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

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

State Of Missouri (NPI 1811137516)

Field	Value
Entity Type	Organization
Organization	State Of Missouri
Address	2323 N Ash St
City	Nevada
State	MO
ZIP	64772
Taxonomy	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NPI Enumerated	February 20, 2009

Payer Source	Total Paid
Medicaid	$65M
Medicare	$0

Key Findings

The provider’s code mix is consistent with its Taxonomy as an Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: the dominant T2016 per‑diem habilitation code indicates the operation is primarily residential habilitation under waiver programs, with supplementary nursing (T1002) and escort/attendant transportation (T2001) billed alongside those per‑diem services. This pattern points to a facility-centered, census‑driven model where room/residential habilitation is the core service line.

Revenue is highly concentrated in a single code: the top 3 Medicaid codes account for 100.0% of this provider’s Medicaid revenue, and T2016 alone represents $64.3M (98.9%) of the $65M in total Medicaid revenue, based on 106.2K claims at an average paid amount of $605 per claim. This level of concentration means nearly all Medicaid dollars flow from the per‑diem habilitation activity.

This entity is effectively single‑payer at present: there is no Medicare billing on file for this NPI (listed as "none"), while Medicaid accounts for $65M in lifetime revenue. Analysts should treat the provider as Medicaid‑dependent for revenue exposure and benchmarking.

Despite the large absolute Medicaid revenue tied to T2016, the provider’s statewide competitive standing on that code is not an outlier: T2016 ranks #25 of 193 providers in-state (88th percentile) and is described as "typical, unremarkable volume for this code." In other words, the facility generates substantial dollars because of the high per‑claim payment and volume mix, but its per‑code volume is within a broadly observed range among peers.

The provider is relatively prominent in RN services billing by rank even though that revenue is small in absolute terms: T1002 (Rn services, up to 15 minutes) generated $535.2K (0.8% of Medicaid revenue) from 16.7K claims and ranks #6 of 195 providers in-state (97th percentile), labeled "typical, unremarkable volume for this code." This suggests the facility bills nursing time at a higher relative frequency than most peers, which may reflect in‑house nursing coverage models that complement residential habilitation.

Non‑emergency patient attendant/escort transportation (T2001) is a measurable but minor revenue stream, producing $203.6K (0.3% of Medicaid revenue) on 3.5K claims and ranking #23 of 150 providers in-state (85th percentile) with a "typical, unremarkable" profile. This indicates the provider consistently bills attendant/escort transport but does not rely on it for material revenue.

The provider has long tenure in the program: this NPI was enumerated on 2009-02-20 (~17 years ago), indicating sustained participation in Medicaid billing and likely operational stability in delivering waiver‑based residential services over time.

Operational and reimbursement implications follow from the concentration: because 98.9% of Medicaid revenue derives from T2016 per‑diem habilitation, the provider’s financial performance will be highly sensitive to changes in residential census, Medicaid authorization policies, or per‑diem rate adjustments for T2016. The relatively small contribution of ancillary codes (T1002 and T2001) suggests limited revenue diversification beyond the core residential habilitation line.

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
T2016	Habilitation, residential, waiver; per diem	106,200	$610	$64.3M
T1002	Rn services, up to 15 minutes	16,730	$30	$535.2K
T2001	Non-emergency transportation; patient attendant/escort	3,510	$60	$203.6K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Missouri Distribution

State Of Missouri — 1 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. Missouri median

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	25	190	38,330	$450	$27M
T2001	Non-emergency transportation; patient attendant/escort	23	150	1,300	$150	$296.4K
T1002	Rn services, up to 15 minutes	6	200	1,720	$50	$194.4K

Nearby Providers

Other providers in the same ZIP code as State Of Missouri, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Skills Unlimited Inc	MO	Developmentally Disabled Services Day Training Agency	$0	$52.1M
Preferred Family Healthcare	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$25M
On My Own, Inc.	MO	Clinic/Center	$0	$20.4M
At Home Independence,llc	MO	Home Health Agency	$0	$7.8M
Nevada City Hospital	MO	Rural Acute Care Hospital	$0	$5.8M
Vernon County Ambulance District	MO	Land Ambulance	$284.8K	$1.4M
Christopher Mitchell	MO	Physical Therapist	$57.3K	$0

State Of Missouri — Billing Profile & Reimbursement Data

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State Of Missouri — 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