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

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

Volunteer Behavioral Health Care System (NPI 1043267107)

Key Findings

Field	Value
Entity Type	Organization
Organization	Volunteer Behavioral Health Care System
Address	1504 Williams Dr
City	Murfreesboro
State	TN
ZIP	37129
Taxonomy	Counselor
NPI Enumerated	May 27, 2006

Payer Source	Total Paid
Medicaid	$168M
Medicare	$0

This provider bills only to Medicaid and not to Medicare: there is no Medicare revenue on file and total Medicaid revenue is $168M, indicating the organization operates effectively as a Medicaid-focused provider. The absence of Medicare billing means its financial profile and strategic exposure are tied almost entirely to state Medicaid policy and payer contracts.

Revenue is highly concentrated in a very small set of codes: the precomputed top three Medicaid codes account for 90.4% of the provider’s Medicaid revenue, with S0280 alone representing $117.8M (70.1% of Medicaid revenue). Heavy concentration at the top of the code list signals that a few service lines drive the vast majority of dollars for this entity.

The top revenue-driving code mix points to an integrated clinical and community-support model: S0280 (Medical home program, comprehensive care coordination and planning, initial plan) and H0043 (Supported housing, per diem) together imply substantial investment in care coordination and housing supports, while 99213 (high-volume outpatient E/M visits) indicates large-scale clinic-based patient follow-up. These codes together suggest the organization operates both clinical outpatient services and non-clinical social-support programs that are billed to Medicaid.

Competitive standing is mixed by service line. For S0280 the provider ranks #2 of 40 in-state (97th percentile) and is described as an extreme outlier, indicating near-dominant statewide scale for medical-home care coordination; for 99213 the provider ranks #3 of 4050 (100th percentile) and is also an extreme outlier, representing exceptional volume in outpatient E/M visits. By contrast, H0043 (Supported housing) is ranked #16 of 20 (21th percentile) and characterized as a typical, unremarkable volume for that code, so the provider is not a dominant player in the supported-housing market relative to the small set of in-state housing providers.

High-volume outpatient behavioral-health and assessment codes reinforce the clinical footprint: 90834 (115.1K claims; ranks #4 of 360, 99th percentile, notably above typical), 90832 (151.7K claims; ranks #3 of 300, 99th percentile, extreme outlier), and 90791 (42.9K claims; ranks #4 of 310, 99th percentile, extreme outlier) together show substantial psychotherapy and psychiatric evaluation throughput. Those volumes indicate the provider delivers large-scale, ongoing mental-health treatment and intake/diagnostic services in addition to care coordination.

Operational scale is large in absolute Medicaid billing terms and in encounter volume: S0280 alone shows 1.3M claims at $94 avg paid/claim for $117.8M revenue, and 99213 shows 289.8K claims for $12.5M revenue, demonstrating both very high claim counts and concentrated dollar impact. This pattern is consistent with an organization managing large caseloads and recurring services rather than episodic, high-dollar inpatient events.

The payer concentration represents strategic and financial risk: with $168M coming exclusively from Medicaid and no Medicare billing on file, changes to state Medicaid reimbursement, program eligibility, or care-coordination rules could materially affect revenue. Diversification into other payers or service lines is not evidenced in the billing data provided.

The provider has an established tenure in the dataset, with NPI enumeration on 2006-05-27 (~20 years ago), signaling a longstanding operational presence in the market. Combined with the extreme outlier rankings on multiple outpatient and care-coordination codes, this longevity suggests entrenched capacity in both clinical behavioral-health services and Medicaid-funded community supports.

Medicaid: Complete Services Breakdown

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

34 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S0280	Medical home program, comprehensive care coordination and planning, initial plan	1,253,640	$90	$117.8M
H0043	Supported housing, per diem	12,420	$1,740	$21.6M
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	289,760	$40	$12.5M
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	115,130	$40	$4.4M
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	85,360	$50	$4.2M
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	151,700	$30	$3.9M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	42,860	$60	$2.7M
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	5,160	$60	$289K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	6,140	$30	$196.6K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	22,030	$10	$154.2K

Showing 1–10 of 34

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Volunteer Behavioral Health Care System — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

34 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S0280	Medical home program, comprehensive care coordination and planning, initial plan	2	40	22,180	$140	$21.3M
H0043	Supported housing, per diem	16	20	69,350	$180	$18.6M
H0034	Medication training and support, per 15 minutes	13	20	610	$60	$421.5K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	4	360	350	$50	$414.4K
S9485	Crisis intervention mental health services, per diem	2	20	1,410	$60	$291.9K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	126	440	530	$70	$282.3K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	3	300	480	$30	$221.2K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	30	3,760	610	$40	$202.3K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	3	4,050	620	$30	$183.9K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	12	110	450	$50	$182.5K

Showing 1–10 of 34

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jakeisha Goston	TN	Family Nurse Practitioner	$94.1K	$0
Eunice Kim	AE (Armed Forces Europe)	Psychiatric/Mental Health Nurse Practitioner	$560	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Twelvestone Medical, Inc.	TN	Home Infusion Therapy Pharmacy	$0	$52.7M
Crossroads Urgent Care PLLC	TN	Family Medicine Physician	$0	$21.6M
Murfreesboro Medical Clinic, P.A.	TN	Specialist	$0	$19.7M
Jones Therapy Services LLC	TN	Pediatric Rehabilitation Medicine Physician	$0	$19.3M
Saint Thomas Rutherford Hospital	TN	General Acute Care Hospital	$0	$16.2M
Charis Hearts Inc.	TN	Home Health Agency	$0	$8.2M
Gateway Healthcare, PC	TN	Urgent Care Clinic/Center	$0	$3.9M
Duratech Medical, Inc.	TN	Prosthetic/Orthotic Supplier	$0	$3.3M
Trustpoint Hospital LLC	TN	Psychiatry Physician	$0	$3.2M
Hometown Respiratory Consultants LLC	TN	Oxygen Equipment & Supplies (DME)	$0	$3.1M

Volunteer Behavioral Health Care System — Billing Profile & Reimbursement Data

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Volunteer Behavioral Health Care System — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References