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

Why is the Medicaid comparison limited to New Hampshire 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. New Hampshire (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.

Crotched Mountain Community Care (NPI 1679786131)

Field	Value
Entity Type	Organization
Organization	Crotched Mountain Community Care
Address	186 Granite St Ste 3c
City	Manchester
State	NH
ZIP	03101
Taxonomy	Case Management Agency
NPI Enumerated	May 8, 2007

Payer Source	Total Paid
Medicaid	$20.6M
Medicare	$0

Key Findings

CROTCHED MOUNTAIN COMMUNITY CARE has no Medicare billing on file and reports $20.6M in lifetime Medicaid revenue, making it effectively a single-payer (Medicaid-focused) billing entity in the available data. This payer mix indicates its financial footprint and risk exposure are concentrated in Medicaid reimbursement streams rather than Medicare.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 97.2% of the provider’s total Medicaid revenue, with T1016 generating $15.6M (75.7%), T1020 generating $3.3M (16.2%), and T2021 generating $1.1M (5.3%). This concentration shows that a very small set of services drives the overwhelming majority of billed Medicaid dollars.

The code mix indicates a service model centered on case management and community support rather than medical/clinical procedures: T1016 (case management) is the dominant revenue driver, supported by T1020 (personal care services) and T2021 (day habilitation, waiver), while H0043 (supported housing) appears as a smaller adjunct service. Together these codes are consistent with an organization operating as a Case Management Agency focused on long-term community supports and habilitation services.

Operationally, T1016 shows very high claim volume (202K claims) with a low average paid per claim ($77), while T1020 shows very low claim volume (2.2K claims) but a high average paid per claim ($1502), and T2021 has moderate claim volume (5.9K claims) at $185 average paid. This mix implies the provider’s revenue base is built on a high-throughput, low-unit-rate case management workflow supplemented by a smaller number of high-dollar-per-claim personal care placements.

Competitive standing by service line is mixed within New Hampshire: for T1016 the provider ranks #5 of 33 (88th percentile), indicating a relatively strong statewide position in case management volume; by contrast, T1020 ranks #32 of 41 (23th percentile), T2021 ranks #29 of 39 (26th percentile), and H0043 ranks #9 of 10 (11th percentile), all of which indicate modest to minor presence in those supplemental service lines. The provider is therefore a notable actor for case management but not a leading competitor for personal care, day habilitation, or supported housing.

The provider has an established tenure: its NPI was enumerated on 2007-05-08 (~19 years ago), signaling long-term participation in Medicaid billing and likely operational experience in the state’s waiver and community support programs. This longevity supports interpretation of the observed code mix as a sustained business model rather than a transient billing pattern.

None of the major codes are labeled as statistical outliers in the supplied descriptors; each top code is characterized as "typical, unremarkable volume for this code," so the provider’s reported activity falls within expected in-state ranges rather than being unusually high or low relative to peers. That suggests the concentration in T1016 is a market-position outcome rather than an anomalous billing spike.

Strategically, the combination of a single-payer Medicaid footprint and extreme revenue concentration in T1016 (75.7% of Medicaid revenue) creates sensitivity to policy or rate changes affecting case management reimbursement and authorization practices. Given the top three codes account for 97.2% of Medicaid revenue, analysts should monitor Medicaid rate, service definition, and utilization trends for T1016, T1020, and T2021 to assess near-term revenue risk.

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
T1016	Case management, each 15 minutes	202,010	$80	$15.6M
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…	2,220	$1,500	$3.3M
T2021	Day habilitation, waiver; per 15 minutes	5,920	$190	$1.1M
H0043	Supported housing, per diem	310	$1,820	$566.6K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Hampshire Distribution

Crotched Mountain Community Care — 0 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Hampshire

Full comparison — all codes billed, vs. New Hampshire median

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	32	40	14,020	$330	$32.2M
T2021	Day habilitation, waiver; per 15 minutes	29	40	11,650	$170	$12.7M
T1016	Case management, each 15 minutes	5	30	35,170	$170	$12.5M
H0043	Supported housing, per diem	9	10	1,780	$180	$1.6M

Nearby Providers

Other providers in the same ZIP code as Crotched Mountain Community Care, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Siddharth Services, Inc.	NH	Foster Care Agency	$0	$23.8M
Waypoint	NH	Community/Behavioral Health Agency	$0	$20.8M
Amoskeag Health	NH	Federally Qualified Health Center (FQHC)	$0	$20.2M
Community Integrated Services, Inc	NH	Community/Behavioral Health Agency	$0	$17M
Northeast Family Services Of New Hampshire, Inc.	NH	Community/Behavioral Health Agency	$0	$15.4M
Independent Services Network, Inc.	NH	Community/Behavioral Health Agency	$0	$14M
Amoskeag Health	NH	Federally Qualified Health Center (FQHC)	$0	$11.6M
Habit Opco, LLC	NH	Methadone Clinic	$539.9K	$4.3M
Impress Healthcare Corporation	NH	In Home Supportive Care Agency	$0	$3.1M
Economy Vision	NH	Optometrist	$0	$2.2M

Crotched Mountain Community Care — Billing Profile & Reimbursement Data

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Crotched Mountain Community Care — 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