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

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

Rehabilitation Enterprises Of Northeastern Wyoming (NPI 1689716227)

Field	Value
Entity Type	Organization
Organization	Rehabilitation Enterprises Of Northeastern Wyoming
Address	1969 S Sheridan Ave
City	Sheridan
State	WY
ZIP	82801
Taxonomy	Clinical Psychologist
NPI Enumerated	February 12, 2007

Payer Source	Total Paid
Medicaid	$3.5M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and is effectively a single-payer (Medicaid) operation: lifetime Medicare revenue is listed as none while total Medicaid revenue is $3.5M. The absence of Medicare activity means payer-risk and revenue forecasting should be evaluated primarily against Medicaid program and waiver policies rather than Medicare-based benchmarks.

Revenue is highly concentrated in a few waiver/day-service codes: the precomputed top-3 Medicaid codes account for 98.4% of this provider's total Medicaid revenue, indicating that a small set of service lines drive nearly all billings. This concentration suggests the business is operationally dependent on a narrow set of Medicaid-funded programs and could be sensitive to rate or policy changes affecting those specific codes.

T2016 is the single largest revenue driver at $2.7M (75.7% of the provider's Medicaid revenue) with 16.3K claims and a $164 avg paid/claim; this code is for habilitation, residential, waiver per diem. The prominence of T2016 in the mix indicates the provider’s core business is residential habilitation services under waiver funding, implying a residential facility model with per-diem staffing and bed-day economics.

T2021 ($451.5K, 12.7% of Medicaid revenue; 5.4K claims; $83 avg paid/claim) and S5100 ($355.6K, 10.0% of Medicaid revenue; 5.6K claims; $63 avg paid/claim) together represent the provider’s day habilitation and adult day-care activity. These per-15-minute billing codes show the provider also operates or bills substantial day-program services in addition to residential habilitation, consistent with a mixed residential/day-services provider profile.

Competitive standing by in-state rank is middling-to-meaningful for the largest codes: T2016 ranks #5 of 19 providers in-state (78th percentile), which positions the provider above many peers but not as a statewide dominant operator. T2021 ranks #5 of 8 (43th percentile) and S5100 ranks #8 of 18 (59th percentile), both labeled as "typical, unremarkable volume," indicating the provider is a routine participant rather than an outlier in day-service lines.

Smaller ancillary services are present but immaterial to overall revenue: S5135 produced $55.5K (1.6% of Medicaid revenue) across 1.6K claims at a $35 avg paid/claim and ranks #5 of 12 (64th percentile). This indicates companion/ADL support is part of the service mix but not a strategic revenue driver.

The provider’s long tenure is notable: the NPI was enumerated on 2007-02-12 (~19 years ago), which suggests established operations and experience administering waiver and day-program services over an extended period. Longevity combined with concentrated Medicaid revenue implies institutional knowledge in state waiver billing but also a sustained exposure to Medicaid policy shifts.

From a risk and planning perspective, the combination of no Medicare presence, $3.5M in Medicaid revenue concentrated (98.4%) in T2016/T2021/S5100, and above-average in-state ranking on the largest code (T2016 at #5/19, 78th percentile) points to a provider that is a meaningful regional player in residential habilitation and day services under Medicaid waivers, yet remains vulnerable to changes in those specific program rates or utilization patterns.

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
T2016	Habilitation, residential, waiver; per diem	16,350	$160	$2.7M
T2021	Day habilitation, waiver; per 15 minutes	5,440	$80	$451.5K
S5100	Day care services, adult; per 15 minutes	5,640	$60	$355.6K
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	1,590	$40	$55.5K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wyoming Distribution

Rehabilitation Enterprises Of Northeastern Wyoming — 0 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wyoming

Full comparison — all codes billed, vs. Wyoming median

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	5	20	5,630	$520	$10.5M
S5100	Day care services, adult; per 15 minutes	8	20	3,260	$210	$2.3M
T2021	Day habilitation, waiver; per 15 minutes	5	10	6,090	$260	$2.1M
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	5	10	960	$210	$276.8K

Nearby Providers

Other providers in the same ZIP code as Rehabilitation Enterprises Of Northeastern Wyoming, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Normative Services, Inc.	WY	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$8.5M
Lgbtq Telepsychiatry	WY	Psychiatric/Mental Health Nurse Practitioner	$0	$3.9M
Northeast Wyoming Pediatric Associates, P.C.	WY	Pediatrics Physician	$0	$3.2M
Gillette Pediatric Dentistry LLC	WY	Pediatric Dentistry	$0	$2.9M
Eagle Ridge Rehabilitative Services	WY	Case Management Agency	$0	$2.6M
David Bailey	WY	Pediatric Dentistry	$0	$2.6M
Sensational Kids, LLC	WY	Pediatric Occupational Therapist	$0	$2.1M
Memorial Hospital Of Sheridan County	WY	General Acute Care Hospital	$0	$989.7K
Linda Garretson	WY	Developmentally Disabled Services Day Training Agency	$0	$989.3K
Senior Citizens Council	WY	Home Health Agency	$0	$959.7K

Rehabilitation Enterprises Of Northeastern Wyoming — Billing Profile & Reimbursement Data

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Rehabilitation Enterprises Of Northeastern Wyoming — 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