rather than isolated or sporadic interventions.

Operational scale is evident from claim volumes: T1019 reports 126.6K claims and T2001 reports 98.7K claims, while 96165 and T1020 report 70.1K and 61.8K claims respectively. The combination of very high claim counts and concentrated revenue lines suggests the district operates programmatically (large caseloads, frequent short-interval services) rather than relying on a small number of high-priced procedures.

The provider is long-tenured in the NPI system—enumerated 2007-01-05 (~19 years ago)—which supports an interpretation of sustained program presence and likely established relationships with state Medicaid administration and local school-based service contracts. Longevity combined with the extreme-outlier billing patterns indicates institutionalized service lines rather than recent or transient program activity.

Medicaid: Complete Services Breakdown

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

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	61,810	$170	$10.2M
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…	126,640	$40	$4.8M
96165	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of the patients’ physical health…	70,100	$40	$2.9M
96153	N/A	42,010	$60	$2.5M
A0110	Non-emergency transportation and bus, intra or inter state carrier	91,190	$20	$1.9M
T2001	Non-emergency transportation; patient attendant/escort	98,690	$20	$1.5M
96159	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of a patient’s physical health…	14,930	$60	$880.9K
96152	N/A	12,500	$70	$825.1K
96164	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of the patients’ physical health…	78,140	$10	$625.1K
96158	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of a patient’s physical health…	20,740	$20	$331.9K

Showing 1–10 of 14

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Iowa Distribution

Dubuque Community School District — 6 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Iowa

Full comparison — all codes billed, vs. Iowa median

14 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	2	50	7,300	$210	$2.9M
96153	N/A	3	30	3,940	$90	$1.1M
96159	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of a patient’s physical health…	10	70	3,810	$130	$1.1M
96165	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of the patients’ physical health…	2	40	6,560	$80	$994.2K
96152	N/A	5	60	2,980	$140	$595.5K
A0110	Non-emergency transportation and bus, intra or inter state carrier	1	30	8,760	$30	$462.2K
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…	1	50	3,000	$60	$441.8K
A0130	Non-emergency transportation: wheelchair van	34	50	4,150	$40	$302.6K
T2001	Non-emergency transportation; patient attendant/escort	1	30	7,500	$20	$272.6K
96158	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of a patient’s physical health…	5	70	3,930	$20	$143.7K

Showing 1–10 of 14

Nearby Providers

Other providers in the same ZIP code as Dubuque Community School District, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hills And Dales Child Development Center	IA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$68.5M
Area Residential Care Inc.	IA	Intellectual Disabilities Intermediate Care Facility	$0	$32.8M
Hillcrest Family Services	IA	Child & Adolescent Psychiatry Physician	$0	$32.5M
Crescent Community Health Center	IA	Federally Qualified Health Center (FQHC)	$0	$29.5M
The Finley Hospital	IA	General Acute Care Hospital	$0	$14.1M
City Of Dubuque	IA	Land Ambulance	$690.9K	$8.9M
Hillcrest Family Services	IA	Social Worker	$0	$7.1M
Mercy Medical Center-dubuque	IA	General Acute Care Hospital	$0	$5.2M
Hills And Dales Child Development Center	IA	Intellectual Disabilities Intermediate Care Facility	$0	$4.7M
Dubuque Internal Medicine PC	IA	Internal Medicine Physician	$0	$3.9M

Dubuque Community School District — Billing Profile & Reimbursement Data

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Dubuque Community School District — 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