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

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

Point Of Hope Inc. (NPI 1801286349)

Field	Value
Entity Type	Organization
Organization	Point Of Hope Inc.
Address	34 Blevins Dr Ste 5
City	New Castle
State	DE
ZIP	19720
Taxonomy	Intellectual & Developmental Disabilities Psychologist
NPI Enumerated	February 4, 2015

Payer Source	Total Paid
Medicaid	$10M
Medicare	$0

Key Findings

POINT OF HOPE INC. shows an effectively single-payer billing profile: there is no Medicare revenue on file and total Medicaid revenue is $10M, indicating the organization’s paid activity is concentrated entirely within Medicaid programs. This makes Medicaid program changes materially meaningful to the provider’s overall revenue picture.

Revenue concentration is extreme within the Medicaid portfolio: the precomputed top three codes account for 100.0% of the provider’s Medicaid revenue, and a single code, T2020, represents $10M in revenue or 99.5% of the provider’s Medicaid receipts. This level of concentration makes the provider highly dependent on continued authorization, utilization, and reimbursement stability for that one service line.

The dominant code, T2020 (Day habilitation, waiver; per diem), accounts for 70.3K claims with an average paid of $142 per claim and $10M in revenue, and is described in the source as having typical, unremarkable volume among peers. Taken together with the provider taxonomy (Intellectual & Developmental Disabilities Psychologist), this code mix indicates the organization primarily operates day habilitation services for waiver-eligible individuals and is configured around per-diem habilitation delivery.

Two transportation codes—T2004 (Non-emergency transport; commercial carrier, multi-pass) and A0110 (Non-emergency transportation and bus, intra or inter state carrier)—are present but marginal in revenue contribution: T2004 is $50.9K (3.4K claims, $15 avg paid/claim) and A0110 is $2.3K (55 claims, $42 avg paid/claim). Both are labeled in the data as typical, unremarkable volume for these codes, suggesting transport functions are ancillary operational services rather than core revenue drivers.

Competitive standing by code is mixed: for the primary service T2020 the provider ranks #3 of 11 in-state (80th percentile), signaling a solid regional position for day habilitation but not an outright dominant market share. By contrast, T2004 ranks #7 of 7 (0th percentile) and A0110 ranks #3 of 3 (0th percentile), indicating minimal in-state relative presence for the transport services.

Operational implications follow from the claims pattern: processing 70.3K T2020 claims at an average paid of $142 per claim implies substantial recurring, day-to-day service delivery capacity concentrated in per-diem habilitation billing. The volume and per-claim reimbursement profile are consistent with an organization running high-frequency, programmatic waiver services rather than episodic clinical billing.

The provider has been enumerated since 2015-02-04 (~11 years ago), which indicates over a decade of registration in the NPI system; despite this tenure there is no Medicare billing on file, reinforcing that the organization’s revenue model and payer relationships are focused on Medicaid waiver programs rather than Medicare fee-for-service.

Because T2020 drives 99.5% of Medicaid revenue and the top three codes total 100.0% of Medicaid revenue, the provider’s financial performance is highly sensitive to policy, utilization authorization, or rate changes affecting day habilitation waiver reimbursement. Analysts should treat changes to waiver rules or per-diem rates as primary risk levers for this entity’s near-term revenue trajectory.

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2020	Day habilitation, waiver; per diem	70,320	$140	$10M
T2004	Non-emergency transport; commercial carrier, multi-pass	3,390	$20	$50.9K
A0110	Non-emergency transportation and bus, intra or inter state carrier	60	$40	$2.3K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Delaware Distribution

Point Of Hope Inc. — 0 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. Delaware median

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2020	Day habilitation, waiver; per diem	3	10	19,250	$120	$6.3M
T2004	Non-emergency transport; commercial carrier, multi-pass	7	10	11,330	$10	$187.5K
A0110	Non-emergency transportation and bus, intra or inter state carrier	3	10	9,480	$10	$123.8K

Nearby Providers

Other providers in the same ZIP code as Point Of Hope Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Easter Seals Delaware & Marylands Eastern Shore, Inc	DE	Intellectual & Developmental Disabilities Psychologist	$0	$315.9M
Bayada Home Health Care, Inc.	DE	Home Health Agency	$0	$61.2M
Conexio Care, Inc.	DE	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$15.8M
Nurses 'n Kids, Inc.	DE	Medically Fragile Infants and Children Day Care	$0	$14.3M
Delaware Diagnostic Labs, LLC	DE	Clinical Medical Laboratory	$3.1M	$8.5M
Anesthesia Services PA	DE	Anesthesiology Physician	$0	$6.3M
Collaborative Effort To Reinforce Transition Success, Inc	DE	Intellectual & Developmental Disabilities Psychologist	$0	$4M
Abundant Life Community Development Corporation	DE	Intellectual & Developmental Disabilities Psychologist	$0	$2M
State Of Delaware	DE	Local Education Agency (LEA)	$0	$2M
Family Care Associates, Inc	DE	Family Medicine Physician	$0	$1.6M

Point Of Hope Inc. — Billing Profile & Reimbursement Data

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Point Of Hope 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