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

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

Individual Advocacy Group (NPI 1942453048)

Field	Value
Entity Type	Organization
Organization	Individual Advocacy Group
Address	1289 Windham Pkwy
City	Romeoville
State	IL
ZIP	60446
Taxonomy	Developmental Disabilities Clinic/Center
NPI Enumerated	November 3, 2008

Payer Source	Total Paid
Medicaid	$30.2M
Medicare	$0

Key Findings

This provider is effectively single-payer: there is no Medicare billing on file and its lifetime Medicaid revenue totals $30.2M. The absence of Medicare activity means the organization’s clinical and financial exposure is concentrated in Medicaid policy and reimbursement dynamics rather than a mixed Medicare/Medicaid portfolio.

Revenue is extremely concentrated in a narrow set of service lines: the top three Medicaid codes account for 100.0% of the provider’s Medicaid revenue. T2016 alone represents $26.1M (86.3% of Medicaid revenue), while S5135 accounts for $2.3M (7.5%) and H0025 for $1.9M (6.2%).

The code mix and volumes point to a residential habilitation–focused operation consistent with its Developmental Disabilities Clinic/Center taxonomy. High-volume T2016 billing (45K claims at $580 avg paid/claim) indicates per-diem residential habilitation is the core service, supplemented by companion care (S5135, 13.7K claims at $166 avg paid/claim) and behavioral health prevention education (H0025, 7.5K claims at $250 avg paid/claim).

Competitive standing on the dominant code is modest: for T2016 the provider ranks #2 of 3 in-state and is at the 50th percentile, described in the source as "typical, unremarkable volume for this code." This suggests the organization is a routine participant in residential habilitation within Illinois rather than a clear market leader on that service line.

For S5135 and H0025 the provider is the only in-state reporter (rank #1 of 1, 0th percentile with no state peer volume comparison available). Being the sole in-state filer for these codes limits benchmarking opportunities; it may reflect either a narrow niche offering or gaps in peer reporting rather than clear dominance.

Operationally, the high claim counts (45K T2016, 13.7K S5135, 7.5K H0025) combined with non-trivial average paid amounts per claim indicate an ongoing, high-frequency service delivery model with material per-claim reimbursement levels. Those volumes imply staffing and facility capacity aligned to continuous residential and supportive services rather than episodic clinic visits.

The provider’s long tenure — NPI enumerated 2008-11-03 (~18 years ago) — indicates an established presence in the market. Sustained billing at scale over this period suggests operational stability in delivering developmental-disability residential and supportive services.

Concentration risk is notable: reliance on a single code (T2016 at 86.3% of Medicaid revenue) and exclusive exposure to Medicaid means the provider is sensitive to rate changes, prior-authorization policy shifts, or programmatic redesigns affecting Medicaid habilitation and waiver funding. Diversification of payer mix or service lines would materially change its revenue risk profile.

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	44,970	$580	$26.1M
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	13,650	$170	$2.3M
H0025	Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior)	7,500	$250	$1.9M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Illinois Distribution

Individual Advocacy Group — 0 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Illinois

Full comparison — all codes billed, vs. Illinois median

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	2	10	44,970	$280	$17.3M
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	1	10	13,650	$170	$2.3M
H0025	Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior)	1	10	7,500	$250	$1.9M

Nearby Providers

Other providers in the same ZIP code as Individual Advocacy Group, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Valley View Cusd 365u	IL	Local Education Agency (LEA)	$0	$6.4M
Vna Health Care	IL	Federally Qualified Health Center (FQHC)	$0	$5.4M
Village Of Romeoville	IL	Land Ambulance	$114.1K	$4M
Catherine Kiley	IL	Family Nurse Practitioner	$70K	$9.7K
Joseph Mullen	IL	Psychiatry Physician	$20.4K	$0

Individual Advocacy Group — Billing Profile & Reimbursement Data

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Individual Advocacy Group — 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