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.

Exceptional Persons Inc (NPI 1861567794)

Field	Value
Entity Type	Organization
Organization	Exceptional Persons Inc
Address	760 Ansborough Avenue
City	Waterloo
State	IA
ZIP	50701
Taxonomy	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NPI Enumerated	November 24, 2006

Payer Source	Total Paid
Medicaid	$80.3M
Medicare	$0

Key Findings

This provider is effectively single-payer: there is no Medicare billing on file while total Medicaid revenue is $80.3M, indicating the organization’s entire recorded reimbursement base in the dataset is driven by Medicaid programs. Analysts should treat Medicaid policy, rate changes, and eligibility shifts as primary levers affecting this entity’s financial performance.

Revenue concentration is very high: the top 3 Medicaid codes account for 95.2% of this provider's total Medicaid revenue, driven by S5136 (55.9%), H2016 (34.5%), and T2020 (4.9%). This concentration means a small set of service lines — not a broad portfolio — produces nearly all reported income, which amplifies the financial impact of utilization or rate movement in those specific programs.

The top revenue-driving codes reflect a community-based residential and habilitation operating model: S5136 (Companion care, adult; per diem) and H2016 (Comprehensive community support services; per diem) together account for the majority of revenue, and the high claim volumes (S5136 at 211.7K claims and H2016 at 103.7K claims) imply intensive, recurring per-diem service delivery and census-driven revenue. T2020 (Day habilitation, waiver; per diem) appears as a smaller but complementary day-program line, consistent with a provider that combines residential/companion supports with day habilitation services.

Competitive standing within the state is asymmetric: the provider ranks #3 of 82 for S5136 and sits in the 98th percentile, a position described as notably above typical state volume, showing clear scale and market strength in companion care. For H2016 it ranks #19 of 176 (90th percentile) and for T2020 it ranks #16 of 101 (85th percentile), both described as typical or unremarkable volumes, indicating that while companion care is a market-leading service for this provider, other program lines are competitive but not dominant.

Operational implications from the code mix include heavy reliance on per-diem billing and sustained daily service hours: the leading codes are per-diem supports and waiver day habilitation, which points to operational priorities like facility capacity, staffing levels, and day-program throughput as direct drivers of revenue. Maintaining or expanding census and daily program participation will likely be the primary path to revenue growth within existing payers.

Tenure and market presence are long-standing: the NPI was enumerated on 2006-11-24 (~20 years ago), signaling a multi-year established presence in the state Medicaid market that likely underpins its scale in S5136 companion care. Analysts should consider legacy relationships with payers and referral sources as contributing factors to current volume.

Smaller ancillary lines are present but do not materially change the revenue profile: codes such as H2015 (2.2% of revenue, 34K claims, $1.7M), H2025 (1.6%, $1.3M), and several transportation and supported employment codes appear in the mix but collectively represent a minor share relative to the dominant per-diem services. These secondary codes indicate breadth of service offerings (15-minute supports, employment supports, NEMT) but not meaningful diversification of revenue.

From a strategic viewpoint, the provider’s notable statewide leadership in S5136 creates both an advantage and a concentration exposure: scale in companion care suggests negotiating leverage and programmatic expertise in that service, but the business is sensitive to changes specific to those high-share codes given the 95.2% concentration in the top three lines. Monitoring state-level policy updates, reimbursement changes, and waiver rules that affect S5136 and H2016 should be prioritized by payers and competitors assessing this entity.

Medicaid: Complete Services Breakdown

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5136	Companion care, adult (e.g., iadl/adl); per diem	211,720	$210	$44.9M
H2016	Comprehensive community support services, per diem	103,650	$270	$27.7M
T2020	Day habilitation, waiver; per diem	49,950	$80	$3.9M
H2015	Comprehensive community support services, per 15 minutes	33,950	$50	$1.7M
H2025	Ongoing support to maintain employment, per 15 minutes	3,850	$340	$1.3M
T2003	Non-emergency transportation; encounter/trip	15,620	$20	$343.7K
T2018	Habilitation, supported employment, waiver; per diem	2,260	$90	$203K
H2023	Supported employment, per 15 minutes	3,090	$40	$117.4K
S0215	Non-emergency transportation; mileage, per mile	2,890	$40	$101.1K
T2021	Day habilitation, waiver; per 15 minutes	1,150	$30	$32.1K

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

Exceptional Persons Inc — 1 of 10 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

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5136	Companion care, adult (e.g., iadl/adl); per diem	3	80	9,410	$490	$17.9M
H2016	Comprehensive community support services, per diem	19	180	10,790	$390	$15.2M
T2020	Day habilitation, waiver; per diem	16	100	10,960	$110	$3M
H2025	Ongoing support to maintain employment, per 15 minutes	27	70	2,970	$300	$1.9M
H2015	Comprehensive community support services, per 15 minutes	9	100	4,130	$160	$1.9M
S0215	Non-emergency transportation; mileage, per mile	17	30	8,260	$40	$722.2K
H2023	Supported employment, per 15 minutes	18	30	4,810	$60	$542.5K
T2003	Non-emergency transportation; encounter/trip	6	20	2,170	$40	$447.5K
T2021	Day habilitation, waiver; per 15 minutes	73	100	2,780	$60	$386.9K
T2018	Habilitation, supported employment, waiver; per diem	6	30	440	$100	$140.6K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
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
North Star Community Services, Inc	IA	Developmentally Disabled Services Day Training Agency	$0	$26.7M
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

Exceptional Persons Inc — Billing Profile & Reimbursement Data

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Exceptional Persons 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