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.

Able Inc (NPI 1679171235)

Field	Value
Entity Type	Organization
Organization	Able Inc
Address	1951 1st Street West
City	Dickinson
State	ND
ZIP	58601
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	October 15, 2020

Payer Source	Total Paid
Medicaid	$39.8M
Medicare	$0

Key Findings

ABLE INC is effectively a single-payer Medicaid provider: the firm has no Medicare billing on file and reports $39.8M in lifetime Medicaid revenue, indicating its operations are concentrated entirely in the Medicaid program rather than split across Medicare and Medicaid. This payer concentration limits cross-payer revenue diversification and makes the provider's performance and risk profile highly dependent on state Medicaid policy and waiver programs.

Revenue is highly concentrated in a small set of waiver-related codes: the top three Medicaid codes (T2016, W0725, T2021) together account for 82.4% of the provider's total Medicaid revenue, with T2016 representing $17.1M (43.0%), W0725 $11.4M (28.7%), and T2021 $4.3M (10.7%). That concentration means most of the provider's revenue flows from a few service lines tied to waiver habilitation payments.

The code mix points to a business model focused on habilitation services: T2016 is labeled as habilitation, residential, waiver (per diem) and T2021 as day habilitation (per 15 minutes), which together suggest ABLE INC primarily delivers residential and day habilitation supports for waiver-eligible populations. The large average paid-per-claim figures reported for those top codes — T2016 at $3864 avg paid/claim and W0725 at $6580 avg paid/claim — are consistent with per-diem or bundled residential services rather than brief outpatient encounters.

Despite T2016 being the single largest revenue driver ($17.1M, 43.0% of Medicaid revenue), ABLE INC is a modest statewide participant on that code: it ranks #21 of 29 providers in-state (29th percentile). In other words, T2016 dominates this provider's internal revenue mix but the provider is not a leading residential habilitation biller compared with many in-state peers.

For its other top revenue codes the provider shows typical, not dominant, market positions: W0725 (1.7K claims, $11.4M; rank #12 of 25, 54th percentile) and T2021 (26.6K claims, $4.3M; rank #16 of 26, 40th percentile) are both described as typical, unremarkable volumes relative to in-state peers. These ranks indicate ABLE INC participates broadly in day and other habilitation services but does not appear to be a frontrunner across these lines statewide.

There are a few service-line areas where ABLE INC has relatively stronger standing: T2019 (supported employment) generated $3M (7.6% of Medicaid revenue) and ranks #7 of 20 providers (68th percentile), and W0200 produced $359.8K (0.9% of revenue) while ranking #7 of 25 (75th percentile). These percentiles suggest the provider has above-typical presence in supported employment and certain W02xx service buckets even though those codes are smaller contributors to total revenue.

The provider's NPI was enumerated on 2020-10-15 (~6 years ago), so ABLE INC is a relatively recent entrant compared with long-established community behavioral health agencies; this tenure may reflect mid-stage growth where Medicaid waiver services form the core revenue base. Analysts should consider the implication that the current footprint and code mix could still be evolving as the provider matures.

Interpretation is constrained by data gaps and code descriptions: W0725 and several W07xx codes have no description available in the dataset, which limits clinical and service-level interpretation for those high-dollar lines, and the absence of any Medicare billing prevents cross-payer comparisons. These limitations mean conclusions should be drawn primarily from the well-described habilitation codes (T2016, T2021, T2019) and treated cautiously for the unnamed W07xx entries.

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	4,430	$3,860	$17.1M
W0725	N/A	1,740	$6,580	$11.4M
T2021	Day habilitation, waiver; per 15 minutes	26,570	$160	$4.3M
T2019	Habilitation, supported employment, waiver; per 15 minutes	21,560	$140	$3M
W0715	N/A	6,600	$260	$1.7M
W0710	N/A	3,020	$330	$986.2K
W0700	N/A	3,300	$260	$870.4K
W0200	N/A	450	$800	$359.8K
W0730	N/A	10	$890	$12.5K

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

Able Inc — 0 of 9 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

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	21	30	21,220	$400	$14.1M
W0725	N/A	12	30	1,380	$2,520	$9.9M
T2021	Day habilitation, waiver; per 15 minutes	16	30	32,410	$170	$6.6M
W0715	N/A	12	30	6,250	$450	$3.8M
T2019	Habilitation, supported employment, waiver; per 15 minutes	7	20	11,310	$80	$1.2M
W0700	N/A	10	20	3,430	$280	$1.2M
W0710	N/A	9	10	3,170	$170	$605.8K
W0200	N/A	7	30	200	$1,670	$454.3K
W0730	N/A	11	10	130	$530	$107.3K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hit Inc.	ND	Early Intervention Provider Agency	$0	$17.4M
St Josephs Hospital And Health Center	ND	Rural Acute Care Hospital	$0	$4.1M
Dickinson Area Ambulance Service Inc	ND	Land Ambulance	$574.5K	$1.8M
Omaha Therapy, Inc	ND	Rehabilitation Clinic/Center	$0	$1.8M
Badlands Behavioral Health Clinic	ND	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$1.4M
High Plains Dental	ND	General Practice Dentistry	$0	$1.1M
Sanford Bismarck	ND	Multi-Specialty Clinic/Center	$0	$771.3K
Heartview Foundation Dickinson	ND	Substance Use Disorder Rehabilitation Clinic/Center	$0	$677.5K
Joann Nupen Lindemann	ND	Family Nurse Practitioner	$517.4K	$0
St Joseph's Hospital And Health Center	ND	Clinic/Center	$0	$398.8K

Able Inc — Billing Profile & Reimbursement Data

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Able 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