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

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

Transition Ii (NPI 1942638077)

Field	Value
Entity Type	Organization
Organization	Transition Ii
Address	346 Shelburne Rd
City	Burlington
State	VT
ZIP	05401
Taxonomy	Case Manager/Care Coordinator
NPI Enumerated	October 29, 2013

Payer Source	Total Paid
Medicaid	$17.3M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and is effectively a Medicaid-only billing entity at scale; total Medicaid revenue on file is $17.3M, with no recorded Medicare revenue to compare. The NPI was enumerated 2013-10-29 (~13 years ago), so the organization has an established Medicaid billing history over roughly a decade.

Revenue is extremely concentrated: the precomputed top 3 Medicaid codes by revenue account for 100.0% of this provider's total Medicaid revenue, and that concentration is entirely driven by a single code. Specifically, 99199 accounts for $17.3M of revenue (2.9K claims, $5927 avg paid/claim) and represents 100.0% of the provider's Medicaid payments on file.

Despite the provider taxonomy of Case Manager/Care Coordinator, traditional case-management codes show activity without payment: T1016 (Case management, each 15 minutes) records 3K claims but $0 avg paid/claim and $0 revenue. The code mix — high paid volume under 99199 (other medicine services) and $0 payments on explicit case-management and habilitation codes — suggests the provider receives Medicaid dollars primarily under a broadly billed or uncoded service line rather than under the named case-management CPT/HCPCS codes.

There is a material disconnect between claims volume and paid revenue across several waiver and support codes. Codes with high claim counts such as T2021 (16.4K claims), T2017 (15K claims), S5150 (12.9K claims), and S0215 (6.7K claims) all show $0 avg paid/claim and $0 revenue on file, indicating substantial reported activity that did not translate into direct Medicaid payments under those specific codes. This pattern may reflect contractual, bundled, or eligibility/payment-routing arrangements and therefore warrants contract- and claim-mapping review by analysts.

Competitive standing for the revenue-driving code is modest: although 99199 provides all Medicaid revenue for this provider, it ranks #12 of 16 providers in-state (27th percentile), characterized in the data as "typical, unremarkable volume for this code." In other words, the provider is not a dominant statewide payer for its single revenue source despite the large absolute dollar amount.

There are outlier signals in claims ranking separate from payment: S0215 (Non-emergency transportation; mileage) ranks #1 of 2 providers in-state (100th percentile) by claims but contributes $0 revenue, and T2017 ranks #3 of 10 (78th percentile) by claims with $0 revenue. Those high-claim, zero-payment combinations are operational signals that should be interpreted differently from payment-based market share; they reflect service delivery or billing-reporting intensity rather than direct Medicaid reimbursement.

From an operational diligence perspective, the fact that a single "other medicine services" code (99199) captures all $17.3M in payments while many programmatic habilitation and respite codes show high claim volumes but no payments suggests analysts should prioritize review of coding practices, claim adjudication paths, and contract structures. This is a concrete, reviewable pattern that affects revenue allocation and comparative cost analyses across peers.

For payer/provider strategy, the data imply a focused Medicaid business line heavily reliant on non-specific procedure coding for revenue recognition. Given the provider’s ~13-year enumeration and the concentrated revenue profile, payers and competitors should treat TRANSITION II as an established, Medicaid-dependent participant with an atypical billing model that merits targeted contract and utilization inquiry rather than labeling the provider a large statewide market leader.

Medicaid: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	2,920	$5,930	$17.3M
H2025	Ongoing support to maintain employment, per 15 minutes	3,330	$0	$0
S0215	Non-emergency transportation; mileage, per mile	6,720	$0	$0
S5150	Unskilled respite care, not hospice; per 15 minutes	12,850	$0	$0
T1016	Case management, each 15 minutes	3,040	$0	$0
T2017	Habilitation, residential, waiver; 15 minutes	15,000	$0	$0
T2021	Day habilitation, waiver; per 15 minutes	16,430	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Vermont Distribution

Transition Ii — 0 of 1 code billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Vermont

Full comparison — all codes billed, vs. Vermont median

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	12	20	6,570	$6,270	$59.7M
T1016	Case management, each 15 minutes	20	40	3,900	$1	$31.1K
T2021	Day habilitation, waiver; per 15 minutes	10	10	28,170	$1	$210
H2025	Ongoing support to maintain employment, per 15 minutes	11	20	3,440	$0	$0
S0215	Non-emergency transportation; mileage, per mile	1	10	3,630	$0	$0
S5150	Unskilled respite care, not hospice; per 15 minutes	9	10	27,240	$0	$0
T2017	Habilitation, residential, waiver; 15 minutes	3	10	11,900	$0	$0

Nearby Providers

Other providers in the same ZIP code as Transition Ii, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Howard Center Inc	VT	Developmentally Disabled Services Day Training Agency	$0	$332.2M
Howard Center Inc	VT	Adolescent and Children Mental Health Clinic/Center	$0	$130.1M
Vermont Department Of Mental Health	VT	Adult Mental Health Clinic/Center	$0	$105.1M
Community Health Centers Of Burlington Inc	VT	Federally Qualified Health Center (FQHC)	$0	$39.8M
Howard Center Inc	VT	Methadone Clinic	$517.9K	$35M
Howard Center Inc	VT	State or Local Public Health Clinic/Center	$0	$23.4M
University Of Vermont Medical Center Inc	VT	Internal Medicine Physician	$0	$17.6M
The Dental Center At Community Health Center Of Burlington	VT	Dental Clinic/Center	$0	$6.7M
City Of Burlington Vermont	VT	Land Ambulance	$677.2K	$4.3M
Spectrum, Inc.	VT	Addiction (Substance Use Disorder) Counselor	$0	$2.4M

Transition Ii — Billing Profile & Reimbursement Data

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Transition Ii — 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