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

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

Community Systems, Inc. (NPI 1992863583)

Field	Value
Entity Type	Organization
Organization	Community Systems, Inc.
Address	250 Corporate Blvd
City	Newark
State	DE
ZIP	19702
Taxonomy	Intellectual & Developmental Disabilities Psychologist
NPI Enumerated	December 5, 2006

Payer Source	Total Paid
Medicaid	$96.7M
Medicare	$0

Key Findings

COMMUNITY SYSTEMS, INC. is effectively a Medicaid-only billing entity: total Medicare revenue is none (no Medicare billing on file) while total Medicaid revenue is $96.7M, indicating the organization’s financial footprint is concentrated in state Medicaid waiver programs rather than Medicare fee-for-service. This makes the provider functionally single-payer (Medicaid) for the claims recorded.

Revenue is highly concentrated in three codes: the precomputed top-3 Medicaid codes account for 100.0% of the provider’s Medicaid revenue. Those codes are T2025 ($50.9M, 52.7% of total Medicaid revenue), T2016 ($45.1M, 46.6%), and T1001 ($706.6K, 0.7%), showing almost all Medicaid dollars flow through these specific waiver and nursing assessment services.

The code mix and activity levels indicate a residential/habilitation-focused operation: T2016 (Habilitation, residential, waiver; per diem) and T2025 (Waiver services; not otherwise specified (nos)) together dominate billing and are per-diem/waiver-oriented services consistent with residential intellectual and developmental disabilities care, while T1001 (Nursing assessment / evaluation) represents a small, supportive clinical service. High claim volumes — 82.2K claims for T2016 and 77.1K claims for T2025 — along with average paid/claim values ($548 and $661 respectively) point to recurring, day-rate style billing rather than isolated episodic procedures.

Competitive standing on T2016 is strong within the state: the provider ranks #1 of 9 providers in-state (100th percentile) for T2016, marking it as a statewide leader for residential habilitation per-diem billing even though the dataset describes the volume as typical, unremarkable relative to the broader distribution of similar providers. Being top-ranked for this high-revenue code signals market leadership in that specific service line.

For T2025 the provider ranks #4 of 10 in-state (67th percentile), a modestly above-median position that the data characterizes as typical, unremarkable volume; this suggests the provider is a solid but not dominant participant for this NOS waiver service in Delaware. The $661 avg paid/claim and $50.9M revenue for T2025 reinforce that it is a major revenue driver despite the mid-tier rank.

T1001 (Nursing assessment / evaluation) is materially small in revenue terms ($706.6K, 0.7% of Medicaid revenue) but the provider ranks #9 of 51 in-state (84th percentile), indicating relatively high percentile placement on a widely used code while contributing little to overall revenue. The dataset labels this volume as typical, unremarkable, implying nursing assessments support the main waiver/residential services rather than driving the business.

Operational scale is large and recurring: tens of thousands of claims for the two dominant codes (82.2K for T2016 and 77.1K for T2025) combined with substantial per-claim payments ($548 and $661) suggest ongoing residential/day-rate delivery and steady cash flow patterns typical of waiver-based service providers. This claim profile is consistent with organizations that operate multiple residential sites or high census habilitation programs.

The provider has an established presence in the market, with its NPI enumerated on 2006-12-05 (~20 years ago). That tenure, together with $96.7M in Medicaid revenue concentrated in waiver and residential habilitation codes, supports the interpretation of COMMUNITY SYSTEMS, INC. as a long-standing participant in Delaware’s IDD waiver service delivery ecosystem.

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
T2025	Waiver services; not otherwise specified (nos)	77,050	$660	$50.9M
T2016	Habilitation, residential, waiver; per diem	82,230	$550	$45.1M
T1001	Nursing assessment / evaluation	6,670	$110	$706.6K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Delaware Distribution

Community Systems, Inc. — 1 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. Delaware median

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2025	Waiver services; not otherwise specified (nos)	4	10	37,650	$670	$43M
T2016	Habilitation, residential, waiver; per diem	1	10	23,150	$620	$21.9M
T1001	Nursing assessment / evaluation	9	50	1,950	$50	$294K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mosaic	DE	Mental Illness Community Based Residential Treatment Facility	$0	$118.5M
Resources For Human Development Inc.	DE	Intellectual & Developmental Disabilities Psychologist	$0	$86M
Epic Health Services (de), LLC	DE	Home Health Agency	$0	$33.7M
Jay J Harris Dmd PC	DE	Dentist	$0	$16.7M
Elite Home Health Care Inc	DE	In Home Supportive Care Agency	$0	$14.8M
Accredo Health Group Inc	DE	Pharmacy	$0	$10.2M
Bear-glasgow Dental, LLC	DE	General Practice Dentistry	$0	$8.2M
Center For Child Development, Incorporated	DE	Psychologist	$0	$4.9M
Comfort Care At Home, Inc.	DE	Home Health Agency	$0	$4M
Collins Dental LLC	DE	Dentist	$0	$2.9M

Community Systems, Inc. — Billing Profile & Reimbursement Data

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Community Systems, 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