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

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

Rww Outpatient Rehab Services, Inc. (NPI 1629409867)

Field	Value
Entity Type	Organization
Organization	Rww Outpatient Rehab Services, Inc.
Address	248 State St
City	Brewer
State	ME
ZIP	04412
Taxonomy	In Home Supportive Care Agency
NPI Enumerated	December 12, 2013

Payer Source	Total Paid
Medicaid	$36.5M
Medicare	$0

Key Findings

This provider is effectively a single‑payer Medicaid operator: there is no Medicare billing on file while total Medicaid revenue is $36.5M, indicating the organization’s revenue base is concentrated in Medicaid programs rather than Medicare. The NPI was enumerated 2013-12-12 (~13 years ago), so the provider has an established presence in the market.

Revenue concentration is high: the precomputed top three Medicaid codes (96165, T2016, 96153) account for 72.6% of this provider’s total Medicaid revenue. Those three codes alone are reported as $12M (96165, 32.8%), $9M (T2016, 24.7%), and $5.5M (96153, 15.0%), showing a heavy reliance on a small set of service lines for most revenue.

The code mix and taxonomy (In Home Supportive Care Agency) point to a service model focused on cognitive/behavioral habilitation and residential/waiver habilitation: 96165 and 96153 relate to group and individual cognitive/behavioral management, T2016 is a habilitation residential waiver per diem, and codes such as 97130, 97129, and G0515 represent one‑on‑one cognitive/therapeutic interventions. This combination suggests the provider operates frequent, ongoing therapeutic services often delivered in a residential or waiver setting.

Competitive standing is mixed across codes: 96165 ranks #1 of 5 providers in-state (100th percentile) but is described in the source as typical, unremarkable volume for the code, while 96153 also ranks #1 of 5 in-state (100th percentile) with a similar characterization. By contrast, 97129 ranks #1 of 6 in-state (100th percentile) and is explicitly labeled as notably above typical state volume, indicating that for some one‑on‑one therapy codes the provider is meaningfully above peers.

T2016 (habilitation, residential, waiver; per diem) is a material revenue driver at $9M and ranks #17 of 75 providers in-state (78th percentile), characterized as typical, unremarkable volume. The relatively high per‑claim average for T2016 ($452 avg paid/claim) combined with its per‑diem nature suggests residential day‑rate capacity that meaningfully contributes to revenue without making the provider the absolute top volumetric performer statewide for that code.

Operational intensity is evident from very large claim counts on time‑based codes: 96165 has 60.2K claims with $199 avg paid/claim, 96164 shows 60.4K claims at $35 avg paid/claim, and 97130 has 40.3K claims at $79 avg paid/claim. These high unit counts on 15‑ and 30‑minute units imply ongoing, frequent therapy sessions and group contacts rather than occasional episodic care, consistent with a home‑and‑community habilitation model.

Secondary revenue streams are meaningful but much smaller than the top three: 97130 ($3.2M, 8.7%), 96164 ($2.1M, 5.8%), T1016 ($1.9M, 5.2%), and G0515 ($1.7M, 4.6%) together form the mid‑tier of the Medicaid portfolio. These codes reflect case management, one‑on‑one cognitive skill development, and additional therapy modalities that diversify the provider’s Medicaid revenue beyond per‑diem habilitation and group behavioral services.

Given the provider’s ~13 years of enrollment and the concentrated revenue profile (72.6% from the top three codes), strategic sensitivity to changes in Medicaid policy or rate adjustments for 96165, T2016, and 96153 is high: shifts in billing rules, allowed units, or per‑diem rates for these specific codes would disproportionately affect the provider’s financial performance. Monitoring utilization trends and peer rank movement for those top codes will be critical for payers and analysts assessing contract risk or network capacity tied to this entity.

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
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…	60,160	$200	$12M
T2016	Habilitation, residential, waiver; per diem	19,930	$450	$9M
96153	N/A	25,270	$220	$5.5M
97130	The provider works directly one–on–one with the patient to help him improve cognitive functions such as thinking, remembering, reasoning, and problem solving and the ability to plan, organize, and…	40,280	$80	$3.2M
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…	60,440	$40	$2.1M
T1016	Case management, each 15 minutes	40,640	$50	$1.9M
G0515	Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes	16,590	$100	$1.7M
97129	The provider works directly one–on–one with the patient to help him improve cognitive functions such as thinking, remembering, reasoning, and problem solving and the ability to plan, organize, and…	39,790	$20	$756K
97537	In this procedure, the provider works one on one with a patient to provide community work reintegration training. The training helps the injured or ill patient to return to employment and the…	2,360	$140	$326K
96152	N/A	330	$60	$19.9K

Showing 1–10 of 13

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Maine Distribution

Rww Outpatient Rehab Services, Inc. — 6 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maine

Full comparison — all codes billed, vs. Maine median

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	17	80	7,300	$1,670	$30.8M
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…	1	10	22,450	$200	$5M
96153	N/A	1	10	4,960	$270	$2.8M
97130	The provider works directly one–on–one with the patient to help him improve cognitive functions such as thinking, remembering, reasoning, and problem solving and the ability to plan, organize, and…	1	10	21,520	$100	$2.2M
T1016	Case management, each 15 minutes	3	10	20,670	$40	$1.3M
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…	1	10	22,320	$40	$996K
G0515	Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes	1	10	4,070	$130	$965K
97129	The provider works directly one–on–one with the patient to help him improve cognitive functions such as thinking, remembering, reasoning, and problem solving and the ability to plan, organize, and…	1	10	9,230	$20	$345.3K
97537	In this procedure, the provider works one on one with a patient to provide community work reintegration training. The training helps the injured or ill patient to return to employment and the…	1	10	2,360	$140	$324.9K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	170	200	1,410	$30	$150.6K

Showing 1–10 of 13

Nearby Providers

Other providers in the same ZIP code as Rww Outpatient Rehab Services, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Penobscot Community Health Center	ME	Federally Qualified Health Center (FQHC)	$0	$24.6M
A&m Home Care Corp	ME	Personal Care Attendant	$0	$17.3M
Mainely Kids & Teens, LLC	ME	Pediatric Dentistry	$0	$9M
Manzo Corporation	ME	In Home Supportive Care Agency	$0	$8.5M
Higher Ground Services LLC	ME	Community/Behavioral Health Agency	$0	$5.7M
Total Renal Care Inc	ME	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.3M
Albert Adams	ME	Pediatrics Physician	$0	$1.1M
Autumn Of Life In Home Care	ME	In Home Supportive Care Agency	$0	$659.4K
A Time To Rise - Counseling & Wellness LLC	ME	Substance Use Disorder Rehabilitation Clinic/Center	$0	$556.6K
Gentle Hands Home Care	ME	Home Health Agency	$0	$382.3K

Rww Outpatient Rehab Services, Inc. — Billing Profile & Reimbursement Data

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Rww Outpatient Rehab Services, 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