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

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

Capitol City Residential Healthcare Tn LLC (NPI 1851657761)

Field	Value
Entity Type	Organization
Organization	Capitol City Residential Healthcare Tn LLC
Address	725 Cool Springs Blvd
City	Franklin
State	TN
ZIP	37067
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	April 4, 2012

Payer Source	Total Paid
Medicaid	$29.4M
Medicare	$0

Key Findings

CAPITOL CITY RESIDENTIAL HEALTHCARE TN LLC is a Developmentally Disabled Services Day Training Agency located in FRANKLIN, TN with an NPI enumerated on 2012-04-04 (~14 years ago). Its billing profile is effectively Medicaid-only: total Medicaid revenue on file is $29.4M and there is no Medicare billing on file.

This provider is effectively single‑payer from a claims perspective: there is no Medicare revenue on file, while Medicaid accounts for the entire reported lifetime revenue figure of $29.4M. Analysts should treat Medicaid policy and state waiver rules as the primary drivers of revenue change for this entity.

Revenue is highly concentrated in a very small set of service lines: the precomputed top three Medicaid codes account for 97.6% of Medicaid revenue, led by T2033 at 85.1%, followed by H0018 at 10.1% and T2021 at 2.4%. That concentration implies that small shifts in reimbursement, utilization, or eligibility for these specific codes would materially affect overall revenue.

The code mix signals a facility-based, residential and habilitation operation rather than scattered outpatient medical services. T2033 (Residential care, waiver; per diem) is the dominant line, H0018 (short-term residential behavioral health, per diem without room and board) is the second largest, and T2021 (Day habilitation, waiver; per 15 minutes) provides the primary day-program support component, which aligns with the provider’s Developmentally Disabled Services Day Training Agency taxonomy.

Competitive standing varies by code: for T2033 this provider reports $25M (85.1% of Medicaid revenue) and ranks #4 of 97 providers in-state (97th percentile) but that volume is characterized in the data as "typical, unremarkable volume" for this code, indicating strong absolute revenue but not an unusual outlier relative to peers. In contrast, H0018 generates $3M (10.1% of Medicaid revenue) and ranks #1 of 5 providers in-state (100th percentile), explicitly labeled as "notably above typical state volume," which indicates a localized leadership position in short-term residential behavioral health.

Secondary service lines are small and show modest competitive positions: T2021 produced $697K (2.4% of Medicaid revenue) and ranks #37 of 104 in-state (65th percentile), while T2016 produced $534.1K (1.8% of Medicaid revenue) and ranks #27 of 45 (41th percentile). Smaller codes such as H0019 ($163.9K, 0.6% of revenue) and 97151 ($506, negligible share) together underscore limited diversification beyond the few dominant residential and habilitation codes.

Operationally, the heavy reliance on per‑diem residential codes (T2033 and H0018) suggests occupancy, program length of stay, and waiver authorization are likely the primary operational levers for revenue management. Given that the top three codes make up 97.6% of Medicaid revenue, capacity management and compliance with waiver documentation for those per‑diem and habilitation services will disproportionately affect financial performance.

Medicaid: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2033	Residential care, not otherwise specified (nos), waiver; per diem	68,540	$370	$25M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	7,500	$400	$3M
T2021	Day habilitation, waiver; per 15 minutes	5,620	$120	$697K
T2016	Habilitation, residential, waiver; per diem	1,720	$310	$534.1K
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	570	$290	$163.9K
H2011	Crisis intervention service, per 15 minutes	280	$40	$10.2K
97151	The provider, a physician or other qualified healthcare professional, identifies the adaptive or maladaptive behavior of the patient by administering several different types of tests in person; he…	20	$20	$510

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Capitol City Residential Healthcare Tn LLC — 2 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2033	Residential care, not otherwise specified (nos), waiver; per diem	4	100	4,520	$320	$31.6M
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	13	20	1,590	$1,740	$16.5M
T2016	Habilitation, residential, waiver; per diem	27	50	2,620	$430	$11.9M
T2021	Day habilitation, waiver; per 15 minutes	37	100	3,920	$80	$3.4M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	1	10	1,520	$360	$872.7K
H2011	Crisis intervention service, per 15 minutes	11	20	350	$110	$856.7K
97151	The provider, a physician or other qualified healthcare professional, identifies the adaptive or maladaptive behavior of the patient by administering several different types of tests in person; he…	12	20	70	$130	$19.7K

Nearby Providers

Other providers in the same ZIP code as Capitol City Residential Healthcare Tn LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Health Connect America, Inc	TN	Community/Behavioral Health Agency	$0	$285.6M
Summit Bhc New Jersey, LLC	TN	Substance Abuse Rehabilitation Facility	$0	$21.9M
Miller Helpers	TN	In Home Supportive Care Agency	$0	$15.3M
Results-ast Jv, LLC	TN	Physical Therapist	$0	$6.9M
Williamson County Hospital District	TN	General Acute Care Hospital	$0	$4.8M
Skin Solutions Dermatology & Skin Cancer Surgery, P.C.	TN	Specialist	$0	$4.4M
Dr. Mark Lynn & Associates, PLLC	TN	Optometrist	$0	$3.2M
Ambulatory Surgery Center Of Cool Springs LLC	TN	Ambulatory Surgical Clinic/Center	$2.5M	$0
Chase Escott	TN	Radiation Oncology Physician	$1.3M	$0
Douglas Kingma	TN	Hematology (Pathology) Physician	$1.2M	$0

Capitol City Residential Healthcare Tn LLC — Billing Profile & Reimbursement Data

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Capitol City Residential Healthcare Tn LLC — 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