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

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

Conexio Care, Inc. (NPI 1679141501)

Field	Value
Entity Type	Organization
Organization	Conexio Care, Inc.
Address	590 Naamans Rd
City	Claymont
State	DE
ZIP	19703
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	June 16, 2021

Payer Source	Total Paid
Medicaid	$12M
Medicare	$0

Key Findings

This entity has no Medicare billing on file and reported $12M in lifetime Medicaid revenue, making it effectively a single-payer (Medicaid) billing operation at present. The absence of Medicare activity contrasts sharply with its material Medicaid footprint and should be treated as a Medicaid-centric profile for competitive and network analyses.

Revenue is extremely concentrated: the precomputed top-3 Medicaid codes account for 100.0% of this provider's Medicaid revenue, with H0040 alone generating $11.7M (97.9% of Medicaid revenue) and H0036 contributing $253.7K (2.1%). These exact figures indicate that nearly all Medicaid dollars flow from a very small set of service lines.

The code mix corresponds to intensive community-based mental health services. H0040 (Assertive community treatment program, per diem) with 50K claims and a $235 avg paid/claim signals large-scale delivery of per-diem ACT services, while H0036 (Community psychiatric supportive treatment, face-to-face, per 15 minutes) represents a much smaller volume of direct, time-based supportive visits.

For H0040 the provider is a dominant statewide participant: it ranks #1 of 15 providers in-state, sits at the 100th percentile, and is described as an extreme outlier far above typical state volume for this code. That ranking identifies the provider as a leading in-state source of ACT per-diem services rather than a marginal or mid-tier supplier.

By contrast, H0036 is a modest contributor and the provider is not a major competitor for that code: it ranks #15 of 21 providers in-state and sits at the 30th percentile, a position characterized as typical and unremarkable for face-to-face community psychiatric supportive treatment. This suggests the organization’s competitive strength is highly concentrated in per-diem ACT rather than in time-based outpatient units.

The provider’s NPI was enumerated on 2021-06-16 (~5 years ago), indicating relatively recent market entry but rapid scaling of a single service line given the large cumulative H0040 volume. The combination of recent enumeration and very high per-diem claim volume implies operational focus and rapid build-out of ACT capacity.

The extreme revenue concentration in H0040 (97.9% of Medicaid revenue) creates operational and reimbursement risk: changes to Medicaid policy, per-diem rates, or contracting for ACT services could materially affect the provider’s financial profile. Analysts should consider dependency on that single code when modeling reimbursement sensitivity or negotiating network arrangements.

Average paid-per-claim levels are roughly comparable across the two reported codes ($235 avg paid/claim for H0040 and $233 avg paid/claim for H0036), indicating that the revenue disparity is driven by claim volume (50K claims for H0040 versus 1.1K claims for H0036) rather than markedly different unit prices. This reinforces that the provider’s scale advantage is volume-based for the per-diem ACT program rather than price differentiation.

Medicaid: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0040	Assertive community treatment program, per diem	49,960	$240	$11.7M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	1,090	$230	$253.7K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Delaware Distribution

Conexio Care, Inc. — 1 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. Delaware median

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0040	Assertive community treatment program, per diem	1	20	11,300	$240	$3.4M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	15	20	2,510	$160	$2M

Nearby Providers

Other providers in the same ZIP code as Conexio Care, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Conexio Care, Inc.	DE	Intellectual & Developmental Disabilities Psychologist	$0	$37.9M
State Of Delaware	DE	Local Education Agency (LEA)	$0	$1.5M
Ats Of Delaware, LLC	DE	Methadone Clinic	$190.3K	$1.1M
Claymont Family Dentistry	DE	Dental Clinic/Center	$0	$968.9K
Claymont Fire Company 1	DE	Land Ambulance	$351.7K	$421.5K
Ivyrehab Delaware LLC	DE	Physical Medicine & Rehabilitation Physician	$0	$750.7K
Bc Home Healthcare Services, Inc.	DE	Home Health Agency	$0	$441.6K
Southbridge Medical Advisory Council, Inc.	DE	Federally Qualified Health Center (FQHC)	$0	$364.4K
Patricia Manchak	DE	Physical Therapist	$315.6K	$0
Herman Ortez	DE	Professional Counselor	$0	$180.6K

Conexio Care, Inc. — Billing Profile & Reimbursement Data

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Conexio Care, 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