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

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

Commonwealth Of Massachusetts (NPI 1609099910)

Field	Value
Entity Type	Organization
Organization	Commonwealth Of Massachusetts
Address	49 Nursery Lane
City	Fitchburg
State	MA
ZIP	01420
Taxonomy	Case Management Agency
NPI Enumerated	April 11, 2007

Payer Source	Total Paid
Medicaid	$352.1M
Medicare	$0

Key Findings

This entity is effectively a Medicaid-focused provider: it reports none (no Medicare billing on file) and $352.1M in lifetime Medicaid revenue, indicating near-exclusive reliance on state Medicaid reimbursement rather than Medicare. Analysts should treat payer mix as single-payer for strategic comparisons.

Revenue is highly concentrated in a small set of Medicaid services: the top three codes—T2016, S5100, and T2023—account for 92.4% of this provider’s Medicaid revenue. Individually those codes contribute $277M (78.7%), $32.4M (9.2%), and $15.9M (4.5%) respectively, underscoring that a very large share of dollars is tied to a narrow set of program lines.

The code mix signals operations centered on long-term habilitation and community supports: T2016 (Habilitation, residential, waiver; per diem) as the dominant line suggests a large residential waiver footprint, S5100 (Day care services, adult; per 15 minutes) reflects substantial adult day services capacity, and T2023 (Targeted case management; per month) documents a material case-management business line. These service types together indicate a behavioral health/developmental-disability support model rather than acute medical care.

Competitive standing varies by service line within the state. For T2016 the provider ranks #12 of 25 providers in-state (54th percentile; typical, unremarkable volume for this code), indicating it is not a statewide leader in residential habilitation; by contrast S5100 ranks #6 of 189 providers in-state (97th percentile; notably above typical state volume), and T2023 ranks #6 of 70 providers in-state (93th percentile; notably above typical state volume), showing a comparatively strong competitive position in adult day services and targeted case management.

Several secondary community-support codes further diversify the service mix but remain small contributors to revenue: H2023 (Supported employment) generates $10.3M (2.9%) and ranks #5 of 23 providers in-state (82th percentile; typical, unremarkable), while H2015 (Comprehensive community support services) adds $9.3M (2.6%) and ranks #26 of 147 providers in-state (83th percentile; typical, unremarkable). These lines reinforce a comprehensive community-based services platform beyond the dominant residential payments.

High claim volumes underline operational scale in specific programs: the file shows 31.5K claims for T2016, 93.4K claims for S5100, and 46.8K claims for T2023, indicating substantial throughput in residential, day services, and case management respectively. Such volumes suggest significant staffing and site capacity tied to these core Medicaid programs.

The extreme dependence on a single code for dollars—T2016 at $277M (78.7% of Medicaid revenue)—creates material sensitivity to reimbursement changes, waiver policy decisions, or enrollment shifts tied to that program. From a payer-analytics perspective, contract negotiations or policy changes affecting residential habilitation rates or eligibility could disproportionately affect this provider’s revenue.

This provider has an established market presence, with its NPI enumerated on 2007-04-11 (~19 years ago), which supports interpretation of its footprint as long-standing rather than a recent entrant; combined with concentrated Medicaid scale, this suggests entrenched operational relationships with state waiver and day-service systems.

Medicaid: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	31,480	$8,800	$277M
S5100	Day care services, adult; per 15 minutes	93,430	$350	$32.4M
T2023	Targeted case management; per month	46,830	$340	$15.9M
H2023	Supported employment, per 15 minutes	37,200	$280	$10.3M
H2015	Comprehensive community support services, per 15 minutes	50,060	$190	$9.3M
T2003	Non-emergency transportation; encounter/trip	96,800	$30	$2.6M
T2019	Habilitation, supported employment, waiver; per 15 minutes	24,530	$90	$2.2M
T2021	Day habilitation, waiver; per 15 minutes	6,170	$260	$1.6M
S5125	Attendant care services; per 15 minutes	1,800	$400	$721.4K
T1005	Respite care services, up to 15 minutes	1,460	$110	$157.8K

Showing 1–10 of 13

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

Commonwealth Of Massachusetts — 1 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	12	30	29,930	$10,070	$358.9M
T2023	Targeted case management; per month	6	70	8,210	$510	$8.6M
H2023	Supported employment, per 15 minutes	5	20	28,450	$190	$5.6M
H2015	Comprehensive community support services, per 15 minutes	26	150	7,770	$140	$4.8M
S5125	Attendant care services; per 15 minutes	26	40	3,390	$300	$4.7M
T2021	Day habilitation, waiver; per 15 minutes	22	20	20,590	$210	$4.5M
S5100	Day care services, adult; per 15 minutes	6	190	2,000	$230	$3.1M
T2019	Habilitation, supported employment, waiver; per 15 minutes	13	20	24,690	$120	$3.1M
T2003	Non-emergency transportation; encounter/trip	72	250	40,490	$30	$2.2M
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	72	70	2,890	$90	$1.4M

Showing 1–10 of 13

Nearby Providers

Other providers in the same ZIP code as Commonwealth Of Massachusetts, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Health Connections, Inc.	MA	Federally Qualified Health Center (FQHC)	$0	$31.7M
The Arc Of Opportunity In No. Central Mass., Inc.	MA	Foster Care Agency	$0	$14.6M
Department Of Mental Health	MA	Case Management Agency	$0	$9.9M
Active Life Health Care Management, LLC	MA	Adult Day Care Clinic/Center	$0	$8.4M
Arc Community Services, Inc.	MA	Developmentally Disabled Services Day Training Agency	$0	$8.2M
Luk Crisis Center Inc.	MA	Community/Behavioral Health Agency	$0	$7.5M
Ick -assurance Home Health Care. Inc.	MA	Home Health Agency	$0	$6.7M
Hannah Yamin	MA	Hematology & Oncology Physician	$1.1M	$0
Umass Memorial Mri & Imaging Center, LLC	MA	Mobile Radiology Clinic/Center	$394.2K	$297.6K
Omar Qureshi	MA	Interventional Pain Medicine Physician	$406.5K	$242.1K

Commonwealth Of Massachusetts — Billing Profile & Reimbursement Data

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Commonwealth Of Massachusetts — 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