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

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

Commonwealth Of Massachusetts (NPI 1942339825)

Field	Value
Entity Type	Organization
Organization	Commonwealth Of Massachusetts
Address	280 Merrimack Street
City	Lawrence
State	MA
ZIP	01843
Taxonomy	Case Management Agency
NPI Enumerated	March 5, 2007

Payer Source	Total Paid
Medicaid	$444M
Medicare	$0

Key Findings

COMMONWEALTH OF MASSACHUSETTS is effectively a single-payer Medicaid provider: it has no Medicare billing on file and reports $444M in lifetime Medicaid revenue, indicating its operations and revenue are concentrated wholly within the Medicaid program. This makes Medicaid policy, fee schedules, and state waiver arrangements the primary drivers of its financial performance and growth prospects.

Revenue is highly concentrated in a small set of codes: the top three Medicaid codes account for 91.2% of the provider's total Medicaid revenue, with T2016 alone representing 75.0% ($333.1M) of Medicaid revenue, S5100 contributing 11.8% ($52.4M), and T2023 contributing 4.3% ($19.2M). This concentration means a small number of service lines determine the vast majority of cash flow.

The code mix points to a service model focused on long-term and programmatic supports: T2016 (Habilitation, residential, waiver; per diem) as the dominant code implies a large residential habilitation/waiver footprint, S5100 (Day care services, adult; per 15 minutes) indicates substantial adult day services capacity, and T2023 (Targeted case management; per month) shows a built-in case-management infrastructure supporting enrolled beneficiaries. Together these codes suggest the provider operates integrated waiver and community-based support programs rather than episodic clinical care.

S5100 is a clear statewide outlier: the provider ranks #2 of 189 in-state and sits in the 99th percentile for this code, which the dataset labels an "extreme outlier." That ranking and label indicate this entity is a major, above-typical provider of adult day services in Massachusetts and likely commands significant market share or capacity in that service line.

T2016 shows solid but not dominant in-state standing: the provider ranks #7 of 25 for T2016 and is at the 75th percentile, characterized as a "typical, unremarkable volume" for this code. While T2016 produces the single largest revenue stream ($333.1M, 75.0% of Medicaid revenue), its rank suggests there are other meaningful residential habilitation providers in the state.

T2023 (Targeted case management) is another strong programmatic asset: the provider ranks #3 of 70 and is in the 97th percentile, described as "notably above typical state volume." At $19.2M (4.3% of Medicaid revenue), T2023 confirms the organization has scaled case-management services that likely support its residential and day-program populations.

Beyond the top three codes, the provider bills a range of community support services in smaller amounts—H2015 $13.5M (3.0%), S5125 $9.3M (2.1%), H2023 $4.8M (1.1%), T2019 $4.2M (0.9%), T2021 $4.1M (0.9%), T2003 $3.4M (0.8%), and H0038 $52.3K (0.0%). These secondary codes reflect attendant care, supported employment, day habilitation, non-emergency transportation, and peer/self-help services that broaden the provider’s service mix but do not materially diversify its revenue base given the concentration in the top three codes.

The provider has an established operating history, with an NPI enumeration date of 2007-03-05 (~19 years ago), suggesting long-term engagement in state waiver and Medicaid programs and potential institutional relationships with payers and local referral sources. That tenure likely supports its high-volume S5100 and scaled T2016 operations but also means historical reliance on Medicaid program structures.

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
T2016	Habilitation, residential, waiver; per diem	41,520	$8,020	$333.1M
S5100	Day care services, adult; per 15 minutes	192,640	$270	$52.4M
T2023	Targeted case management; per month	56,640	$340	$19.2M
H2015	Comprehensive community support services, per 15 minutes	61,630	$220	$13.5M
S5125	Attendant care services; per 15 minutes	20,440	$450	$9.3M
H2023	Supported employment, per 15 minutes	32,100	$150	$4.8M
T2019	Habilitation, supported employment, waiver; per 15 minutes	39,160	$110	$4.2M
T2021	Day habilitation, waiver; per 15 minutes	21,090	$200	$4.1M
T2003	Non-emergency transportation; encounter/trip	118,170	$30	$3.4M
H0038	Self‑help/peer services, per 15 minutes	970	$50	$52.3K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

Commonwealth Of Massachusetts — 2 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	7	30	29,930	$10,070	$358.9M
T2023	Targeted case management; per month	3	70	8,210	$510	$8.6M
H2023	Supported employment, per 15 minutes	9	20	28,450	$190	$5.6M
H2015	Comprehensive community support services, per 15 minutes	19	150	7,770	$140	$4.8M
S5125	Attendant care services; per 15 minutes	8	40	3,390	$300	$4.7M
T2021	Day habilitation, waiver; per 15 minutes	12	20	20,590	$210	$4.5M
S5100	Day care services, adult; per 15 minutes	2	190	2,000	$230	$3.1M
T2019	Habilitation, supported employment, waiver; per 15 minutes	6	20	24,690	$120	$3.1M
T2003	Non-emergency transportation; encounter/trip	50	250	40,490	$30	$2.2M
H0038	Self‑help/peer services, per 15 minutes	27	40	4,420	$80	$471.4K

Nearby Providers

Other providers in the same ZIP code as Commonwealth Of Massachusetts, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Agespan, Inc.	MA	Case Management Agency	$0	$163.5M
Elder Services Of The Merrimack Valley, Inc.	MA	Home Health Agency	$0	$86.8M
Maestro-connections Health Systems, LLC	MA	Home Health Agency	$0	$52.7M
Column Health, LLC	MA	Clinic/Center	$72.6K	$32.7M
Fidelity House, Inc	MA	Foster Care Agency	$0	$26.3M
Fcp, Inc	MA	Community/Behavioral Health Agency	$0	$21.2M
Royal Comfort Home Care Inc	MA	Home Health Agency	$0	$20.5M
Gentle Home Care Services Inc	MA	Home Health Agency	$0	$17M
Northeast Independent Living Program Inc	MA	Counselor	$0	$15.8M
New England Family Dentistry, PC	MA	General Practice Dentistry	$0	$12.5M

Commonwealth Of Massachusetts — Billing Profile & Reimbursement Data

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Commonwealth Of Massachusetts — 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