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

Why is the Medicaid comparison limited to New Jersey 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. New Jersey (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.

Capitol Care, Inc. (NPI 1609117522)

Field	Value
Entity Type	Organization
Organization	Capitol Care, Inc.
Address	7 Waterloo Rd
City	Stanhope
State	NJ
ZIP	07874
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	March 4, 2013

Payer Source	Total Paid
Medicaid	$50.3M
Medicare	$0

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
H2016	Comprehensive community support services, per diem	129,590	$340	$44.1M
T2021	Day habilitation, waiver; per 15 minutes	50,650	$120	$5.9M
H0004	Behavioral health counseling and therapy, per 15 minutes	4,590	$40	$192.8K
H2021	Community-based wrap-around services, per 15 minutes	960	$150	$143.7K
T2015	Habilitation, prevocational, waiver; per hour	1,170	$30	$30.5K
A0090	Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest	150	$30	$3.9K
T2019	Habilitation, supported employment, waiver; per 15 minutes	70	$50	$3.3K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Jersey Distribution

Capitol Care, Inc. — 0 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Jersey

Full comparison — all codes billed, vs. New Jersey median

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2016	Comprehensive community support services, per diem	55	210	23,310	$490	$41.9M
T2021	Day habilitation, waiver; per 15 minutes	65	220	14,500	$170	$7.7M
H2021	Community-based wrap-around services, per 15 minutes	145	190	3,010	$260	$3.1M
T2019	Habilitation, supported employment, waiver; per 15 minutes	60	60	1,540	$110	$696.7K
T2015	Habilitation, prevocational, waiver; per hour	49	70	2,810	$100	$671.2K
H0004	Behavioral health counseling and therapy, per 15 minutes	20	60	1,570	$70	$253.4K
A0090	Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest	213	230	7,800	$10	$218.8K

Nearby Providers

Other providers in the same ZIP code as Capitol Care, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Center For Humanistic Change Of Nj, Inc.	NJ	Developmentally Disabled Services Day Training Agency	$0	$50.2M
Adriana Guido Rios	NJ	Family Medicine Physician	$36.9K	$0

Capitol Care, Inc. — Billing Profile & Reimbursement Data

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Capitol Care, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References