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

Why is the Medicaid comparison limited to South Dakota 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. South Dakota (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.

Sesdac, Inc. (NPI 1982759924)

Field	Value
Entity Type	Organization
Organization	Sesdac, Inc.
Address	1314 E Cherry St
City	Vermillion
State	SD
ZIP	57069
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	January 23, 2007

Payer Source	Total Paid
Medicaid	$26.2M
Medicare	$0

Key Findings

This provider is effectively single-payer in the available claims data: Medicare revenue is listed as none, while Medicaid revenue is $26.2M, indicating operations are almost entirely funded through Medicaid rather than Medicare. Analysts evaluating payer mix should treat SESDAC, INC. as a Medicaid-focused habilitation services provider.

Revenue is highly concentrated in a very small set of waiver-related codes: the precomputed top three Medicaid codes account for 97.1% of the provider's total Medicaid revenue. Specifically, T2016 generated $19.5M (74.4% of Medicaid revenue), T2020 generated $4.3M (16.5%), and S0281 generated $1.6M (6.2%), which together form the overwhelming bulk of reported Medicaid receipts.

The mix of top codes points to core business lines in residential and day habilitation plus care coordination: T2016 is reported as habilitation, residential, waiver (per diem) and T2020 as day habilitation, waiver (per diem), while S0281 maps to medical home program/comprehensive care coordination and planning. This combination and the provider taxonomy of Developmentally Disabled Services Day Training Agency indicate service delivery focused on waiver-funded habilitation and care planning rather than clinical outpatient procedures.

Although the provider reports substantial Medicaid dollars, its competitive standing within the state appears modest rather than dominant for its top codes. T2016 ranks #13 of 21 providers in-state (40th percentile), T2020 ranks #13 of 20 (37th percentile), and S0281 ranks #14 of 21 (35th percentile); each code is characterized in the source data as typical, unremarkable volume for the code, signaling middle-market positioning rather than market leadership.

Claim- and unit-level detail explains why T2016 drives revenue despite similar claim volumes: T2016 shows 5.8K claims with an average paid per claim of $3384, while T2020 has 6.3K claims with an average paid per claim of $688 and S0281 has 4.8K claims at $341 avg paid/claim. These per-claim payment differences make T2016 the primary revenue engine, even though claims counts for habilitation and day habilitation are comparable.

A number of secondary codes generate only modest revenue and reflect limited diversification beyond the top waiver services. Examples include T1016 at $448.7K (1.7% of Medicaid revenue) ranked #13 of 38 in-state (68th percentile), T2025 at $192.3K (0.7%) ranked #15 of 19 (22nd percentile), and T2028 at $20K (0.1%) ranked #30 of 33 (9th percentile); each of these is described as typical, unremarkable volume for the code, indicating they are minor contributors to the overall Medicaid picture.

The provider has an established enrollment history, with its NPI enumerated on 2007-01-23 (~19 years ago), which supports interpreting these billing patterns as the output of a long-standing Medicaid habilitation operator rather than a new entrant or short-term program.

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	5,770	$3,380	$19.5M
T2020	Day habilitation, waiver; per diem	6,270	$690	$4.3M
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	4,750	$340	$1.6M
T1016	Case management, each 15 minutes	7,610	$60	$448.7K
T2025	Waiver services; not otherwise specified (nos)	2,470	$80	$192.3K
T2017	Habilitation, residential, waiver; 15 minutes	220	$250	$54.3K
A9900	Miscellaneous dme supply, accessory, and/or service component of another hcpcs code	320	$130	$41.4K
T2028	Specialized supply, not otherwise specified, waiver	250	$80	$20K
T2019	Habilitation, supported employment, waiver; per 15 minutes	70	$140	$10.2K
T2035	Utility services to support medical equipment and assistive technology/devices, waiver	50	$50	$2.4K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Dakota Distribution

Sesdac, Inc. — 0 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. South Dakota median

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	13	20	6,880	$1,660	$31.6M
T2020	Day habilitation, waiver; per diem	13	20	7,340	$500	$8.9M
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	14	20	6,090	$420	$3M
T2025	Waiver services; not otherwise specified (nos)	15	20	5,410	$180	$1.9M
T1016	Case management, each 15 minutes	13	40	6,470	$50	$708.1K
T2017	Habilitation, residential, waiver; 15 minutes	10	10	470	$270	$437.9K
T2019	Habilitation, supported employment, waiver; per 15 minutes	13	20	480	$90	$288.6K
T2028	Specialized supply, not otherwise specified, waiver	30	30	910	$50	$169.8K
A9900	Miscellaneous dme supply, accessory, and/or service component of another hcpcs code	18	30	340	$140	$53.7K
T2035	Utility services to support medical equipment and assistive technology/devices, waiver	3	10	50	$50	$8.8K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sanford Health Network	SD	Family Medicine Physician	$0	$1.3M
Sesdac, Inc.	SD	Case Management Agency	$0	$422.8K
Sesdac, Inc.	SD	Case Management Agency	$0	$395.7K
Knutson Familty Dentistry LLP	SD	Dentist	$0	$306.6K
Houska Dental Clinic	SD	Dental Clinic/Center	$0	$303.3K
Sanford Health Network	SD	Critical Access Hospital	$0	$274.4K
Brown Optometric Clinic PC	SD	Optometrist	$0	$238.2K
Great Plains Therapy LLC	SD	Physical Therapy Clinic/Center	$0	$219.7K
City Of Vermillion	SD	Land Ambulance	$164.7K	$52.4K
Allison Walsh	SD	Mental Health Counselor	$0	$185.5K

Sesdac, Inc. — Billing Profile & Reimbursement Data

Sign up for Sesdac, Inc. — Billing Profile & Reimbursement Data policy alerts

Sesdac, Inc. — Billing Profile & Reimbursement Data

Sign up for Sesdac, Inc. — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References