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

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

Adult Learning Systems-u.p. (NPI 1659602076)

Field	Value
Entity Type	Organization
Organization	Adult Learning Systems-u.p.
Address	228 W Washington St Ste 4
City	Marquette
State	MI
ZIP	49855
Taxonomy	Intellectual Disabilities Intermediate Care Facility
NPI Enumerated	January 25, 2010

Payer Source	Total Paid
Medicaid	$65.8M
Medicare	$0

Key Findings

This provider is effectively single-payer in practice: there is no Medicare billing on file while total Medicaid revenue is $65.8M, so all recorded lifetime revenue is driven by Medicaid programs. The absence of Medicare activity indicates contracting, care delivery, and revenue dependence are concentrated in state Medicaid arrangements rather than fee-for-service Medicare markets.

Revenue is highly concentrated in a very small set of services: the precomputed top three Medicaid codes account for 99.4% of the provider's total Medicaid revenue. The three codes are H2016 ($43.2M, 65.7% of Medicaid revenue), T1020 ($19.2M, 29.2%), and H0043 ($3M, 4.5%), demonstrating that nearly the entire Medicaid business is captured by per-diem community support, personal care, and supported housing lines.

The code mix (H2016 — Comprehensive community support services, per diem; T1020 — Personal care services, per diem; and H0043 — Supported housing, per diem) indicates an operational focus on long-term, community-based supports and supported-living arrangements rather than acute medical or episodic outpatient care. High per-diem averages (e.g., H2016 $2404 avg paid/claim and T1020 $1089 avg paid/claim) are consistent with sustained daily service delivery models rather than brief visits.

H2016 is the dominant single revenue driver: 18K claims, $2404 avg paid/claim, $43.2M revenue (65.7% of this provider's total Medicaid revenue). In-state competitive positioning for H2016 is middle-to-upper tier — the provider ranks #100 of 297 in-state (67th percentile) and is described as having a typical, unremarkable volume for this code, so it is a meaningful participant but not a statewide leader for this service.

T1020 is the second major revenue stream with 17.6K claims, $1089 avg paid/claim, and $19.2M revenue (29.2% of total Medicaid revenue), and the provider ranks #78 of 221 in-state (65th percentile) with typical volume. This sizable secondary concentration means the provider’s scale in personal care services materially contributes to overall Medicaid revenue and complements its H2016 community-support activity.

H0043 (11.7K claims, $254 avg paid/claim, $3M revenue, 4.5% of Medicaid revenue) represents a modest supported-housing line and ranks #62 of 130 in-state, placing it around the median for in-state peers. H2015 is a very small contributor (3.1K claims, $138 avg paid/claim, $423.8K revenue, 0.6% of Medicaid revenue) and ranks low in-state (#478 of 614), further underscoring that a small set of per-diem services dominate the revenue mix.

Operational and payer-mix implications: the heavy reliance on two per-diem codes (H2016 and T1020) that together account for 94.9% of Medicaid revenue suggests the provider operates a high-volume, daily-support model where billing and reimbursement for ongoing care are the primary revenue mechanism. That concentration implies limited product-line diversification within Medicaid and a business profile highly tied to state-managed long-term service programs.

Tenure and market implications: the NPI was enumerated on 2010-01-25 (~16 years ago), indicating the provider has an established presence in the market. Coupled with $65.8M in Medicaid lifetime revenue and the concentrated code mix, this tenure supports the conclusion that ADULT LEARNING SYSTEMS-U.P. is an established, Medicaid-focused community-support and personal-care provider with steady in-state participation but not a dominant statewide leader in its top codes.

Medicaid: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2016	Comprehensive community support services, per diem	17,970	$2,400	$43.2M
T1020	Personal care services, per diem, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	17,610	$1,090	$19.2M
H0043	Supported housing, per diem	11,720	$250	$3M
H2015	Comprehensive community support services, per 15 minutes	3,070	$140	$423.8K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Michigan Distribution

Adult Learning Systems-u.p. — 0 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2016	Comprehensive community support services, per diem	100	300	6,660	$310	$8.7M
H2015	Comprehensive community support services, per 15 minutes	478	610	14,740	$90	$6M
T1020	Personal care services, per diem, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	78	220	7,030	$170	$4.6M
H0043	Supported housing, per diem	62	130	10,330	$210	$4.5M

Nearby Providers

Other providers in the same ZIP code as Adult Learning Systems-u.p., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pathways	MI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$89.1M
Dlp Marquette Physician Practices Inc	MI	Obesity Medicine (Internal Medicine) Physician	$0	$17.8M
Dlp Marquette General Hospital LLC	MI	General Acute Care Hospital	$0	$16.3M
Great Lakes Recovery Centers	MI	Substance Use Disorder Rehabilitation Clinic/Center	$0	$8M
Prac Holdings, Inc.	MI	In Home Supportive Care Agency	$0	$6M
Upper Michigan Associates LLC	MI	Ambulatory Surgical Clinic/Center	$1.4M	$0
Nelson Winkler	MI	Ophthalmology Physician	$1M	$0
Sean Rooney	MI	Ophthalmology Physician	$843.7K	$0
Zachary Leonard	MI	Orthopaedic Surgery Physician	$220.4K	$0
Keith Connolly	MI	Orthopaedic Surgery Physician	$197.8K	$0

Adult Learning Systems-u.p. — Billing Profile & Reimbursement Data

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Adult Learning Systems-u.p. — 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