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

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

North Metro Community Services, Inc. (NPI 1720125115)

Field	Value
Entity Type	Organization
Organization	North Metro Community Services, Inc.
Address	1185 W 124th Ave
City	Westminster
State	CO
ZIP	80234
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	February 1, 2007

Payer Source	Total Paid
Medicaid	$107.8M
Medicare	$0

Key Findings

NORTH METRO COMMUNITY SERVICES, INC. reports $107.8M in lifetime Medicaid revenue and has no Medicare billing on file, making it effectively a Medicaid-focused (single-payer) operation in our dataset. The absence of Medicare activity suggests its services are largely specialized to waiver and developmental-disability programs that are funded through state Medicaid rather than Medicare.

Revenue is highly concentrated: the precomputed top 3 Medicaid codes (T2016, T2021, S5150) account for 85.5% of this provider's total Medicaid revenue. Those three codes individually generate $75.2M (T2016, 69.8%), $12.4M (T2021, 11.5%), and $4.6M (S5150, 4.3%), indicating most dollars flow through residential habilitation, day habilitation, and respite services.

The code mix (T2016 – habilitation residential waiver; T2021 – day habilitation, waiver; and S5150 – unskilled respite care) signals an operating model centered on long-term community-based habilitation and day-program delivery for people with developmental disabilities. High per-diem and per-15-minute reimbursement levels in the top codes imply a service-delivery model with sustained staff time and facility or program capacity rather than brief episodic medical care.

State competitive standing is mixed: for its largest code T2016 the provider ranks #55 of 191 (72th percentile) — characterized in the source as typical and unremarkable volume — while for T2021 it ranks #42 of 290 (86th percentile) and S5150 is #15 of 86 (84th percentile), both labeled typical. In plain terms, NORTH METRO is not a statewide dominant player on its largest residential code but shows stronger relative placement in day habilitation and respite services, indicating competitive strength in specific service lines rather than overall market dominance.

Beyond habilitation, the provider bills a range of waiver and support services that broaden its service footprint: T1017 (targeted case management) shows 26.4K claims and $3.8M revenue while non-emergency transport (T2003) accounts for 18.8K claims and $3M revenue. It also reports notable placements in specialized supply and transport categories (T2028 $455.9K, rank #3 of 21 at the 90th percentile; T2004 $794.5K, rank #6 of 39 at the 87th percentile), reflecting operational capabilities in transportation/logistics and waiver supply provisioning.

Several service lines show high relative utilization versus peers even if absolute dollars are smaller: T1017 is in the 94th percentile statewide (26.4K claims, $3.8M), and T2035 (utility services to support medical equipment) is ranked #1 of 5 in-state (100th percentile) though it contributes $161.8K. These high-percentile placements suggest established programmatic roles in case management and niche waiver services that complement the provider’s core habilitation offerings.

There are billing patterns that warrant attention from analysts: T2034 (crisis intervention, waiver) records 2.5K claims with a $0 avg paid/claim and $0 revenue while still ranking #13 of 162 (93th percentile). The presence of non-payment encounters at measurable volume may reflect encounter-only reporting, rate-setting features of the waiver program, or billing practices that produce zero-paid records and should be interpreted in context rather than assumed to reflect clinical activity levels.

NORTH METRO’s NPI was enumerated on 2007-02-01 (~19 years ago), indicating long tenure in the Medicaid provider community. This longevity, paired with concentrated revenue in waiver habilitation and consistent case-management and transport volumes, points to an established provider with sustained state program participation and embedded operational capabilities in developmental-disability services.

Medicaid: Complete Services Breakdown

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

21 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	20,610	$3,650	$75.2M
T2021	Day habilitation, waiver; per 15 minutes	26,920	$460	$12.4M
S5150	Unskilled respite care, not hospice; per 15 minutes	7,200	$640	$4.6M
T1017	Targeted case management, each 15 minutes	26,400	$140	$3.8M
T2003	Non-emergency transportation; encounter/trip	18,830	$160	$3M
T2019	Habilitation, supported employment, waiver; per 15 minutes	4,400	$440	$1.9M
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…	4,740	$390	$1.8M
S5130	Homemaker service, nos; per 15 minutes	6,480	$260	$1.7M
T2004	Non-emergency transport; commercial carrier, multi-pass	11,510	$70	$794.5K
H2021	Community-based wrap-around services, per 15 minutes	1,680	$370	$614.3K

Showing 1–10 of 21

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

North Metro Community Services, Inc. — 1 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

21 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	55	190	3,890	$290	$12.4M
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…	250	480	5,200	$150	$3.5M
T2021	Day habilitation, waiver; per 15 minutes	42	290	3,700	$160	$2.3M
T2019	Habilitation, supported employment, waiver; per 15 minutes	38	100	1,940	$200	$1.5M
S5130	Homemaker service, nos; per 15 minutes	127	340	3,530	$80	$1.2M
H2021	Community-based wrap-around services, per 15 minutes	43	100	960	$100	$1.1M
S5150	Unskilled respite care, not hospice; per 15 minutes	15	90	1,540	$130	$1M
T2003	Non-emergency transportation; encounter/trip	52	280	2,640	$20	$881.3K
H2019	Therapeutic behavioral services, per 15 minutes	49	100	1,090	$90	$600.8K
T2015	Habilitation, prevocational, waiver; per hour	16	20	1,670	$120	$578.5K

Showing 1–10 of 21

Nearby Providers

Other providers in the same ZIP code as North Metro Community Services, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Choice Home Care, LLC	CO	In Home Supportive Care Agency	$0	$34.3M
Evergreen Home Healthcare, LLC	CO	In Home Supportive Care Agency	$0	$28.6M
Trust Home Care, LLC	CO	Home Health Agency	$0	$14.4M
Vitalcare Corporation	CO	Home Health Agency	$0	$11M
Childrens Therapy Services Of Colorado, Inc.	CO	Speech-Language Pathologist	$0	$9.9M
C & D Choices, Inc	CO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$9.6M
Trust Home Care, LLC	CO	Home Health Agency	$0	$9.1M
North Metro Community Services, Inc	CO	Case Management Agency	$0	$7.6M
North Metro Community Services, Inc	CO	Developmentally Disabled Services Day Training Agency	$0	$6.5M
Roth Medical Inc	CO	Durable Medical Equipment & Medical Supplies	$0	$6.5M

North Metro Community Services, Inc. — Billing Profile & Reimbursement Data

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North Metro Community 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