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

Why is the Medicaid comparison limited to South Dakota 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. South Dakota (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.

Dakota Milestones (NPI 1811037922)

Field	Value
Entity Type	Organization
Organization	Dakota Milestones
Address	117 E Beebe Ave
City	Chamberlain
State	SD
ZIP	57325
Taxonomy	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NPI Enumerated	February 7, 2007

Payer Source	Total Paid
Medicaid	$18.6M
Medicare	$0

Key Findings

This provider reports no Medicare billing on file and $18.6M in lifetime Medicaid revenue, making its operations effectively single-payer (Medicaid)-dependent based on the available claims data. The absence of Medicare activity means all analyzed clinical and business signals below derive from Medicaid billing patterns rather than a mixed-payer footprint.

Revenue is highly concentrated in three waiver habilitation codes: T2016, T2020, and T2025 together account for 92.7% of this provider’s total Medicaid revenue. Individually those codes represent $12.6M (67.7%), $3.5M (18.8%), and $1.2M (6.3%) of Medicaid revenue respectively, indicating a narrow revenue base anchored in a few per-diem and waiver service lines.

The service mix strongly aligns with an IDD community-based residential habilitation model: T2016 (Habilitation, residential, waiver; per diem) is the single largest revenue driver at $12.6M and suggests the provider’s primary operation is paid residential habilitation. T2020 (Day habilitation, waiver; per diem) at $3.5M indicates a substantial day-program component, while T2025 (Waiver services; nos) represents a modestly sized catch-all for other waiver services at $1.2M. These code-level patterns are consistent with a residential program that also delivers day habilitation and other waiver supports.

Despite the large absolute dollar volume in T2016, the provider is a modest in-state participant for that code: T2016 ranks #17 of 21 providers in-state (20th percentile) and is labeled as typical, unremarkable volume relative to peers. In plain terms, even though T2016 drives most of this provider’s Medicaid revenue, the provider is not a dominant statewide provider of residential habilitation by volume.

T2020 and T2025 similarly show middling competitive standing within the state. T2020 ($3.5M) ranks #16 of 20 providers (21st percentile) and T2025 ($1.2M) ranks #14 of 19 providers (28th percentile); both are described as typical, unremarkable volumes, indicating the provider occupies a middle- to lower-tier market position for day habilitation and miscellaneous waiver services.

The provider also bills for coordinated-care services: S0281 (Medical home program, comprehensive care coordination and planning) generated $1.1M (6.1% of Medicaid revenue) and ranks #16 of 21 providers in-state (25th percentile). That share and rank indicate the provider offers structured care coordination as part of its waiver portfolio, but it is not a leading statewide provider of medical-home style coordination services.

Smaller code lines—T2014 ($97K, 0.5%), T2018 ($73.8K, 0.4%), T2028 ($38.5K, 0.2%), and T2019 ($11.1K, 0.1%)—contribute only marginally to the revenue mix and are each characterized as typical, unremarkable volume with low-to-middle in-state percentiles. These lower-revenue codes suggest limited activity in prevocational, supported-employment, specialized supplies, and per-15-minute supported employment billing relative to peers, reinforcing the dominance of per-diem residential and day habilitation in the business model.

The provider’s NPI was enumerated on 2007-02-07 (~19 years ago), indicating a long tenure in the market. Combined with the concentrated Medicaid revenue base, this longevity suggests operational stability in a Medicaid-funded service niche but also a sensitivity to Medicaid policy and rate changes given the lack of Medicare diversification.

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	3,430	$3,680	$12.6M
T2020	Day habilitation, waiver; per diem	4,150	$840	$3.5M
T2025	Waiver services; not otherwise specified (nos)	2,750	$420	$1.2M
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	3,130	$360	$1.1M
T2014	Habilitation, prevocational, waiver; per diem	370	$260	$97K
T2018	Habilitation, supported employment, waiver; per diem	690	$110	$73.8K
T2028	Specialized supply, not otherwise specified, waiver	800	$50	$38.5K
T2019	Habilitation, supported employment, waiver; per 15 minutes	50	$240	$11.1K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Dakota Distribution

Dakota Milestones — 0 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. South Dakota median

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	17	20	6,880	$1,660	$31.6M
T2020	Day habilitation, waiver; per diem	16	20	7,340	$500	$8.9M
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	16	20	6,090	$420	$3M
T2025	Waiver services; not otherwise specified (nos)	14	20	5,410	$180	$1.9M
T2018	Habilitation, supported employment, waiver; per diem	13	20	1,510	$80	$433.9K
T2014	Habilitation, prevocational, waiver; per diem	15	20	1,210	$130	$410.3K
T2019	Habilitation, supported employment, waiver; per 15 minutes	14	20	480	$90	$288.6K
T2028	Specialized supply, not otherwise specified, waiver	18	30	910	$50	$169.8K

Nearby Providers

Other providers in the same ZIP code as Dakota Milestones, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dakota Milestones	SD	Case Manager/Care Coordinator	$0	$1.7M
Sanford Health Network	SD	Critical Access Hospital	$0	$1.5M
605 Vision, PC	SD	Optometrist	$0	$1.3M
Sanford Health Network	SD	Critical Access Hospital	$0	$1M
Dakota Milestones	SD	Case Manager/Care Coordinator	$0	$284.5K
Dakota Milestones	SD	Case Manager/Care Coordinator	$0	$268.7K
Rural Health Care, Inc.	SD	Federally Qualified Health Center (FQHC)	$0	$233.9K
Missouri Valley Ambulance Service	SD	Land Ambulance	$75.5K	$95.8K
Sanford Health Network	SD	Family Medicine Physician	$0	$142.7K
Chamberlain Family Dentistry	SD	Dental Clinic/Center	$0	$110.5K

Dakota Milestones — Billing Profile & Reimbursement Data

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Dakota Milestones — 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