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

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

North Star Community Services, Inc (NPI 1861544397)

Field	Value
Entity Type	Organization
Organization	North Star Community Services, Inc
Address	3420 University Ave
City	Waterloo
State	IA
ZIP	50701
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	January 17, 2007

Payer Source	Total Paid
Medicaid	$26.7M
Medicare	$0

Key Findings

This provider is effectively a single-payer Medicaid operator: there is no Medicare billing on file and lifetime Medicaid revenue is $26.7M, so all reported government billing activity is concentrated in Medicaid programs rather than Medicare. The absence of Medicare claims indicates its service mix and patient population are focused on Medicaid-eligible developmental disability and day services rather than Medicare-covered medical care.

Revenue is highly concentrated in a few service lines: the precomputed top three Medicaid codes account for 87.5% of the provider's total Medicaid revenue, driven primarily by T2020, H2015, and H2016. Specifically, T2020 accounts for $11.9M (44.6%), H2015 contributes $7.4M (27.9%), and H2016 provides $4M (15.0%) of the $26.7M Medicaid total.

The code mix indicates the organization operates facility-based and community habilitation services: T2020 (Day habilitation, waiver; per diem) and T2021 (Day habilitation, waiver; per 15 minutes) point to day habilitation programs, while H2015 (Comprehensive community support services, per 15 minutes) and H2016 (Comprehensive community support services, per diem) reflect intensive community support and skill-building delivered in structured settings. These codes together suggest a core business of day programs and community support for individuals with developmental disabilities rather than medical outpatient procedures.

Competitive standing within the state is strong for the largest revenue drivers: T2020 ranks #6 of 101 providers in-state (95th percentile) and is described as notably above typical state volume, and H2015 ranks #3 of 95 providers (98th percentile) and is also notably above typical state volume. By contrast, H2016 ranks #63 of 176 (65th percentile) and is characterized as typical/unremarkable, indicating market leadership in certain waiver/day-habilitation services but more ordinary presence for some community-support billing.

S5102 (Day care services, adult; per diem) is an important secondary revenue source with $2.7M in revenue (10.2% of the provider's total Medicaid revenue), 34.4K claims, and a $79 avg paid/claim; it ranks #2 of 19 providers in-state (94th percentile) yet is labeled as typical/unremarkable in volume. This pattern suggests the provider also operates adult day care services at meaningful scale, even if that activity does not stand out as statistically exceptional by the dataset's characterization.

Claim-level economics differ by modality: T2020 shows 114.5K claims at a $104 avg paid/claim, H2015 shows 53.6K claims at a $139 avg paid/claim, and H2016 shows 21.6K claims at a $186 avg paid/claim, reflecting a mix of high-frequency per-diem billing and lower-frequency, higher-rate per-interval community support services. These differences imply operational models that combine high-volume daily attendance programs with time-based community support billing, which has implications for staffing, scheduling, and cash flow management.

The provider has long tenure in the provider ecosystem, with an NPI enumerated on 2007-01-17 (~19 years ago), indicating established operations and experience in Medicaid waiver and community support programs; this longevity can be relevant when assessing contracting stability and institutional knowledge.

Because 87.5% of Medicaid revenue is concentrated in three codes tied to day habilitation and comprehensive community support, the organization is operationally and financially sensitive to Medicaid policy changes, rate adjustments, or waiver eligibility revisions affecting T2020, H2015, and H2016. From a payer/analyst perspective, this concentration highlights both the provider's specialization strengths and its vulnerability to changes in reimbursement or program rules for those specific service lines.

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
T2020	Day habilitation, waiver; per diem	114,450	$100	$11.9M
H2015	Comprehensive community support services, per 15 minutes	53,580	$140	$7.4M
H2016	Comprehensive community support services, per diem	21,560	$190	$4M
S5102	Day care services, adult; per diem	34,360	$80	$2.7M
T2021	Day habilitation, waiver; per 15 minutes	13,710	$30	$397.6K
S5125	Attendant care services; per 15 minutes	310	$500	$153.6K
S5101	Day care services, adult; per half day	920	$50	$43.1K
S5150	Unskilled respite care, not hospice; per 15 minutes	360	$110	$40.7K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Iowa Distribution

North Star Community Services, Inc — 1 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Iowa

Full comparison — all codes billed, vs. Iowa median

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2016	Comprehensive community support services, per diem	63	180	10,790	$390	$15.2M
T2020	Day habilitation, waiver; per diem	6	100	10,960	$110	$3M
H2015	Comprehensive community support services, per 15 minutes	3	100	4,130	$160	$1.9M
S5150	Unskilled respite care, not hospice; per 15 minutes	34	40	2,200	$240	$1.6M
S5102	Day care services, adult; per diem	2	20	3,060	$90	$1.1M
S5125	Attendant care services; per 15 minutes	68	90	1,140	$70	$831.9K
T2021	Day habilitation, waiver; per 15 minutes	16	100	2,780	$60	$386.9K
S5101	Day care services, adult; per half day	5	10	920	$50	$102.8K

Nearby Providers

Other providers in the same ZIP code as North Star Community Services, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Exceptional Persons Inc	IA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$80.3M
Vgm Group, Inc.	IA	Durable Medical Equipment & Medical Supplies	$0	$54.4M
Goodwill Industries Of Ne Iowa Inc	IA	Community Based Hospice Care Agency	$0	$52.5M
Veridian Fiscal Solutions LLC	IA	Community/Behavioral Health Agency	$0	$47M
Families First Counseling Services Of Iowa, L.L.C.	IA	Community/Behavioral Health Agency	$0	$16.3M
Resources For Human Development	IA	Community/Behavioral Health Agency	$0	$13.1M
Cedar Valley Community Support Services	IA	Developmentally Disabled Services Day Training Agency	$0	$11.1M
Vgm Group, Inc.	IA	Case Management Agency	$0	$5.4M
Pathways Behavioral Services Inc	IA	Community/Behavioral Health Agency	$0	$4.5M
Kenny Rodriguez	IA	Otolaryngology Physician	$3.2M	$0

North Star Community Services, Inc — Billing Profile & Reimbursement Data

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North Star Community Services, 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