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

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

Rise, Inc (NPI 1720049190)

Field	Value
Entity Type	Organization
Organization	Rise, Inc
Address	3076 N Five Mile Rd
City	Boise
State	ID
ZIP	83713
Taxonomy	Voluntary or Charitable Agency
NPI Enumerated	March 28, 2006

Payer Source	Total Paid
Medicaid	$263.8M
Medicare	$0

Key Findings

RISE, INC reports no Medicare billing on file and $263.8M in lifetime Medicaid revenue, making its operations effectively single-payer Medicaid-focused at the scale shown in the data. The absence of Medicare revenue suggests the organization’s services are squarely concentrated in Medicaid-funded long-term services and supports rather than fee-for-service Medicare lines.

Revenue concentration is high: the precomputed top three Medicaid codes account for 76.2% of the provider’s total Medicaid revenue, with T2016 at $105.4M (40.0%), S5125 at $69.7M (26.4%), and T2021 at $26M (9.9%). This concentration indicates the bulk of cash flow is driven by a small set of waiver and habilitation services rather than a broad mix of Medicaid procedure lines.

The code mix strongly indicates an LTSS/waiver-focused operating model: T2016 (Habilitation, residential, waiver; per diem), S5125 (Attendant care services; per 15 minutes), and T2021 (Day habilitation, waiver; per 15 minutes) together point to residential habilitation, intensive attendant/home support, and day-program operations as the core service lines. Supporting lines such as A0120 (Non-emergency transportation: mini-bus, $3.8M) and S5150 (Unskilled respite care, $16.8M) reinforce a full-service community habilitation and support infrastructure.

Competitive positioning varies by code: RISE ranks #1 of 44 providers in-state for S5125 and is labeled an extreme outlier at the 100th percentile, indicating it is a statewide volume leader for attendant care services. For T2016 and T2021 the data show rank #1 of 1 providers in-state (0th percentile; no state peer volume comparison available), which means those services are reported only by this entity in the state dataset so standard peer-percentile comparisons aren’t available even though those lines generate large shares of revenue.

Several specific codes are flagged as statistical outliers in the state comparison: S5125 and S5150 are reported as extreme outliers (100th percentile), and H0004 (Behavioral health counseling and therapy) is also ranked #1 of 157 providers (100th percentile; extreme outlier). These labels indicate the provider’s volumes for attendant care, unskilled respite, and behavioral health therapy are far above typical state volumes for those codes, signaling a dominant or atypically large role in those service categories.

Operational scale is reflected in high claim volumes concentrated in time-based billing: S5125 shows 467.6K claims, T2021 shows 285.9K claims, and T2016 shows 274.5K claims, indicating substantial per-15-minute and per-diem service delivery that likely requires large staffing, scheduling, and payroll capacity to support continuous community and residential services. High volume in minute-based codes suggests operational emphasis on sustained, recurring care rather than low-frequency procedures.

While revenue is concentrated, there is some service-line diversification beyond the top three codes: S5150 contributes $16.8M (6.4%), T2017 contributes $14.9M (5.6%), and H0004 contributes $12.8M (4.9%), with additional smaller lines such as 97537 ($3.7M) and A0120 ($3.8M) present. These mid-tier codes indicate complementary program offerings (respite, additional habilitation modalities, therapy, and transportation) that reduce absolute dependence on any single sub-service but do not meaningfully lower overall concentration risk given the top-three share.

RISE’s NPI tenure dates to 2006-03-28 (~20 years ago), reflecting an established presence in the state Medicaid market; this longevity, combined with the large Medicaid revenue base, suggests institutional experience in managing waiver contracts, high-volume attendant programs, and the operational demands of residential and day habilitation services. Established tenure may underpin the provider’s ability to sustain high-volume, time-based service lines and to hold the market positions reflected in the rank/percentile data.

Medicaid: Complete Services Breakdown

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

31 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	274,510	$380	$105.4M
S5125	Attendant care services; per 15 minutes	467,610	$150	$69.7M
T2021	Day habilitation, waiver; per 15 minutes	285,880	$90	$26M
S5150	Unskilled respite care, not hospice; per 15 minutes	202,550	$80	$16.8M
T2017	Habilitation, residential, waiver; 15 minutes	193,260	$80	$14.9M
H0004	Behavioral health counseling and therapy, per 15 minutes	175,600	$70	$12.8M
H2032	Activity therapy, per 15 minutes	79,590	$50	$4M
A0120	Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems	156,570	$20	$3.8M
97537	In this procedure, the provider works one on one with a patient to provide community work reintegration training. The training helps the injured or ill patient to return to employment and the…	131,220	$30	$3.7M
T2019	Habilitation, supported employment, waiver; per 15 minutes	47,230	$70	$3.2M

Showing 1–10 of 31

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Idaho Distribution

Rise, Inc — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. Idaho median

31 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	1	10	274,510	$380	$105.5M
T2021	Day habilitation, waiver; per 15 minutes	1	10	285,880	$90	$26.1M
T2017	Habilitation, residential, waiver; 15 minutes	1	10	193,260	$80	$14.8M
A0120	Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems	1	10	156,570	$20	$3.8M
T2019	Habilitation, supported employment, waiver; per 15 minutes	1	10	47,230	$70	$3.2M
S5125	Attendant care services; per 15 minutes	1	40	5,180	$110	$2.3M
H0004	Behavioral health counseling and therapy, per 15 minutes	1	160	4,020	$140	$1.6M
H2032	Activity therapy, per 15 minutes	4	40	19,190	$50	$1.6M
97537	In this procedure, the provider works one on one with a patient to provide community work reintegration training. The training helps the injured or ill patient to return to employment and the…	3	40	30,150	$20	$1.2M
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	4	10	3,200	$180	$1.1M

Showing 1–10 of 31

Related Providers

Other providers that share a Tax Identification Number (TIN) with Rise, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Toni Carles	ID	Family Nurse Practitioner	$11K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
James Earl	ID	Retina Specialist (Ophthalmology) Physician	$3.1M	$0
Trivium Life Services Mountain West, LLC	ID	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$3M
Trinity Mountain Health	ID	Home Health Agency	$0	$2.2M
Boise Toothtown Dentistry For Kids PLLC	ID	Pediatric Dentistry	$0	$2.1M
Mountain View Behavioral Health, LLC	ID	Community/Behavioral Health Agency	$0	$1.7M
Denton Roberts	ID	Ophthalmology Physician	$1.6M	$0
Edgewood Spring Creek Boise, LLC	ID	Assisted Living Facility	$0	$1.6M
Edgewood Spring Creek Eagle Island LLC	ID	Assisted Living Facility	$0	$1.3M
Zrj Inc	ID	Physical Therapist	$0	$1.2M
Community Partnerships Of Idaho, Inc.	ID	Community/Behavioral Health Agency	$0	$1.2M

Rise, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References