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

Why is the Medicaid comparison limited to North Dakota 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. North Dakota (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.

Red River Human Services Foundation (NPI 1629677463)

Field	Value
Entity Type	Organization
Organization	Red River Human Services Foundation
Address	701 6th St S
City	Wahpeton
State	ND
ZIP	58075
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	October 22, 2020

Payer Source	Total Paid
Medicaid	$34.5M
Medicare	$0

Key Findings

RED RIVER HUMAN SERVICES FOUNDATION is effectively a Medicaid-focused Community/Behavioral Health Agency: it reports $34.5M in lifetime Medicaid revenue and has no Medicare billing on file. Its NPI was enumerated on 2020-10-22 (about 6 years ago), indicating a relatively recent enrollment window for Medicare/Medicaid reporting.

Revenue is highly concentrated in a small set of Medicaid codes: the precomputed top 3 codes account for 73.2% of the provider's total Medicaid revenue, led by T2016 ($14.6M, 42.4%), followed by T2021 ($6.5M, 18.8%) and W0725 ($4.1M, 12.0%). This concentration indicates a business model driven by a few high-revenue service lines rather than a broad portfolio of evenly distributed Medicaid billings.

The top codes with descriptions point to a habilitation-focused operation: T2016 (Habilitation, residential, waiver; per diem) and T2021 (Day habilitation, waiver; per 15 minutes) together make up the largest share of revenue and reflect a service mix centered on residential supports and day habilitation programs. High claim volumes for T2021 (40.2K claims, $161 avg paid/claim) and T2016 (8.2K claims, $1793 avg paid/claim) suggest routine, recurring delivery of day and residential habilitation services as core business activities.

Several W-prefixed codes lack public descriptions but exhibit material per-claim averages that shape revenue composition: W0725 averages $5327 paid/claim and contributes $4.1M (12.0%) to revenue, while other W codes such as W0260 ($3133 avg paid/claim) and W0200 ($1582 avg paid/claim) add notable high-dollar line items. The presence of both high-volume, low-unit-rate habilitation codes and lower-volume, high-unit-rate W codes indicates a mixed delivery model of frequent support services plus episodic or bundled high-cost services.

Competitive standing across core Medicaid codes is mixed rather than dominant. For the largest code T2016 the provider ranks #18 of 29 in-state (39th percentile), indicating a modest position for residential habilitation; for T2021 it ranks #10 of 26 (64th percentile), reflecting a mid-level presence in day habilitation; and for W0725 it ranks #17 of 25 (~33rd percentile), which is lower relative participation for that high-dollar code.

There is at least one clear in-state specialty where the provider outperforms peers: W0720 (no description available) shows a relatively strong statewide position at rank #2 of 11 providers (90th percentile) despite contributing a smaller absolute share ($603.2K, 1.7% of Medicaid revenue). This suggests the provider may occupy a niche or focused capability in that specific service line compared with other statewide providers.

Operational scale is characterized by a very large number of small-unit claims in day habilitation combined with substantial per-diem revenue from residential habilitation: T2021 accounts for 40.2K claims while T2016 accounts for 8.2K claims, showing the provider relies on both high-frequency minute-based billing and per-diem residential arrangements. This blend of claim volume and payment types has implications for staffing models, facility capacity, and cash-flow timing tied to day versus residential service delivery.

The absence of any Medicare billing (none on file) leaves the organization effectively single-payer (Medicaid) in scope for the available datasets, which concentrates regulatory and reimbursement risk on state Medicaid policy and reimbursement rates. Given the NPI enumeration in 2020-10-22 (~6 years ago) and the concentrated revenue mix (top 3 codes = 73.2%), payers and analysts should treat changes in Medicaid reimbursement or waiver design as having potentially outsized impact on this provider's revenue base.

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	8,160	$1,790	$14.6M
T2021	Day habilitation, waiver; per 15 minutes	40,210	$160	$6.5M
W0725	N/A	780	$5,330	$4.1M
W0700	N/A	3,360	$580	$1.9M
W0715	N/A	3,980	$440	$1.8M
T2019	Habilitation, supported employment, waiver; per 15 minutes	12,740	$100	$1.3M
T2047	Habilitation, prevocational, waiver; per 15 minutes	5,970	$150	$913.6K
T2017	Habilitation, residential, waiver; 15 minutes	10,250	$90	$901.8K
W0720	N/A	4,940	$120	$603.2K
W0710	N/A	2,350	$250	$596.9K

Showing 1–10 of 13

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Dakota Distribution

Red River Human Services Foundation — 0 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Dakota

Full comparison — all codes billed, vs. North Dakota median

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	18	30	21,220	$400	$14.1M
W0725	N/A	17	30	1,380	$2,520	$9.9M
T2021	Day habilitation, waiver; per 15 minutes	10	30	32,410	$170	$6.6M
W0300	N/A	12	10	2,370	$630	$4M
W0715	N/A	18	30	6,250	$450	$3.8M
T2019	Habilitation, supported employment, waiver; per 15 minutes	10	20	11,310	$80	$1.2M
W0700	N/A	9	20	3,430	$280	$1.2M
W0260	N/A	11	20	150	$4,920	$1M
T2017	Habilitation, residential, waiver; 15 minutes	5	10	4,870	$100	$1M
T2047	Habilitation, prevocational, waiver; per 15 minutes	9	10	8,770	$90	$988.3K

Showing 1–10 of 13

Nearby Providers

Other providers in the same ZIP code as Red River Human Services Foundation, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wahpeton Public School District	ND	Local Education Agency (LEA)	$0	$1.3M
Innovis Health, LLC.	ND	Family Medicine Physician	$0	$464.9K
Healing Arts Chiropractic, PC	ND	Chiropractor	$0	$246.4K
Duane Strand	ND	Internal Medicine Physician	$180.3K	$0
Patrick Emery	ND	Family Medicine Physician	$76.5K	$0
Brian Cooper	ND	Physician Assistant	$72.5K	$0
Timothy Nyarandi	ND	Family Medicine Physician	$65.3K	$0
Hornstein Family Chiropractic, Ltd	ND	Chiropractor	$0	$64.6K
Cheri Berge	ND	Family Nurse Practitioner	$56.7K	$0
Bonita Jenzen	ND	Family Nurse Practitioner	$53.7K	$0

Red River Human Services Foundation — Billing Profile & Reimbursement Data

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Red River Human Services Foundation — 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