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

Why is the Medicaid comparison limited to South 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. South 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.

Ability Building Services, Inc. (NPI 1710028527)

Field	Value
Entity Type	Organization
Organization	Ability Building Services, Inc.
Address	909 W 23rd St
City	Yankton
State	SD
ZIP	57078
Taxonomy	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NPI Enumerated	February 12, 2007

Payer Source	Total Paid
Medicaid	$39.2M
Medicare	$0

Key Findings

ABILITY BUILDING SERVICES, INC. reports no Medicare activity on file and is effectively a single-payer Medicaid provider, with Total Medicaid revenue of $39.2M and Total Medicare revenue listed as none (no Medicare billing on file). This concentration means any analysis of scale, utilization, or competitive position should focus on Medicaid program dynamics and state waiver services rather than Medicare fee-for-service dynamics.

Revenue is highly concentrated in a small set of waiver habilitation codes: the precomputed top three Medicaid codes (T2016, T2020, T2025) together account for 91.2% of the provider's Medicaid revenue. In particular, T2016 alone generates $25.4M (64.9% of Medicaid revenue), making residential habilitation the dominant revenue stream for this provider.

The provider’s operational mix is consistent with a residential and day habilitation service model: T2016 (Habilitation, residential, waiver; per diem) accounts for 7.7K claims, $3297 avg paid/claim, and $25.4M revenue, while T2020 (Day habilitation, waiver; per diem) accounts for 7.4K claims, $884 avg paid/claim, and $6.5M revenue. This pattern—high per-diem payments for residential habilitation plus substantial day habilitation volume—suggests the organization operates waiver-funded residential placements supported by day programs rather than primarily outpatient clinical care.

Average payment levels are materially different across the top codes, indicating different service intensities: T2016 has an avg paid/claim of $3297, which is notably higher than T2020 at $884 and T2025 at $626. That disparity aligns with the code descriptions (residential per-diem versus day or unspecified waiver services) and implies that revenue concentration is driven both by volume and by higher per-diem rates for residential care.

On competitive standing within the state, the provider is a modest but not dominant participant for its top codes: T2016 ranks #8 of 21 providers in-state (65th percentile; described as typical, unremarkable volume), T2020 ranks #10 of 20 (53th percentile; typical, unremarkable volume), and T2025 ranks #8 of 19 (61th percentile; typical, unremarkable volume). These mid-range ranks indicate steady market participation in state waiver services without clear statewide dominance.

Secondary codes and lower-percentile services show a broader waiver footprint but limited revenue impact: S0281 (Medical home program…) contributes $2.4M (6.1% of Medicaid revenue) with 6.9K claims and ranks #9 of 21 (60th percentile; typical, unremarkable volume), while other habilitation codes such as T2018, T2014, and T2019 each contribute under 1.1% of Medicaid revenue. This distribution suggests the provider offers a range of waiver supports in addition to its core residential and day habilitation offerings, but those supports are small contributors to overall revenue.

Tenure and registry history indicate long-standing participation in Medicaid waiver markets: the NPI was enumerated on 2007-02-12 (~19 years ago), which supports the interpretation that current coding mix and market position reflect an established organization rather than a newly entered provider. Analysts should consider this longevity when assessing referral relationships, historical utilization patterns, and potential capacity for service continuity.

Medicaid: Complete Services Breakdown

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	7,710	$3,300	$25.4M
T2020	Day habilitation, waiver; per diem	7,380	$880	$6.5M
T2025	Waiver services; not otherwise specified (nos)	6,050	$630	$3.8M
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	6,880	$350	$2.4M
T2018	Habilitation, supported employment, waiver; per diem	2,230	$190	$421.1K
T2014	Habilitation, prevocational, waiver; per diem	830	$410	$338.6K
T2019	Habilitation, supported employment, waiver; per 15 minutes	640	$240	$156.4K
T2028	Specialized supply, not otherwise specified, waiver	1,350	$60	$79.6K
T2017	Habilitation, residential, waiver; 15 minutes	240	$260	$62.5K
T2035	Utility services to support medical equipment and assistive technology/devices, waiver	30	$180	$5.5K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Dakota Distribution

Ability Building Services, Inc. — 0 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. South Dakota median

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	8	20	6,880	$1,660	$31.6M
T2020	Day habilitation, waiver; per diem	10	20	7,340	$500	$8.9M
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	9	20	6,090	$420	$3M
T2025	Waiver services; not otherwise specified (nos)	8	20	5,410	$180	$1.9M
T2017	Habilitation, residential, waiver; 15 minutes	9	10	470	$270	$437.9K
T2018	Habilitation, supported employment, waiver; per diem	7	20	1,510	$80	$433.9K
T2014	Habilitation, prevocational, waiver; per diem	12	20	1,210	$130	$410.3K
T2019	Habilitation, supported employment, waiver; per 15 minutes	6	20	480	$90	$288.6K
T2028	Specialized supply, not otherwise specified, waiver	13	30	910	$50	$169.8K
T2035	Utility services to support medical equipment and assistive technology/devices, waiver	6	10	50	$50	$8.8K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lewis & Clark Behavioral Health Services, Inc.	SD	Community/Behavioral Health Agency	$0	$24M
Yankton Medical Clinic PC	SD	Internal Medicine Physician	$0	$6.3M
Yankton Ph	SD	Assisted Living Facility (Mental Illness)	$0	$4.1M
Cedar Vilage Assisted Living Center	SD	Assisted Living Facility (Mental Illness)	$0	$2.4M
Heartland Psychological Services	SD	Psychiatry Physician	$0	$1.3M
Avera At Home	SD	Home Health Agency	$0	$1M
Sacred Heart Health Services	SD	Rural Acute Care Hospital	$0	$942.8K
Mary Lee Villanueva	SD	Hematology & Oncology Physician	$788.7K	$0
Sacred Heart Health Services	SD	Emergency Care Clinic/Center	$0	$766.6K
Kore Cares In Home Services, LLC	SD	In Home Supportive Care Agency	$0	$700.6K

Ability Building Services, Inc. — Billing Profile & Reimbursement Data

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Ability Building Services, 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