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.

Conexio Care, Inc. (NPI 1841868510)

Field	Value
Entity Type	Organization
Organization	Conexio Care, Inc.
Address	590 Naamans Rd
City	Claymont
State	DE
ZIP	19703
Taxonomy	Intellectual & Developmental Disabilities Psychologist
NPI Enumerated	June 17, 2021

Payer Source	Total Paid
Medicaid	$37.9M
Medicare	$0

Key Findings

This entity is effectively a Medicaid-only biller: it reports $37.9M in lifetime Medicaid revenue and has no Medicare billing on file, so its commercial/Medicare exposure is effectively nil and Medicaid drives the entirety of its reported public-payer business.

Revenue is highly concentrated in a very small set of services: the top three Medicaid codes (T2025, T2016, G0175) together account for 99.6% of this provider's total Medicaid revenue, with T2025 alone contributing 57.2% and T2016 contributing 39.7% of Medicaid receipts.

The code mix points to an operation focused on waiver and residential habilitation services and related care coordination: T2025 (Waiver services; nos) has 32.2K claims at $674 avg paid/claim and $21.7M revenue, and T2016 (Habilitation, residential, waiver; per diem) has 23.1K claims at $650 avg paid/claim and $15M revenue, indicating substantial per-diem/waiver-based residential service delivery.

Despite large absolute volumes, the provider is not a statewide outlier in these lines: T2025 ranks #6 of 10 providers in-state (44th percentile) and T2016 ranks #5 of 9 (50th percentile), both labeled as typical, unremarkable volumes, which suggests a modest competitive position rather than dominance in Delaware's waiver/residential market.

Smaller service lines contribute negligible revenue or show atypical payment patterns: G0175 has 20.4K claims at $51 avg paid/claim generating $1M (2.7% of Medicaid revenue) and is a typical-volume contributor (rank #5 of 9, 50th percentile), while H0036 shows 819 claims with $0 avg paid/claim and $0 revenue, indicating billed activity that did not generate paid dollars in the dataset.

Per-claim payment levels underscore the per-diem/waiver economics here: the two largest codes pay at approximately $674 and $650 per claim respectively, which aligns with residential or daily habilitation reimbursement models and explains why relatively modest claim counts can produce multi-million-dollar revenue lines.

Operational scale is visible in claim counts: tens of thousands of claims (32.2K for T2025, 23.1K for T2016, 20.4K for G0175) accompany the $37.9M Medicaid revenue total, signaling a sizable on-the-ground residential/waiver presence rather than a purely consultative or episodic service model.

The provider’s enrollment tenure is relatively recent: the NPI was enumerated on 2021-06-17 (~5 years ago), indicating it achieved its current billing scale over a comparatively short period, which may be relevant when assessing growth trajectory or market entry timing.

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
T2025	Waiver services; not otherwise specified (nos)	32,210	$670	$21.7M
T2016	Habilitation, residential, waiver; per diem	23,150	$650	$15M
G0175	Scheduled interdisciplinary team conference (minimum of three exclusive of patient care nursing staff) with patient present	20,370	$50	$1M
T1001	Nursing assessment / evaluation	2,950	$50	$132.8K
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	820	$0	$0

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

Conexio Care, Inc. — 0 of 4 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

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2025	Waiver services; not otherwise specified (nos)	6	10	37,650	$670	$43M
T2016	Habilitation, residential, waiver; per diem	5	10	23,150	$620	$21.9M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	17	20	2,510	$160	$2M
G0175	Scheduled interdisciplinary team conference (minimum of three exclusive of patient care nursing staff) with patient present	5	10	20,370	$50	$986.1K
T1001	Nursing assessment / evaluation	19	50	1,950	$50	$294K

Nearby Providers

Other providers in the same ZIP code as Conexio Care, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Conexio Care, Inc.	DE	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$12M
State Of Delaware	DE	Local Education Agency (LEA)	$0	$1.5M
Ats Of Delaware, LLC	DE	Methadone Clinic	$190.3K	$1.1M
Claymont Family Dentistry	DE	Dental Clinic/Center	$0	$968.9K
Claymont Fire Company 1	DE	Land Ambulance	$351.7K	$421.5K
Ivyrehab Delaware LLC	DE	Physical Medicine & Rehabilitation Physician	$0	$750.7K
Bc Home Healthcare Services, Inc.	DE	Home Health Agency	$0	$441.6K
Southbridge Medical Advisory Council, Inc.	DE	Federally Qualified Health Center (FQHC)	$0	$364.4K
Patricia Manchak	DE	Physical Therapist	$315.6K	$0
Herman Ortez	DE	Professional Counselor	$0	$180.6K

Conexio Care, Inc. — Billing Profile & Reimbursement Data

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Conexio Care, 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