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

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

State Of Missouri (NPI 1992871958)

Field	Value
Entity Type	Organization
Organization	State Of Missouri
Address	1515 E Pythian St
City	Springfield
State	MO
ZIP	65802
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	November 28, 2006

Payer Source	Total Paid
Medicaid	$72.6M
Medicare	$0

Key Findings

STATE OF MISSOURI (Developmentally Disabled Services Day Training Agency) is effectively a Medicaid-focused provider with lifetime Medicaid revenue of $72.6M and no Medicare billing on file; its NPI was enumerated on 2006-11-28 (~20 years ago), indicating long-established operations in Springfield, MO. The absence of Medicare billing makes this organization a near-single-payer operation driven by state Medicaid programs.

Revenue is extremely concentrated in a single Medicaid service line: the precomputed top 3 Medicaid codes account for 100.0% of the provider’s Medicaid revenue, with T1019 alone representing $71.7M (98.8% of Medicaid revenue) and T2029 contributing $876.1K (1.2% of Medicaid revenue). This concentration means most of the provider’s financial performance hinges on continued authorization and reimbursement for these specific waiver and personal-care services.

The code mix and descriptions point to an operational model centered on time-based personal care for individuals with developmental disabilities: T1019 (personal care services, per 15 minutes, part of an individualized plan of treatment) dominates activity and revenue, while T2029 (specialized medical equipment, waiver) represents a small complementary revenue stream. Together, these codes align with a day-training and community-based support provider that bills heavily for direct care minutes and a narrower set of waiver-related supplies or equipment.

Activity and payment metrics underline scale and intensity of direct-care delivery: T1019 shows 419.3K claims with an $171 avg paid/claim, reflecting both very high claim volume and substantial per-claim payments for time-based services. By contrast, T2029 has 3.5K claims with a $247 avg paid/claim, indicating far lower claim frequency but higher unit payments for equipment-related items. These figures suggest operational emphasis on sustained staff-delivered services supported by occasional equipment purchases.

Competitively, the provider is a major in-state participant for its primary service: T1019 ranks #40 of 1332 providers in Missouri (97th percentile) and is described as notably above typical state volume, which positions the organization as one of the larger volume suppliers of personal care services within the state’s peer set. That rank signals meaningful market presence in the Medicaid personal-care arena, even if it is not the absolute top biller statewide.

For specialized equipment waiver billing (T2029), the provider ranks #14 of 41 in-state (68th percentile) with activity characterized as typical and unremarkable relative to peers; this indicates the organization participates in equipment waiver billing but is not a dominant supplier in that narrower category. The juxtaposition of a dominant T1019 footprint and modest T2029 activity suggests a primary focus on direct care rather than durable medical equipment provisioning.

Because the provider reports no Medicare revenue, its financial and operational exposure is concentrated on Medicaid policy, reimbursement rates, and waiver program rules. Any state-level changes to authorization practices, per-15-minute rate-setting for T1019, or waiver eligibility could materially affect the provider’s revenue given that $71.7M of $72.6M Medicaid revenue is linked to a single service code.

Operational implications of the billing pattern include scale-driven administrative and workforce requirements: delivering 419.3K T1019 claims implies large staff-hours and scheduling infrastructure to support time-based billing at scale, while the relatively few T2029 claims suggest a smaller, possibly centralized process for equipment procurement and billing. This mix creates sensitivity to labor costs, time-capture accuracy, and Medicaid audit or documentation policy changes tied to personal care services.

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
T1019	Personal care services, per 15 minutes, 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…	419,340	$170	$71.7M
T2029	Specialized medical equipment, not otherwise specified, waiver	3,550	$250	$876.1K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Missouri Distribution

State Of Missouri — 1 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. Missouri median

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1019	Personal care services, per 15 minutes, 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…	40	1,330	6,550	$80	$4.6M
T2029	Specialized medical equipment, not otherwise specified, waiver	14	40	1,720	$200	$1.4M

Nearby Providers

Other providers in the same ZIP code as State Of Missouri, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Arc Of The Ozarks	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$98M
The Arc Of The Ozarks	MO	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$95.9M
The Arc Of The Ozarks	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$64.6M
Nova Center Of The Ozarks Inc.	MO	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$50.5M
Mercy Hospital Springfield	MO	Land Ambulance	$0	$46.7M
The Arc Of The Ozarks	MO	Community/Behavioral Health Agency	$0	$20.1M
Developmental Center Of The Ozarks	MO	Developmentally Disabled Services Day Training Agency	$0	$14.5M
Forensic Testing Services, LLC	MO	Durable Medical Equipment & Medical Supplies	$0	$13.4M
Holloman Care Cds LLC	MO	Home Health Agency	$0	$11.3M
Advocates For A Healthy Community, Inc.	MO	Federally Qualified Health Center (FQHC)	$0	$3.8M

State Of Missouri — Billing Profile & Reimbursement Data

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State Of Missouri — 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