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

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

New Communities, Inc. (NPI 1952635039)

Field	Value
Entity Type	Organization
Organization	New Communities, Inc.
Address	109 Davis Avenue
City	Auburn
State	ME
ZIP	04210
Taxonomy	Mental Illness Community Based Residential Treatment Facility
NPI Enumerated	September 23, 2009

Payer Source	Total Paid
Medicaid	$26.4M
Medicare	$0

Key Findings

NEW COMMUNITIES, INC. is a Mental Illness Community Based Residential Treatment Facility by taxonomy and bills almost exclusively to Medicaid, reporting $26.4M in lifetime Medicaid revenue and no Medicare billing on file; this makes the organization effectively single-payer (Medicaid) in scope based on the claims data available.

Revenue is highly concentrated in a very small set of Medicaid service codes: precomputed data show the top 3 Medicaid codes by revenue account for 100.0% of this provider's total Medicaid revenue, indicating nearly all billed services fall into a narrow set of residential and personal-care per diem lines.

The largest revenue driver is H0019, with 18.1K claims, $1167 avg paid/claim, and $21.1M revenue (79.8% of this provider's total Medicaid revenue). H0019's description (long-term residential behavioral health, without room and board) and its share of revenue indicate the provider operates an ongoing, non-medical residential treatment program as its primary service line.

The secondary revenue code is T1020, with 18.1K claims, $295 avg paid/claim, and $5.3M revenue (20.2% of this provider's total Medicaid revenue). T1020 (personal care services, per diem, part of an individualized plan of treatment) complements H0019 and suggests routine per-diem personal care supports are billed alongside the long-term residential treatment.

Competitive standing in-state is modest rather than dominant: H0019 ranks #13 of 28 providers in Maine (56th percentile) and is described as typical, unremarkable volume for that code, while T1020 ranks #7 of 21 providers in-state (70th percentile) and is also labelled typical, unremarkable volume. These ranks indicate the provider has meaningful scale in its niche but is not among the top statewide leaders for these service lines.

Operational scale is evident from claim volumes and average payments: both H0019 and T1020 report 18.1K claims each, and the avg paid/claim amounts ($1167 for H0019 and $295 for T1020) show that the majority of revenue is driven by a higher per-diem rate for the residential behavioral health service. This mix underscores a business model centered on ongoing, per-diem funded residential care rather than episodic medical procedures.

The provider has an established presence with an NPI enumeration date of 2009-09-23 (~17 years ago), which aligns with the sustained claim volume and long-term residential service profile visible in the Medicaid billing data.

Medicaid: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	18,070	$1,170	$21.1M
T1020	Personal care services, per diem, 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…	18,070	$300	$5.3M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Maine Distribution

New Communities, Inc. — 0 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maine

Full comparison — all codes billed, vs. Maine median

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	13	30	13,990	$560	$23.9M
T1020	Personal care services, per diem, 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…	7	20	8,350	$340	$9.2M

Nearby Providers

Other providers in the same ZIP code as New Communities, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
John F Murphy Homes, Inc.	ME	Nursing Facility/Intermediate Care Facility	$0	$260.1M
Happy Haven, LLC	ME	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$65.3M
Health Affiliates Maine, LLC	ME	Community/Behavioral Health Agency	$0	$61.6M
Opportunity Enterprises, Inc.	ME	Developmentally Disabled Services Day Training Agency	$0	$47.6M
Bedard Medical Inc	ME	Durable Medical Equipment & Medical Supplies	$0	$24.6M
Personal Onsite Development	ME	Developmentally Disabled Services Day Training Agency	$0	$9M
Community Clinical Services, Inc.	ME	Federally Qualified Health Center (FQHC)	$0	$5.2M
New England Home Therapies, Inc.	ME	Oxygen Equipment & Supplies (DME)	$0	$4.2M
Maine Oral & Maxillofacial Surgery Associates, P.A.	ME	Oral and Maxillofacial Surgery (Dentist)	$0	$3.5M
City Of Auburn	ME	Land Ambulance	$317.2K	$2.7M

New Communities, Inc. — Billing Profile & Reimbursement Data

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New Communities, Inc. — 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