Bethany Ranch Home, Inc — Billing Profile & Reimbursement Data

This provider has no Medicare billing on file and reports $74.4M in lifetime Medicaid revenue, making it effectively a Medicaid-focused operation without any Medicare revenue to diversify payer exposure. The absence of Medicare activity indicates the provider’s business model and reimbursement dependence rest almost entirely on state Medicaid programs and waiver payments.

Revenue is highly concentrated: the top 3 Medicaid codes by revenue account for 98.7% of this provider's total Medicaid revenue. In particular, T2016 alone represents $64.2M (86.3%), T2021 contributes $7.8M (10.5%), and S5125 adds $1.4M (1.9%) of the $74.4M total.

The code mix and taxonomy (Intellectual Disabilities Intermediate Care Facility) point to a core operation centered on residential habilitation and day habilitation services. T2016 (Habilitation, residential, waiver; per diem) and T2021 (Day habilitation, waiver; per 15 minutes) dominate revenue, indicating the provider operates facility-based residential programs with accompanying day services, while S5125 (Attendant care services; per 15 minutes) functions as a secondary, ancillary service line.

For the largest revenue driver, T2016, the provider ranks #3 of 27 in-state and is in the 92th percentile, a position described in the source as typical and unremarkable volume for this code; this ranking nevertheless places the provider among the top in-state suppliers of residential habilitation billed under T2016. Being near the top of the state rank list for T2016 aligns with the code’s dominant share of the provider’s Medicaid revenue.

T2021 (Day habilitation) is a meaningful secondary line: 77.6K claims, $101 avg paid/claim, $7.8M revenue, ranking #12 of 48 (77th percentile) and labeled typical, unremarkable volume. By contrast, S5125 (Attendant care) is a minor product line with 7.3K claims, $193 avg paid/claim, $1.4M revenue and a low state ranking (#172 of 223, 23th percentile), indicating limited market prominence in attendant-care services.

Several smaller codes confirm the provider’s narrow service mix: T2017 accounts for $834.3K (1.1% of Medicaid revenue) and ranks #45 of 63 (29th percentile), while S5150 contributes $125.8K (0.2%) and ranks #154 of 192 (20th percentile). These smaller shares reinforce that operations and revenue depend heavily on the few top waiver habilitation codes rather than a broad set of Medicaid services.

The operational implications of an 86.3% share from a per-diem residential waiver code (T2016) mean that occupancy, waiver enrollment, and state policy on residential habilitation rates will disproportionately affect revenue performance; similarly, day habilitation utilization (T2021) drives most of the remaining income. This concentration suggests both a clear strategic focus on residential habilitation and an exposure to changes in Medicaid waiver funding or eligibility rules.

The provider’s NPI enumeration date is 2007-04-04 (~19 years ago), indicating a long-standing presence in the state Medicaid network; this tenure supports established contracting and operational experience in delivering waiver-based habilitation services. The combination of longevity and strong state ranking on the flagship code (T2016) suggests institutional scale within its niche despite the overall single-payer concentration.