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

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

Northeast Arc, Inc. (NPI 1992920417)

Field	Value
Entity Type	Organization
Organization	Northeast Arc, Inc.
Address	64 Holten St
City	Danvers
State	MA
ZIP	01923
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	April 17, 2007

Payer Source	Total Paid
Medicaid	$732.6M
Medicare	$0

Key Findings

This entity is effectively a single-payer Medicaid provider: there is no Medicare billing on file and the provider reports $732.6M in Medicaid revenue, indicating its entire documented revenue footprint is concentrated in state Medicaid programs. Analysts should treat Medicare-level comparisons as inapplicable for this profile.

Revenue concentration is extreme: the precomputed top 3 Medicaid codes by revenue account for 100.0% of this provider's total Medicaid revenue, with T1019 alone representing $720.6M or 98.4% of Medicaid revenue. That level of concentration implies the organization’s financial performance is overwhelmingly dependent on a single service line.

The code mix signals a focused personal-care/home-support operation rather than a medical or clinical specialty. The top codes are T1019 (personal care services, per 15 minutes), T1020 (personal care services, per diem), and 99509 (home health provider visits for ADLs/self-care), together reflecting an operational model centered on delivering non-institutional personal care and home support services.

T1019 is a statewide market leader for this service: it ranks #3 of 137 providers in-state and sits in the 99th percentile, which the source notes is notably above typical state volume for this code. By contrast, T1020 (131.3K claims, $7.6M revenue) ranks #11 of 49 (79th percentile) and 99509 (58.5K claims, $4.3M revenue) ranks #7 of 15 (57th percentile), indicating those lines are routine or modest relative to peers.

Operational scale is driven by extremely high utilization of T1019: 9.1M claims with a $79 avg paid/claim generate $720.6M in revenue, dwarfing the 131.3K claims and $7.6M from T1020 (avg $58 paid/claim) and the 58.5K claims and $4.3M from 99509 (avg $74 paid/claim). The raw claim counts and per-claim payments show the business model relies on high-frequency, unit-based personal care billing.

There is minimal revenue from ancillary services: T2022 (case management) appears as a tiny contributor at $82.4K and is listed as 0.0% of total Medicaid revenue, ranking #49 of 75 in-state (35th percentile). This suggests limited involvement in billed case management relative to the provider’s dominant direct-care activities.

The provider has an established operational history with an NPI enumerated on 2007-04-17 (~19 years ago), which supports interpretation of these billing patterns as sustained rather than transient. Longevity combined with the concentrated service mix implies institutional focus and capacity in the personal-care segment.

Strategic and risk implications: given that T1019 is 98.4% of Medicaid revenue and the top three codes make up 100.0% of total Medicaid revenue, the provider faces material program and policy risk specific to personal-care reimbursement rules and utilization controls. Payers and analysts should prioritize monitoring rate changes, prior authorization trends, and utilization reviews for T1019 when assessing future fiscal exposure and contract negotiations.

Medicaid: Complete Services Breakdown

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

4 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…	9,121,810	$80	$720.6M
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…	131,260	$60	$7.6M
99509	A home health provider, such as a registered nurse, or a non nursing practitioner, visits a patient to provide help with activities of daily living, or ADLs, and self care.	58,540	$70	$4.3M
T2022	Case management, per month	1,870	$40	$82.4K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

Northeast Arc, Inc. — 1 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

4 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…	3	140	7,990	$90	$61.6M
99509	A home health provider, such as a registered nurse, or a non nursing practitioner, visits a patient to provide help with activities of daily living, or ADLs, and self care.	7	20	39,290	$50	$29.3M
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…	11	50	11,820	$40	$4.4M
T2022	Case management, per month	49	80	7,230	$50	$2.6M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northeast Arc Inc	MA	Home Health Agency	$0	$90.8M
Care Dimensions, Inc.	MA	Community Based Hospice Care Agency	$0	$66.1M
Northeast Arc, Inc.	MA	Case Management Agency	$0	$37.4M
Northeast Arc	MA	Community/Behavioral Health Agency	$0	$34.3M
Northeast Arc, Inc.	MA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$19.7M
Northeast Arc, Inc.	MA	Community/Behavioral Health Agency	$0	$16.4M
Northeast Arc, Inc.	MA	Early Intervention Provider Agency	$0	$13.9M
North Shore Elder Services, Inc.	MA	Voluntary or Charitable Agency	$0	$12.7M
75 Lindall Street Opco LLC	MA	Substance Abuse Rehabilitation Facility	$0	$7.3M
Vine Homecare	MA	Home Health Agency	$0	$6M

Northeast Arc, Inc. — Billing Profile & Reimbursement Data

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Northeast Arc, 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