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

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

State Of Missouri (NPI 1710053780)

Field	Value
Entity Type	Organization
Organization	State Of Missouri
Address	111 N 7th St
City	Saint Louis
State	MO
ZIP	63101
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	November 28, 2006

Payer Source	Total Paid
Medicaid	$130.3M
Medicare	$0

Key Findings

STATE OF MISSOURI is listed under the Developmentally Disabled Services Day Training Agency taxonomy and has an NPI enumerated 2006-11-28 (~20 years ago), indicating long-standing enrollment in public programs and established participation in state Medicaid networks. The provider is based in SAINT LOUIS, MO, which frames its competitive comparisons to in-state peers in the dataset.

This entity reports $130.3M in lifetime Medicaid revenue and has no Medicare billing on file, making its billing profile effectively single-payer with Medicaid as the sole recorded source of federal program revenue. The absence of Medicare activity concentrates both utilization and reimbursement risk in the Medicaid program alone.

Revenue is extremely concentrated in a single service line: the top 3 Medicaid codes account for 100.0% of the provider's total Medicaid revenue, and a single code, T1019, represents $129.7M and 99.5% of Medicaid revenue. That concentration means most financial activity and performance metrics for this provider will be driven by how T1019 is reimbursed and administered.

The code mix and volumes point to a high-volume, community-based personal care and support operation. T1019 (personal care services, per 15 minutes) accounts for 740.9K claims at a $175 avg paid/claim, which aligns with per-15-minute personal care or day habilitation billing practices; complementary codes T1016 (case management) and G9007 (coordinated care fee) indicate involvement in care planning and multidisciplinary team coordination.

T1019 is a clear state-level outlier: it ranks #22 of 1332 providers in-state (98th percentile; extreme outlier, far above typical state volume for this code). That ranking signals the provider is a dominant volumetric participant for this specific personal-care code within Missouri, not merely an average program.

The remaining billed codes are small by comparison and functionally additive to the core service. T1016 shows 3.8K claims and $605.8K revenue (0.5% of Medicaid revenue) and ranks #3 of 13 providers in-state (83rd percentile; typical, unremarkable volume), while G9007 shows 337 claims and $33.4K revenue (0.0% of Medicaid revenue) and ranks #1 of 2 providers in-state (100th percentile; typical, unremarkable volume). Both lines contribute operationally (case management and team conferences) but do not materially diversify revenue.

The provider’s dependence on a single high-volume code creates operational and reimbursement sensitivity: any policy, eligibility, or rate changes affecting T1019 would likely have outsized impact on reported Medicaid revenue. Analysts should monitor state rate-setting, audit activity, and any Medicaid policy proposals affecting per-15-minute personal care or day habilitation services to assess financial vulnerability.

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1019	Personal care services, per 15 minutes, 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…	740,900	$180	$129.7M
T1016	Case management, each 15 minutes	3,810	$160	$605.8K
G9007	Coordinated care fee, scheduled team conference	340	$100	$33.4K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Missouri Distribution

State Of Missouri — 2 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. Missouri median

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1019	Personal care services, per 15 minutes, 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…	22	1,330	6,550	$80	$4.6M
T1016	Case management, each 15 minutes	3	10	1,710	$110	$304.2K
G9007	Coordinated care fee, scheduled team conference	1	10	190	$100	$19.5K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
State Of Missouri	MO	Case Management Agency	$0	$78.4M
United Care Services Cds LLC	MO	Home Health Agency	$0	$6.1M
Daniel Smith	MO	Occupational Therapist	$28.2K	$0

State Of Missouri — Billing Profile & Reimbursement Data

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State Of Missouri — 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