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.

Mid-step Services, Inc. (NPI 1790846319)

Field	Value
Entity Type	Organization
Organization	Mid-step Services, Inc.
Address	4303 Stone Ave
City	Sioux City
State	IA
ZIP	51106
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	December 13, 2006

Payer Source	Total Paid
Medicaid	$51.5M
Medicare	$0

Key Findings

MID-STEP SERVICES, INC. has no Medicare billing on file and is effectively a single-payer Medicaid operation, with total Medicaid revenue reported at $51.5M. The absence of Medicare activity means payers and competitive analyses should focus exclusively on Medicaid programs and in-state dynamics when evaluating this entity.

Revenue concentration is high: the precomputed top three Medicaid codes (S5136, H2015, T2020) together account for 93.7% of the provider’s total Medicaid revenue. In particular, S5136 alone represents $38.8M (75.5% of the provider's total Medicaid revenue), indicating the business is overwhelmingly dependent on a single per-diem service line.

The code mix aligns with services typical of a Developmentally Disabled Services Day Training Agency: large per-diem companion care billing (S5136 – Companion care, adult; per diem), day habilitation (T2020 – Day habilitation, waiver; per diem) and intensive community support (H2015 – Comprehensive community support services; per 15 minutes). High average paid amounts on per-diem codes (for example, S5136 at $4131 avg paid/claim and H2016 at $8424 avg paid/claim) suggest operations centered on full‑day or bundled supports rather than predominantly brief time-based encounters.

S5136’s in-state competitive standing is middling: the provider ranks #42 of 82 in state (49th percentile) for that code and is described as typical, unremarkable volume relative to peers. Likewise, H2015 (rank #53 of 95, 45th percentile) and T2020 (rank #56 of 101, 45th percentile) are both positioned near the state median, indicating MID-STEP is a modest, not dominant, participant across its primary service lines.

H2016 (Comprehensive community support services, per diem) presents a different profile: only 350 claims but a high $8424 avg paid/claim, producing $2.9M (5.7% of total Medicaid revenue) and ranking #157 of 176 providers in-state (11th percentile). This pattern—low claim count but high per-claim payment—suggests selective use of a high‑value per-diem service that contributes materially to revenue despite limited volume.

Operational and reimbursement sensitivity should be a consideration: with $38.8M (75.5%) tied to S5136, any policy, coverage, or rate changes affecting companion care per-diem payments would disproportionately impact MID-STEP’s financial position. Analysts should flag the concentration in S5136 when assessing revenue stability and contracting negotiations.

MID-STEP has long tenure in the market, with its NPI enumerated on 2006-12-13 (~20 years ago), which supports continuity of operations and established billing patterns over time. Given the provider’s established presence and its concentrated Medicaid footprint, payer strategy and rate-setting decisions in-state will materially shape its short- to medium-term business prospects.

Medicaid: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5136	Companion care, adult (e.g., iadl/adl); per diem	9,400	$4,130	$38.8M
H2015	Comprehensive community support services, per 15 minutes	3,580	$1,410	$5M
T2020	Day habilitation, waiver; per diem	8,880	$490	$4.3M
H2016	Comprehensive community support services, per diem	350	$8,420	$2.9M
T2021	Day habilitation, waiver; per 15 minutes	2,780	$100	$278.4K
T2015	Habilitation, prevocational, waiver; per hour	90	$260	$23.7K

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

Mid-step Services, Inc. — 0 of 6 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

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5136	Companion care, adult (e.g., iadl/adl); per diem	42	80	9,410	$490	$17.9M
H2016	Comprehensive community support services, per diem	157	180	10,790	$390	$15.2M
T2020	Day habilitation, waiver; per diem	56	100	10,960	$110	$3M
H2015	Comprehensive community support services, per 15 minutes	53	100	4,130	$160	$1.9M
T2015	Habilitation, prevocational, waiver; per hour	28	30	1,920	$70	$425.6K
T2021	Day habilitation, waiver; per 15 minutes	52	100	2,780	$60	$386.9K

Nearby Providers

Other providers in the same ZIP code as Mid-step Services, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Michael Wadzinski	IA	Ophthalmology Physician	$4.8M	$0
Northwest Aea 12	IA	Local Education Agency (LEA)	$0	$2.1M
Qualicenters Sioux City, LLC	IA	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.5M
Prairie Pediatrics & Adolescent Clinic, P.C.	IA	Pediatric Cardiology Physician	$0	$1M
Daniel L Kaler Dds PC	IA	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$907K
Heather Longval	IA	Family Medicine Physician	$381.1K	$0
Bryce Robison	IA	Family Medicine Physician	$267.4K	$0
Delna Lee	IA	Family Medicine Physician	$225K	$0
Michael Jennings	IA	Family Medicine Physician	$188.3K	$0
Troy Fluent	IA	Chiropractor	$34.5K	$151.7K

Mid-step Services, Inc. — Billing Profile & Reimbursement Data

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Mid-step 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