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

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

Habilitative Services, LLC (NPI 1992216766)

Field	Value
Entity Type	Organization
Organization	Habilitative Services, LLC
Address	1400 Madison Ave Ste 206
City	Mankato
State	MN
ZIP	56001
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	October 19, 2017

Payer Source	Total Paid
Medicaid	$134M
Medicare	$0

Key Findings

HABILITATIVE SERVICES, LLC is a community/behavioral health agency based in MANKATO, MN with an NPI enumerated on 2017-10-19 (~9 years ago). Its public billing profile shows $134M in lifetime Medicaid revenue and none below for Medicare (no Medicare billing on file), indicating the organization is effectively a Medicaid-focused provider.

Revenue for this provider is extremely concentrated: the top three Medicaid codes (S5140, T2016, S5125) account for 96.8% of its total Medicaid revenue. In particular, S5140 alone represents 70.1% of Medicaid revenue and T2016 contributes 25.0%, demonstrating that a small set of residential/per-diem services generate the vast majority of revenue.

The code mix points to an operation focused on residential and foster-care-oriented habilitation services: S5140 (Foster care, adult; per diem) and T2016 (Habilitation, residential, waiver; per diem) are the two dominant codes, while S5125 (Attendant care services; per 15 minutes) supplies a smaller, time-based support component. This pattern suggests the provider runs high-volume residential placements or group-home style services with supplemental attendant care, consistent with its Community/Behavioral Health Agency taxonomy.

On statewide competitive standing, the provider is a high-volume participant for its dominant foster-care code: S5140 ranks #7 of 59 providers in-state (90th percentile) and is described as notably above typical state volume for this code. By contrast, T2016 ranks #8 of 34 providers in-state (79th percentile) and is characterized as typical or unremarkable in state volume, indicating strong relative specialization in foster-care per-diem billing rather than a uniformly dominant position across all residential habilitation lines.

Claim counts and unit payments underscore scale: S5140 shows 374.4K claims at $251 avg paid/claim and T2016 shows 169.1K claims at $198 avg paid/claim, which together produce the lion’s share of the $134M Medicaid revenue. These figures indicate the provider’s revenue base is driven by very large claim volumes combined with per-diem reimbursement rather than high-cost episodic services.

Smaller Medicaid lines (for example, H2014 – $2.3M, H2032 – $1M, H2019 – $521.1K) represent additional habilitation and therapy services billed on a per-15-minute basis, suggesting some service breadth into skills training, activity therapy, and therapeutic behavioral services. While collectively minor relative to the top two codes, these time-based services indicate clinical and community-support offerings that supplement the dominant residential/foster-care business.

The combination of a single-payer concentration in Medicaid and extreme code concentration (top three codes = 96.8% of Medicaid revenue) implies revenue exposure to state policy or rate changes for S5140 and T2016. The absence of Medicare billing on file further concentrates payer risk; any shifts in Medicaid program design, per-diem rates, or eligibility for foster-care/residential waivers could materially affect this provider’s revenue profile.

Medicaid: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5140	Foster care, adult; per diem	374,380	$250	$94M
T2016	Habilitation, residential, waiver; per diem	169,130	$200	$33.5M
S5125	Attendant care services; per 15 minutes	15,250	$150	$2.3M
H2014	Skills training and development, per 15 minutes	17,600	$130	$2.3M
H2032	Activity therapy, per 15 minutes	9,760	$100	$1M
H2019	Therapeutic behavioral services, per 15 minutes	8,690	$60	$521.1K
T2017	Habilitation, residential, waiver; 15 minutes	2,600	$110	$275.9K
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	3,240	$50	$165K
S5150	Unskilled respite care, not hospice; per 15 minutes	120	$170	$20.2K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Minnesota Distribution

Habilitative Services, LLC — 0 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. Minnesota median

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5140	Foster care, adult; per diem	7	60	33,770	$300	$37.6M
T2016	Habilitation, residential, waiver; per diem	8	30	84,870	$240	$23.9M
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	35	50	5,600	$170	$5.9M
S5125	Attendant care services; per 15 minutes	10	30	7,060	$130	$5.2M
S5150	Unskilled respite care, not hospice; per 15 minutes	17	20	2,680	$150	$3.4M
H2014	Skills training and development, per 15 minutes	49	190	6,230	$120	$2.2M
H2019	Therapeutic behavioral services, per 15 minutes	17	50	5,850	$110	$1.2M
H2032	Activity therapy, per 15 minutes	16	70	3,950	$120	$1M
T2017	Habilitation, residential, waiver; 15 minutes	15	20	6,790	$100	$879.8K

Nearby Providers

Other providers in the same ZIP code as Habilitative Services, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mankato Clinic Ltd	MN	Family Medicine Physician	$0	$39.2M
Mayo Clinic Health System-southwest Minnesota Region	MN	General Acute Care Hospital	$0	$28.5M
Mayo Clinic Health System-southwest Minnesota Region	MN	Multi-Specialty Clinic/Center	$0	$24.3M
Open Door Health Center	MN	Federally Qualified Health Center (FQHC)	$0	$13.5M
County Of Blue Earth	MN	Case Management Agency	$0	$10.8M
Horizon Homes, Inc.	MN	Mental Illness Community Based Residential Treatment Facility	$0	$8.8M
Ms-ac Mankato Ag Senior Living LLC	MN	Assisted Living Facility	$0	$8.3M
Horizon Homes, Inc.	MN	Mental Illness Community Based Residential Treatment Facility	$0	$6.2M
Adult, Child & Family Services, LLC	MN	Psychologist	$0	$5.2M
Pediatric And Adolescent Dentistry	MN	Pediatric Dentistry	$0	$5.1M

Habilitative Services, LLC — Billing Profile & Reimbursement Data

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Habilitative Services, LLC — 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