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

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

Commonwealth Of Massachusetts (NPI 1679602502)

Field	Value
Entity Type	Organization
Organization	Commonwealth Of Massachusetts
Address	178 Albion Street
City	Wakefield
State	MA
ZIP	01880
Taxonomy	Case Management Agency
NPI Enumerated	March 5, 2007

Payer Source	Total Paid
Medicaid	$280.8M
Medicare	$0

Key Findings

COMMONWEALTH OF MASSACHUSETTS is effectively a single-payer Medicaid provider: it has no Medicare billing on file and reports Total Medicaid revenue of $280.8M, indicating its operations and revenue base are almost entirely driven by Medicaid-funded services rather than Medicare. Analysts should treat this profile as Medicaid-dominant when comparing to mixed-payer peers or assessing payer risk exposure.

Revenue concentration is extreme: the precomputed top 3 Medicaid codes account for 92.8% of the provider's total Medicaid revenue, meaning a very small set of service lines (chiefly T2016) drive the vast majority of income and therefore operational focus and risk. This degree of concentration implies that changes in reimbursement or utilization for those specific codes would materially affect overall revenue.

T2016 (Habilitation, residential, waiver; per diem) is by far the primary revenue driver, with 25.7K claims, $8975 avg paid/claim, and $230.6M revenue, representing 82.1% of the provider's Medicaid revenue. Despite generating the bulk of revenue, the provider ranks #18 of 25 in-state (29th percentile) on this code, which characterizes the provider as high-revenue on T2016 but not a statewide volume leader — its heavy dependence on this code is notable even though many other providers have similar or larger T2016 programs.

S5100 (Day care services, adult; per 15 minutes) contributes $18.7M (6.7% of Medicaid revenue) across 81.1K claims with $231 avg paid/claim, and the provider ranks #10 of 189 in-state (95th percentile). That ranking signals a meaningful competitive strength in adult day care services compared with peers: this provider operates at a notably above-typical state volume for S5100 and is likely a significant regional player for day care service capacity.

T2023 (Targeted case management; per month) and H2015 (Comprehensive community support services, per 15 minutes) are meaningful secondary service lines, together accounting for roughly 7.5% of Medicaid revenue ($11.3M and $9.8M respectively). Both codes show the provider as a typical, unremarkable-volume participant in-state (T2023 at the 83rd percentile and H2015 at the 71st percentile), suggesting established case management and community support capabilities but not dominant market share for those services.

The provider shows service-line specialization consistent with a case management agency and community habilitation/residential waiver operator: large per-diem residential habilitation billing (T2016) combined with high-volume day services (S5100), targeted case management (T2023), and time-based community supports (H2015, T2021, H2023) indicates a mixed portfolio of residential, day habilitation, employment support, and case management for populations receiving Medicaid waiver services. This code mix supports an operational model centered on long-term, service-intensive care coordination and habilitation rather than episodic medical procedures.

There are notable code-level competitive outliers: T2021 (Day habilitation, waiver; per 15 minutes) ranks #1 of 24 providers in-state (100th percentile) and is described as notably above typical state volume, indicating market leadership in day habilitation among a small peer set; conversely, the dominant T2016 revenue position paired with a mid-to-low statewide rank (29th percentile) suggests the provider’s T2016 unit economics (very high avg paid/claim of $8975) drive revenue more than relative claim volume. Analysts should consider both rank and avg paid/claim when assessing competitive positioning.

Tenure is long-standing: the NPI was enumerated on 2007-03-05 (~19 years ago), indicating nearly two decades of enrollment in the NPI system. This longevity supports interpretation of the provider as an established Medicaid service organization with sustained presence in its market.

Smaller ancillary codes (e.g., T2003 non-emergency transportation, S5135 companion care) together represent negligible portions of revenue (each under 0.1% of Medicaid revenue), signaling that non-residential transportation and companion services are minor activities relative to the provider’s core habilitation and day services. These ancillary lines are low-volume relative to many peers (rankings in the lower percentiles) and do not materially diversify the provider’s revenue concentration risk.

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	25,690	$8,980	$230.6M
S5100	Day care services, adult; per 15 minutes	81,120	$230	$18.7M
T2023	Targeted case management; per month	33,520	$340	$11.3M
H2015	Comprehensive community support services, per 15 minutes	29,910	$330	$9.8M
T2021	Day habilitation, waiver; per 15 minutes	45,690	$130	$5.8M
H2023	Supported employment, per 15 minutes	28,450	$100	$2.8M
T2019	Habilitation, supported employment, waiver; per 15 minutes	17,640	$90	$1.5M
T2003	Non-emergency transportation; encounter/trip	8,030	$20	$168.5K
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	650	$140	$89.6K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

Commonwealth Of Massachusetts — 2 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	18	30	29,930	$10,070	$358.9M
T2023	Targeted case management; per month	13	70	8,210	$510	$8.6M
H2023	Supported employment, per 15 minutes	12	20	28,450	$190	$5.6M
H2015	Comprehensive community support services, per 15 minutes	44	150	7,770	$140	$4.8M
T2021	Day habilitation, waiver; per 15 minutes	1	20	20,590	$210	$4.5M
S5100	Day care services, adult; per 15 minutes	10	190	2,000	$230	$3.1M
T2019	Habilitation, supported employment, waiver; per 15 minutes	18	20	24,690	$120	$3.1M
T2003	Non-emergency transportation; encounter/trip	199	250	40,490	$30	$2.2M
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	59	70	2,890	$90	$1.4M

Nearby Providers

Other providers in the same ZIP code as Commonwealth Of Massachusetts, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Shore Educational Collaborative	MA	Developmentally Disabled Services Day Training Agency	$0	$14.9M
Communitas, Inc.	MA	Adult Care Home Facility	$0	$10.7M
Commonwealth Of Massachusetts	MA	Case Management Agency	$0	$8.7M
Communitas, Inc.	MA	Developmentally Disabled Services Day Training Agency	$0	$7.5M
New England Aba, Inc.	MA	Behavior Analyst	$0	$6.3M
C. Douglas Evans	MA	Ophthalmology Physician	$699.8K	$4.2K
Glenn Daddario	MA	Physical Therapist	$315.1K	$81.4K
Cvs Pharmacy Inc	MA	Pharmacy	$367.8K	$30
Benjamin Calef	MA	Family Medicine Physician	$184.9K	$7.6K
Prathima Reddy	MA	Internal Medicine Physician	$191K	$0

Commonwealth Of Massachusetts — 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