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

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

Systems Unlimited, Inc. (NPI 1740339381)

Field	Value
Entity Type	Organization
Organization	Systems Unlimited, Inc.
Address	2533 Scott Blvd Se
City	Iowa City
State	IA
ZIP	52240
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	January 10, 2007

Payer Source	Total Paid
Medicaid	$244.7M
Medicare	$0

Key Findings

SYSTEMS UNLIMITED, INC. is effectively a Medicaid-only provider: there is no Medicare billing on file and the organization reports $244.7M in lifetime Medicaid revenue, indicating a business model concentrated entirely on state Medicaid programs rather than dual enrollment with Medicare. This payer mix makes Medicaid reimbursement policy and state waiver rules the primary determinants of its revenue and growth prospects.

Revenue is highly concentrated in a very small set of services: the provider’s top three Medicaid codes account for 95.9% of total Medicaid revenue, creating material dependence on a limited number of service lines. That concentration suggests business risk if reimbursement or utilization policy changes for those specific codes.

H2016 is the single largest revenue driver: H2016 generated $146.6M (59.9% of the provider’s Medicaid revenue) across 22.5K claims with an average paid per claim of $6522, and the provider ranks #59 of 176 in-state (67th percentile; typical, unremarkable volume). This indicates the organization’s core operations are centered on comprehensive community support services provided on a per-diem basis, but its state rank shows it is not an outlier in scale for this service.

S5136 is the second major revenue source: S5136 produced $82.7M (33.8% of Medicaid revenue) from 17.9K claims with an average paid per claim of $4611, ranking #30 of 82 in-state (64th percentile; typical, unremarkable volume). The prominence of S5136 confirms a substantial revenue stream from companion care/adult ADL/IADL support delivered per diem, consistent with a day habilitation and community support operator.

T2021 stands out as a utilization outlier: T2021 accounted for $5.4M (2.2% of Medicaid revenue) across 76.2K claims at $71 average paid per claim and ranks #1 of 103 providers in-state (100th percentile; extreme outlier, far above typical state volume). The combination of a low per-unit payment and exceptionally high claim count implies significant operational emphasis on high-frequency, unit-based day habilitation services and distinguishes the provider from peers on utilization patterns.

Taken together, the code mix (H2016, S5136, T2021) aligns with the provider’s taxonomy as a Developmentally Disabled Services Day Training Agency: the services are predominantly community-based supports, companion care, and day habilitation, signaling a business model focused on long-term, outpatient habilitation and support rather than episodic medical care. This mix points to programmatic specialization in day and community services for individuals with developmental disabilities.

Competitive standing is mixed: the provider is a major Medicaid revenue holder overall given $244.7M lifetime Medicaid receipts, yet ranks only in typical percentiles for its top two per-diem codes (H2016 at the 67th percentile; S5136 at the 64th percentile), while exhibiting market leadership for T2021 by being an extreme outlier at the state level. This suggests SCALE in select utilization-intensive services rather than broad dominance across all its primary service lines.

The provider has longstanding enrollment in Medicare/Medicaid systems (NPI enumerated 2007-01-10, ~19 years ago), which signals operational longevity and likely established payer relationships; combined with the concentrated revenue mix, this tenure suggests stability but also exposure to policy or rate changes that affect its handful of top codes.

Medicaid: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2016	Comprehensive community support services, per diem	22,480	$6,520	$146.6M
S5136	Companion care, adult (e.g., iadl/adl); per diem	17,930	$4,610	$82.7M
T2021	Day habilitation, waiver; per 15 minutes	76,160	$70	$5.4M
H2025	Ongoing support to maintain employment, per 15 minutes	5,500	$780	$4.3M
H2015	Comprehensive community support services, per 15 minutes	7,790	$370	$2.9M
T2020	Day habilitation, waiver; per diem	31,100	$90	$2.7M
S5125	Attendant care services; per 15 minutes	440	$310	$135.7K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Iowa Distribution

Systems Unlimited, Inc. — 1 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Iowa

Full comparison — all codes billed, vs. Iowa median

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5136	Companion care, adult (e.g., iadl/adl); per diem	30	80	9,410	$490	$17.9M
H2016	Comprehensive community support services, per diem	59	180	10,790	$390	$15.2M
T2020	Day habilitation, waiver; per diem	29	100	10,960	$110	$3M
H2025	Ongoing support to maintain employment, per 15 minutes	19	70	2,970	$300	$1.9M
H2015	Comprehensive community support services, per 15 minutes	41	100	4,130	$160	$1.9M
S5125	Attendant care services; per 15 minutes	64	90	1,140	$70	$831.9K
T2021	Day habilitation, waiver; per 15 minutes	1	100	2,780	$60	$386.9K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Reach For Your Potential, Inc	IA	Developmentally Disabled Services Day Training Agency	$0	$63.8M
Iowa City Community Schools	IA	Local Education Agency (LEA)	$0	$25.7M
Systems Unlimited, Inc.	IA	Developmentally Disabled Services Day Training Agency	$0	$14.3M
Caring Hands & More LLC	IA	Home Health Agency	$0	$13.9M
County Of Johnson	IA	Land Ambulance	$1.1M	$10.8M
University Of Iowa Community Medical Services, LLC	IA	Durable Medical Equipment & Medical Supplies	$0	$7.3M
Unlimited Abilities	IA	Community/Behavioral Health Agency	$0	$6.6M
The Arc Of Johnson County	IA	Respite Care	$0	$6.3M
Prelude Behavioral Services	IA	Substance Abuse Rehabilitation Facility	$0	$4.3M
Mayor's Youth Empowerment Program	IA	Developmentally Disabled Services Day Training Agency	$0	$3.5M

Systems Unlimited, Inc. — Billing Profile & Reimbursement Data

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Systems Unlimited, 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