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

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

Tobosa Developmental Services (NPI 1649328147)

Field	Value
Entity Type	Organization
Organization	Tobosa Developmental Services
Address	110 E Summit St
City	Roswell
State	NM
ZIP	88203
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	January 8, 2007

Payer Source	Total Paid
Medicaid	$33.4M
Medicare	$0

Key Findings

TOBOSA DEVELOPMENTAL SERVICES is an established, specialized provider in developmental disability services with an NPI enumeration date of 2007-01-08 (~19 years ago) and is located in ROSWELL, NM. Its taxonomy is Developmentally Disabled Services Day Training Agency, signaling a programmatic focus on habilitation and related waiver services rather than traditional medical care. The provider’s footprint is long-standing, which supports its sizable Medicaid billing profile reported below.

This provider is effectively single-payer in scale: Medicare revenue is none (no Medicare billing on file) while Medicaid revenue totals $33.4M. The absence of Medicare billing indicates the operation is concentrated on Medicaid-funded habilitation and waiver programs instead of fee-for-service medical lines.

Revenue is highly concentrated in a narrow set of waiver/habilitation services: the top three Medicaid codes (T2016, H2021, T2021) together account for 97.7% of the provider’s total Medicaid revenue. Those three codes break down as T2016: 75.8K claims, $321 avg paid/claim, $24.3M revenue (72.8%); H2021: 38.6K claims, $144 avg paid/claim, $5.6M revenue (16.6%); and T2021: 37.1K claims, $74 avg paid/claim, $2.7M revenue (8.2%).

The code mix implies TOBOSA operates a blended service model combining residential habilitation and high-volume time-based community/day habilitation. T2016 (Habilitation, residential, waiver; per diem) dominance by revenue suggests a substantial residential waiver population paid on a per-diem basis, while the large claim counts for H2021 (community-based wrap-around, per 15 minutes) and T2021 (day habilitation, waiver; per 15 minutes) indicate parallel high-volume community and day-program services billed in short time increments.

Competitive standing across these service lines is mixed. For T2016 — the single largest revenue driver at $24.3M (72.8% of Medicaid revenue) — the provider ranks #12 of 40 in-state (72th percentile; typical, unremarkable volume for this code), indicating a solid but not dominant position in residential habilitation. By contrast, H2021 performance is markedly stronger: with $5.6M in revenue the provider ranks #4 of 62 statewide (95th percentile; notably above typical state volume), identifying TOBOSA as a leading provider of community-based wrap-around services in New Mexico.

T2021 (day habilitation) is a meaningful but smaller revenue contributor at $2.7M (8.2% of Medicaid revenue); the provider ranks #6 of 52 in-state (90th percentile; typical, unremarkable volume for this code). This positioning suggests TOBOSA is an active day-habilitation participant in-state but not an outlier leader when compared to peers, complementing its stronger showings in residential per-diem and wrap-around services.

Smaller codes collectively represent a negligible share of revenue and do not materially diversify risk: for example, T2025 generates $513K (1.5% of Medicaid revenue) and S5125 generates $248.4K (0.7% of Medicaid revenue), both ranked in lower state percentiles. With 97.7% of Medicaid revenue tied to the top three codes, payers and analysts should view the provider’s financial exposure and utilization patterns as highly sensitive to policy, rate, or authorization changes affecting those waiver habilitation services.

For payer contracting and utilization review, the mix of high per-diem payments and intensive time-based billing is instructive: T2016 carries a $321 avg paid/claim (per diem) while H2021 and T2021 reflect $144 and $74 avg paid/claim respectively (per 15 minutes), which signals different authorization and monitoring needs across residential versus community/day services. Given the provider’s long tenure, concentrated Medicaid reliance, and particularly strong standing in H2021, payers should prioritize claims-level audits and program integrity checks focused on authorization, service duration, and continuity for those waiver codes.

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
T2016	Habilitation, residential, waiver; per diem	75,830	$320	$24.3M
H2021	Community-based wrap-around services, per 15 minutes	38,610	$140	$5.6M
T2021	Day habilitation, waiver; per 15 minutes	37,140	$70	$2.7M
T2025	Waiver services; not otherwise specified (nos)	630	$810	$513K
S5125	Attendant care services; per 15 minutes	3,550	$70	$248.4K
H2019	Therapeutic behavioral services, per 15 minutes	210	$80	$15.9K
T1002	Rn services, up to 15 minutes	60	$30	$1.8K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Mexico Distribution

Tobosa Developmental Services — 1 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Mexico

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

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	12	40	54,080	$360	$22.1M
H2021	Community-based wrap-around services, per 15 minutes	4	60	6,750	$340	$4.4M
S5125	Attendant care services; per 15 minutes	38	50	10,600	$100	$4.3M
T2021	Day habilitation, waiver; per 15 minutes	6	50	6,810	$120	$1.6M
T2025	Waiver services; not otherwise specified (nos)	23	40	1,010	$360	$1.6M
H2019	Therapeutic behavioral services, per 15 minutes	41	40	5,650	$100	$1.1M
T1002	Rn services, up to 15 minutes	32	40	1,350	$150	$368.7K

Nearby Providers

Other providers in the same ZIP code as Tobosa Developmental Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Next Phase Inc.	NM	In Home Supportive Care Agency	$0	$26.5M
The Peak At Santa Teresa, Inc.	NM	Foster Care Agency	$0	$10.8M
Tobosa Developmental Services, Inc.	NM	Early Intervention Provider Agency	$0	$9.7M
Michele L Carter Dds LLC	NM	Dentist	$0	$6.8M
Recovery Services Of New Mexico, LLC	NM	Methadone Clinic	$58.6K	$6.4M
Fhlp LLC	NM	Pediatrics Physician	$0	$4.3M
Roswell Osteopathic Medical Clinic, Inc	NM	Family Medicine Physician	$0	$2.7M
Donald Wenner	NM	Urology Physician	$156.7K	$0
Erika Anderson	NM	Optometrist	$122.6K	$0
Mark Andrews	NM	Family Medicine Physician	$63.5K	$0

Tobosa Developmental Services — Billing Profile & Reimbursement Data

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Tobosa Developmental Services — 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