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

Why is the Medicaid comparison limited to North Carolina 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. North Carolina (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.

Educare Community Living Corporation - North Carolina (NPI 1912141227)

Field	Value
Entity Type	Organization
Organization	Educare Community Living Corporation - North Carolina
Address	3032 Zebulon Rd
City	Rocky Mount
State	NC
ZIP	27804
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	April 30, 2009

Payer Source	Total Paid
Medicaid	$69.3M
Medicare	$0

Key Findings

This entity is effectively a Medicaid-focused provider: it has no Medicare billing on file and $69.3M in reported Medicaid revenue, so analyses of payer mix should treat this organization as single-payer (Medicaid) at scale. Its NPI was enumerated on 2009-04-30 (~17 years ago), indicating an established operating history in the state.

Revenue is highly concentrated in a small set of waiver and community-support codes: the precomputed top 3 Medicaid codes by revenue account for 78.2% of the provider's total Medicaid revenue. The leading contributors are H2016 ($26.6M, 38.3%), T2020 ($19.3M, 27.9%) and T2014 ($8.3M, 12.0%), so most of the business is driven by a narrow set of per-diem habilitation and community support services.

The code mix (H2016 – Comprehensive community support services, per diem; T2020 – Day habilitation, waiver; per diem; and T2014 – Habilitation, prevocational, waiver; per diem) indicates the provider operates with an emphasis on community-based behavioral/developmental disability supports, day habilitation programs, and prevocational services rather than short outpatient medical procedures. High claim volumes in per-diem habilitation codes point to operating models centered on ongoing program days/slots and group-based service delivery rather than episodic physician-style encounters.

EDUCARE is a major in-state provider for H2016: it ranks #5 of 65 providers and sits in the 94th percentile, which the data labels as notably above typical state volume for this code. That ranking and the $26.6M revenue tied to H2016 support characterizing the organization as a dominant regional participant for comprehensive community support services.

The provider is also a top-tier performer for T2020: it ranks #5 of 48 and is reported at the 91th percentile, again described as notably above typical state volume for this code. With $19.3M in revenue driven by day habilitation, EDUCARE appears to be a leading regional operator of waiver-funded day programs.

By contrast, T2014 is a meaningful but less concentrated revenue stream: it accounts for $8.3M (12.0%) and ranks #6 of 17 (69th percentile), a position the data describes as typical or unremarkable for that code. Other listed codes such as T2013 and H2015 show typical, unremarkable volume by their state percentiles, indicating the provider’s dominance is focused on a narrower subset of habilitation/community-support services.

T1019 is notable for a high average paid per claim ($2524) despite modest claim volume (1.6K claims) and contributes $4.1M (5.9%) of Medicaid revenue; this suggests a small but relatively high-dollar component of the business tied to individualized personal care claims rather than the per-diem day-program model that drives the top revenue lines. Analysts should treat such high-average, lower-volume codes separately when modeling unit economics or reimbursement risk.

The heavy reliance on a few waiver and per-diem service lines (top 3 = 78.2% of Medicaid revenue) implies that changes in Medicaid waiver policy, per-diem rates, or program utilization would disproportionately affect this provider’s revenue. Given the absence of Medicare billing, any state-level changes in Medicaid reimbursement or eligibility could materially shift the organization’s financial profile, so payer contracting and state waiver trends are primary levers to monitor.

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
H2016	Comprehensive community support services, per diem	118,030	$230	$26.6M
T2020	Day habilitation, waiver; per diem	87,800	$220	$19.3M
T2014	Habilitation, prevocational, waiver; per diem	43,550	$190	$8.3M
T2013	Habilitation, educational, waiver; per hour	28,090	$150	$4.2M
H2015	Comprehensive community support services, per 15 minutes	37,570	$110	$4.1M
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	1,610	$2,520	$4.1M
T2016	Habilitation, residential, waiver; per diem	6,350	$420	$2.6M
S5150	Unskilled respite care, not hospice; per 15 minutes	1,570	$70	$103.8K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Carolina Distribution

Educare Community Living Corporation - North Carolina — 0 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. North Carolina median

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2013	Habilitation, educational, waiver; per hour	95	190	29,090	$150	$9.1M
H2016	Comprehensive community support services, per diem	5	70	28,040	$220	$8.2M
T2020	Day habilitation, waiver; per diem	5	50	22,570	$180	$6.2M
T2014	Habilitation, prevocational, waiver; per diem	6	20	16,540	$150	$4.2M
H2015	Comprehensive community support services, per 15 minutes	38	250	10,060	$130	$2.4M
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	47	80	2,380	$160	$1.8M
T2016	Habilitation, residential, waiver; per diem	41	90	5,520	$190	$1.6M
S5150	Unskilled respite care, not hospice; per 15 minutes	116	170	4,310	$80	$958.4K

Nearby Providers

Other providers in the same ZIP code as Educare Community Living Corporation - North Carolina, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nash Hospitals Inc	NC	General Acute Care Hospital	$0	$42.4M
Boice-willis Clinic PA	NC	Internal Medicine Physician	$0	$27.8M
Wake Emergency Physicians PA	NC	Emergency Medicine Physician	$0	$8.8M
Opportunities Industrialization Center, Inc.	NC	Federally Qualified Health Center (FQHC)	$0	$8.1M
County Of Nash	NC	Land Ambulance	$1M	$2.3M
County Of Halifax	NC	Land Ambulance	$495.6K	$2.3M
Boice-willis Clinic, PA	NC	Clinical Medical Laboratory	$509.1K	$735.1K
Karn Gupta	NC	Nephrology Physician	$944.8K	$0
Aristides Assimacopoulos	NC	Infectious Disease Physician	$360.7K	$450.7K
Metz Medical Transport, Inc.	NC	Land Ambulance	$363.8K	$212.1K

Educare Community Living Corporation - North Carolina — Billing Profile & Reimbursement Data

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Educare Community Living Corporation - North Carolina — 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