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

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

Ben Hill Mental Retardation Service (NPI 1740498153)

Field	Value
Entity Type	Organization
Organization	Ben Hill Mental Retardation Service
Address	402 S Main St
City	Fitzgerald
State	GA
ZIP	31750
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	May 18, 2007

Payer Source	Total Paid
Medicaid	$16.3M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-first operation with no Medicare billing on file and $16.3M in lifetime Medicaid revenue reported; its NPI was enumerated on 2007-05-18 (~19 years ago), indicating long-standing participation in state waiver programs. The absence of Medicare activity makes Medicaid the dominant and effectively sole payer reflected in this profile.

Revenue is highly concentrated in a very small set of waiver-related codes: the precomputed top 3 Medicaid codes account for 99.9% of this provider's total Medicaid revenue. In particular, T2017 accounts for $9.2M (56.7% of Medicaid revenue) and T2025 accounts for $7M (42.7% of Medicaid revenue), while the third top code T1002 contributes $86.9K (0.5% of Medicaid revenue).

The code mix (T2017 – Habilitation, residential, waiver and T2025 – Waiver services, nos) indicates the business is primarily delivering waiver-funded habilitation and residential/support services for people with developmental disabilities, consistent with its taxonomy as a Developmentally Disabled Services Day Training Agency. The relatively small T1002 (Rn services, up to 15 minutes) line shows some nurse-provider activity but it is not a principal revenue driver.

Competitive standing on T2017 is modest within the state: the provider ranks #4 of 9 providers in-state (63th percentile; typical, unremarkable volume for this code), which signals a meaningful share of residential habilitation business but not dominance among peer organizations. Despite a large dollar amount on this code, its in-state rank and percentile indicate it operates at a typical scale relative to the limited peer set.

For T2025 the provider ranks #10 of 30 in-state (69th percentile; typical, unremarkable volume for this code), and for T1002 it ranks #8 of 30 (76th percentile; typical, unremarkable volume for this code). These rank/percentile positions characterize the provider as a solid but not market-leading participant for commonly billed waiver services and for the relatively small nursing component.

T2019 (Habilitation, supported employment, waiver) appears as a niche line for this provider: 387 claims produced $13.9K in revenue and the provider is reported as rank #1 of 1 providers in-state (0th percentile; no state peer volume comparison available). This suggests the entity may be the only reported state biller for that specific supported-employment waiver code, though the revenue impact is minimal.

A practical operational implication of the concentration in T2017 and T2025 is elevated sensitivity to state waiver policy or reimbursement changes: because $9.2M (56.7%) and $7M (42.7%) are concentrated in two waiver codes and the top three codes overall account for 99.9% of Medicaid revenue, shifts in coverage, rates, or utilization of those specific codes would materially affect this provider's revenue. Monitoring state waiver policy and peer reimbursement trends should therefore be a priority for payers and analysts assessing continuity of these services.

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2017	Habilitation, residential, waiver; 15 minutes	55,990	$170	$9.2M
T2025	Waiver services; not otherwise specified (nos)	49,000	$140	$7M
T1002	Rn services, up to 15 minutes	3,100	$30	$86.9K
T2019	Habilitation, supported employment, waiver; per 15 minutes	390	$40	$13.9K
T2028	Specialized supply, not otherwise specified, waiver	30	$190	$5K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Georgia Distribution

Ben Hill Mental Retardation Service — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Georgia

Full comparison — all codes billed, vs. Georgia median

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2017	Habilitation, residential, waiver; 15 minutes	4	10	18,160	$180	$18.4M
T2025	Waiver services; not otherwise specified (nos)	10	30	15,890	$130	$7.5M
T2028	Specialized supply, not otherwise specified, waiver	16	20	2,190	$210	$854K
T1002	Rn services, up to 15 minutes	8	30	640	$50	$162.7K
T2019	Habilitation, supported employment, waiver; per 15 minutes	1	10	390	$40	$13.8K

Nearby Providers

Other providers in the same ZIP code as Ben Hill Mental Retardation Service, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vickie Motley	GA	Pediatrics Physician	$0	$1.9M
Ben Hill County School System	GA	Local Education Agency (LEA)	$0	$567.8K
Derrick Taylor	GA	Internal Medicine Physician	$166.9K	$0
Steven Taylor	GA	Physical Therapist	$68.9K	$0
Jennifer Frey	GA	Physical Therapist	$21.4K	$0

Ben Hill Mental Retardation Service — Billing Profile & Reimbursement Data

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Ben Hill Mental Retardation Service — 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