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

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

Lutheran Social Services Of Wisconsin And Upper Michigan, Inc. (NPI 1730253758)

Field	Value
Entity Type	Organization
Organization	Lutheran Social Services Of Wisconsin And Upper Michigan, Inc.
Address	6737 W Washington St Ste 2275
City	West Allis
State	WI
ZIP	53214
Taxonomy	Public Health or Welfare Agency
NPI Enumerated	November 20, 2006

Payer Source	Total Paid
Medicaid	$18M
Medicare	$0

Key Findings

LUTHERAN SOCIAL SERVICES OF WISCONSIN AND UPPER MICHIGAN, INC. appears to operate almost entirely within Medicaid: the provider has no Medicare billing on file and reports $18M in total Medicaid revenue, making it effectively a single-payer Medicaid provider for Medicare/Medicaid comparisons. This payer concentration implies its service portfolio and financial footprint are driven by state Medicaid program demand rather than Medicare beneficiaries.

Revenue concentration is extremely high: the top 3 Medicaid codes by revenue account for 90.3% of this provider's total Medicaid revenue, indicating the organization’s finances are heavily dependent on a very narrow set of services. Such concentration heightens operational sensitivity to policy, rate, or utilization changes affecting those specific codes.

T1016 (Case management, each 15 minutes) is the dominant revenue driver, contributing $14.4M or 80.1% of the provider’s Medicaid revenue with 252.9K claims and a $57 avg paid/claim. The provider ranks #5 of 224 in-state (98th percentile) for T1016 and is described as an extreme outlier, which signals a focused business model centered on high-volume case management and suggests substantial scale or specialization in care coordination services relative to peers.

The second and third top revenue codes — H2021 (Community-based wrap-around services, per 15 minutes) at $984K and S5110 (Home care training, family; per 15 minutes) at $859.2K — together with T1016 form the bulk of billed services. Both H2021 and S5110 show typical, unremarkable volume within the state (H2021 ranks #3 of 7; S5110 ranks #6 of 12), implying that beyond its outsized case management activity the provider delivers a standard mix of community wrap-around and family home-care training services comparable to other organizations.

Competitive standing is mixed: for T1016 the provider is a dominant statewide player (98th percentile, extreme outlier), while for most other high-revenue Medicaid codes it falls into routine percentiles (generally mid-range ranks and labels such as "typical, unremarkable volume"). This suggests market leadership in case management but more modest participation across ancillary Medicaid service lines.

The provider’s NPI was enumerated on 2006-11-20 (~20 years ago), indicating long tenure in the Medicaid market. This duration supports the plausibility of developed operational capacity and established payer relationships that could underlie its sustained, high-volume case management activity.

Several ancillary codes contribute meaningful but much smaller shares of revenue: T1999 ($479.9K, 2.7%), S5136 ($467.8K, 2.6%), and A9999 ($200.4K, 1.1%). These services — miscellaneous therapeutic items/supplies, companion care, and DME accessories — indicate the organization also bills for a diversified set of supportive services, though none approach the scale of T1016.

State-level rank patterns highlight where the provider is atypical versus typical: it is an extreme outlier for T1016 but falls into typical percentiles for H2021, S5110, and most other listed codes. Analysts should view this as a highly concentrated operational model with one clearly dominant service line (case management) and otherwise conventional participation in other Medicaid waiver and home-care service codes.

Medicaid: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1016	Case management, each 15 minutes	252,870	$60	$14.4M
H2021	Community-based wrap-around services, per 15 minutes	10,250	$100	$984K
S5110	Home care training, family; per 15 minutes	3,420	$250	$859.2K
T1999	Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks"	4,170	$120	$479.9K
S5136	Companion care, adult (e.g., iadl/adl); per diem	680	$690	$467.8K
A9999	Miscellaneous dme supply or accessory, not otherwise specified	2,230	$90	$200.4K
G0176	Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more)	1,060	$180	$185.5K
T2041	Supports brokerage, self-directed, waiver; per 15 minutes	3,460	$50	$166.3K
T2028	Specialized supply, not otherwise specified, waiver	1,060	$130	$142.6K
T2017	Habilitation, residential, waiver; 15 minutes	820	$70	$57.4K

Showing 1–10 of 13

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wisconsin Distribution

Lutheran Social Services Of Wisconsin And Upper Michigan, Inc. — 1 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1016	Case management, each 15 minutes	5	220	7,110	$70	$1.7M
H2021	Community-based wrap-around services, per 15 minutes	3	10	4,410	$100	$848.4K
T2017	Habilitation, residential, waiver; 15 minutes	15	30	820	$110	$605.6K
S5110	Home care training, family; per 15 minutes	6	10	2,400	$170	$584.2K
S5136	Companion care, adult (e.g., iadl/adl); per diem	5	10	270	$100	$449.7K
G0176	Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more)	21	50	670	$120	$361.8K
T2041	Supports brokerage, self-directed, waiver; per 15 minutes	2	10	4,780	$50	$231.2K
T2028	Specialized supply, not otherwise specified, waiver	10	40	340	$210	$188.6K
A9999	Miscellaneous dme supply or accessory, not otherwise specified	11	60	460	$170	$177.3K
T1999	Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks"	8	60	610	$40	$97.4K

Showing 1–10 of 13

Nearby Providers

Other providers in the same ZIP code as Lutheran Social Services Of Wisconsin And Upper Michigan, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Noah Associates Incorporated	WI	Clinical Medical Laboratory	$475.8K	$10.6M
Labworks, LLC	WI	Clinical Medical Laboratory	$0	$9.9M
Whitmore International LLC	WI	Case Management Agency	$0	$5.3M
Neb Medical Services, Inc	WI	Durable Medical Equipment & Medical Supplies	$0	$5.2M
Genesis Behavioral Services, Inc.	WI	Substance Abuse Rehabilitation Facility	$0	$4.8M
Wisconsin Renal Care Group, L.L.C.	WI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4.5M
The Home Care Agency, Inc.	WI	Preferred Provider Organization	$0	$3.4M
Wheaton Franciscan Home Health & Hospice, LLC	WI	Home Health Agency	$0	$3.3M
Addiction Services And Pharmacotherapy, Sc	WI	Methadone Clinic	$136.5K	$3M
City Of West Allis	WI	Land Ambulance	$330.7K	$2.6M

Lutheran Social Services Of Wisconsin And Upper Michigan, 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