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

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

Stone Belt Arc, Inc. (NPI 1669535944)

Field	Value
Entity Type	Organization
Organization	Stone Belt Arc, Inc.
Address	2815 E 10th St
City	Bloomington
State	IN
ZIP	47408
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	December 18, 2006

Payer Source	Total Paid
Medicaid	$38.6M
Medicare	$0

Key Findings

This provider is effectively a single-payer Medicaid operation: there is no Medicare billing on file ("none below") and the provider reported $38.6M in total Medicaid revenue. The absence of Medicare activity combined with substantial Medicaid receipts indicates operational focus and revenue dependence on state Medicaid/waiver programs rather than fee-for-service Medicare lines.

Revenue is highly concentrated in a small set of waiver-related codes: the precomputed top three Medicaid codes (T2016, T2020, H0004) account for 92.0% of the provider’s Medicaid revenue, with T2016 alone representing 74.9% of the $38.6M. This concentration means most revenue flows through a narrow set of per diem and habilitation services rather than a broad mix of outpatient or procedural billings.

The code mix points to a core business of waiver habilitation services plus some behavioral health counseling: T2016 (Habilitation, residential, waiver; per diem) and T2020 (Day habilitation, waiver; per diem) together drive the vast majority of revenue, and H0004 (Behavioral health counseling and therapy, per 15 minutes) contributes a meaningful counseling component. In practical terms, the operation appears organized around residential and day habilitation under waiver programs with supporting therapy services rather than episodic clinical procedures.

Competitive standing on the largest revenue driver is solid but not dominant statewide: T2016 generates $28.9M (74.9% of Medicaid revenue) and the provider ranks #14 of 65 in-state at the 80th percentile, a position described in the underlying data as "typical, unremarkable volume." That combination—very high internal reliance on T2016 but a mid-to-high statewide rank—suggests the provider is a major local operator for residential habilitation but is one of several sizable participants in the state market.

Smaller but notable service lines show mixed competitive profiles: T2020 produced $3.6M (9.4%) and ranks #12 of 61 (82nd percentile), while H0004 produced $3.0M (7.8%) and ranks #26 of 72 (65th percentile); both are characterized in the data as "typical, unremarkable volume." Conversely, T2025 (waiver services, NOS) is a relatively small revenue line at $348.2K (0.9%) yet the provider ranks #3 of 23 (91st percentile), indicating strong statewide placement for that specific code despite its low contribution to total revenue.

Tenure is long-standing: the NPI was enumerated on 2006-12-18 (~20 years ago), indicating roughly two decades of enrollment in the national provider registry and an established presence in the market. That longevity aligns with the heavy orientation toward ongoing waiver-based services that require operational stability.

The provider’s revenue concentration creates operational sensitivity to changes in waiver policy, per-diem rates, or contracting for residential/day habilitation: because T2016 alone accounts for 74.9% of Medicaid revenue and the top three codes total 92.0%, reimbursement or eligibility shifts affecting those codes would disproportionately affect the provider’s overall Medicaid revenue. This profile suggests that payers or analysts evaluating network value or contracting should focus diligence on residential habilitation reimbursement terms and utilization trends.

The overall Medicaid footprint includes several ancillary support services consistent with comprehensive waiver programs—examples include T2015 (prevocational habilitation; $1.1M, 2.8%), T2002 (non-emergency transportation; $596.7K, 1.5%), and T2033 (residential care, NOS; $405.7K, 1.1%). These smaller lines confirm the provider offers wraparound services (transportation, prevocational activities, activity therapy) that complement its core residential and day habilitation operations and contribute modestly to the $38.6M Medicaid total.

Medicaid: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	9,830	$2,940	$28.9M
T2020	Day habilitation, waiver; per diem	15,240	$240	$3.6M
H0004	Behavioral health counseling and therapy, per 15 minutes	7,170	$420	$3M
T2015	Habilitation, prevocational, waiver; per hour	6,660	$160	$1.1M
T2002	Non-emergency transportation; per diem	4,890	$120	$596.7K
T2033	Residential care, not otherwise specified (nos), waiver; per diem	740	$550	$405.7K
H2032	Activity therapy, per 15 minutes	1,460	$260	$378.3K
T2025	Waiver services; not otherwise specified (nos)	2,280	$150	$348.2K
T2022	Case management, per month	2,660	$100	$276.6K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Indiana Distribution

Stone Belt Arc, Inc. — 0 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Indiana

Full comparison — all codes billed, vs. Indiana median

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	14	70	3,190	$630	$14.7M
T2033	Residential care, not otherwise specified (nos), waiver; per diem	34	50	1,090	$180	$2.3M
H0004	Behavioral health counseling and therapy, per 15 minutes	26	70	3,960	$130	$1.9M
T2020	Day habilitation, waiver; per diem	12	60	5,550	$110	$1.4M
T2022	Case management, per month	23	100	710	$180	$1.1M
H2032	Activity therapy, per 15 minutes	15	30	1,780	$70	$942.2K
T2015	Habilitation, prevocational, waiver; per hour	10	20	5,180	$80	$733.4K
T2002	Non-emergency transportation; per diem	19	70	2,190	$50	$319.8K
T2025	Waiver services; not otherwise specified (nos)	3	20	850	$140	$173.4K

Nearby Providers

Other providers in the same ZIP code as Stone Belt Arc, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Indiana University Health Southern Indiana Physicians, LLC	IN	Multi-Specialty Clinic/Center	$0	$69.5M
Indiana University Health Bloomington Inc	IN	General Acute Care Hospital	$0	$28.7M
The Growing Place, Inc	IN	Community/Behavioral Health Agency	$0	$8.4M
Julie Morton	IN	Intellectual & Developmental Disabilities Psychologist	$0	$3.6M
Joan Crawford	IN	Cardiovascular Disease Physician	$222.6K	$0
Todd Winkler	IN	Diagnostic Radiology Physician	$125.5K	$0
George Wolfer	IN	Diagnostic Radiology Physician	$31.1K	$0
Alan Sawchuk	IN	Vascular Surgery Physician	$29.9K	$0
Katherine Roza	IN	Hospice and Palliative Medicine (Internal Medicine) Physician	$22K	$1K
Raghunandan Motaganahalli	IN	Vascular Surgery Physician	$22K	$0

Stone Belt Arc, Inc. — Billing Profile & Reimbursement Data

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Stone Belt Arc, 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