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

Why is the Medicaid comparison limited to Vermont 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. Vermont (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 Kingdom Human Services Inc Mh Children (NPI 1043343700)

Key Findings

Field	Value
Entity Type	Organization
Organization	Northeast Kingdom Human Services Inc Mh Children
Address	154 Duchess St
City	Newport
State	VT
ZIP	05855
Taxonomy	Adolescent and Children Mental Health Clinic/Center
NPI Enumerated	March 13, 2007

Payer Source	Total Paid
Medicaid	$2.7M
Medicare	$0

This provider is effectively a Medicaid-only biller in the available data: Total Medicare revenue is none (no Medicare billing on file) while Total Medicaid revenue is $2.7M, indicating the organization’s reimbursement activity in these datasets is concentrated entirely in state Medicaid. Analysts should treat payer-mix conclusions as single-payer (Medicaid) unless other commercial or Medicare data appear elsewhere.

Revenue is extremely concentrated in a single procedure series: the top three Medicaid codes account for 98.1% of the provider’s Medicaid revenue, led by H2017 at $2.5M (94.2% of Medicaid revenue), followed by H0040 at $67K (2.5%) and 99214 at $38.3K (1.4%). This concentration means nearly all Medicaid dollars hinge on that dominant code.

The service mix implied by the top revenue-driving codes indicates a programmatic, community- and time-based behavioral health operation for youth: H2017 (Psychosocial rehabilitation services, per 15 minutes) dominates revenue, and H0040 (Assertive community treatment program, per diem) is present at a smaller scale, consistent with community outreach and rehabilitation models for adolescent/children mental health. The presence of high-volume E/M code 99214 (9.6K claims, $4 avg paid/claim, $38.3K revenue) alongside these program codes suggests the organization also bills routine outpatient evaluation and management encounters in support of those services.

Competitive standing by code is mixed: H2017 ranks #9 of 28 in-state (70th percentile) and is labeled as a typical, unremarkable state volume for that code, so while H2017 generates most revenue here, the provider is not the top state leader for that service. By contrast, 99214 ranks #30 of 323 (91st percentile) and 90837 ranks #16 of 666 (98th percentile) with both described as typical or notably above typical respectively, indicating comparatively strong state-level volume for office psychotherapy/E&M activity even though those codes represent much smaller shares of total revenue.

Claim-volume and payment patterns are uneven: H2017 shows 59.5K claims at a $42 avg paid/claim ($2.5M revenue), demonstrating both high utilization and meaningful per-unit payment, whereas 99214 shows 9.6K claims at only a $4 avg paid/claim ($38.3K revenue). Additionally, a number of frequently billed codes appear with substantial claim counts but $0 avg paid/claim and $0 recorded revenue in the dataset (for example H2015 with 105.1K claims, 90833 with 3.2K claims, and several other H‑series and psychotherapy add‑ons), which suggests many service lines are recorded on claims but have no corresponding Medicaid payment recorded in this extract.

Operationally, the dominance of a per-15-minute code (H2017) combined with per-diem H0040 and frequent short psychotherapy/E/M encounters suggests the provider’s model is built around time-based, programmatic care delivery (psychosocial rehabilitation and community treatment) rather than high-revenue episodic procedures. For payers and network planners this pattern signals a reliance on sustained, community-based behavioral health capacity for children and adolescents rather than episodic specialty care.

Tenure in the billing environment is long-standing: the provider’s NPI was enumerated on 2007-03-13 (~19 years ago), indicating an established presence in the state Medicaid system that should be considered when evaluating referral relationships, historical volume trends, and network stability.

From a financial vulnerability and strategic perspective, the provider’s Medicaid revenue concentration (94.2% from H2017 alone) creates sensitivity to any policy, coding, or rate changes affecting that single code; conversely, the provider’s relatively high state percentiles on E/M and psychotherapy codes (e.g., 99214 at the 91st percentile and 90837 at the 98th percentile) show pockets of clinical volume strength that could support care continuity if program reimbursement shifts occur.

Medicaid: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2017	Psychosocial rehabilitation services, per 15 minutes	59,520	$40	$2.5M
H0040	Assertive community treatment program, per diem	180	$370	$67K
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…	9,590	$1	$38.3K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	2,480	$10	$24.8K
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…	12,080	$1	$24.2K
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…	360	$1	$360
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…	110	$1	$220
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	120	$1	$120
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	210	$0	$0
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	3,190	$0	$0

Showing 1–10 of 20

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Vermont Distribution

Northeast Kingdom Human Services Inc Mh Children — 2 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Vermont

Full comparison — all codes billed, vs. Vermont median

20 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2015	Comprehensive community support services, per 15 minutes	6	20	64,230	$90	$7.1M
H2017	Psychosocial rehabilitation services, per 15 minutes	9	30	6,730	$110	$4.1M
H2014	Skills training and development, per 15 minutes	11	10	7,770	$60	$599.6K
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	320	680	$30	$146.1K
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…	16	670	760	$70	$143.9K
H0040	Assertive community treatment program, per diem	4	10	180	$430	$99K
H2011	Crisis intervention service, per 15 minutes	6	20	1,680	$20	$96.2K
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…	106	320	760	$20	$88.2K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	5	110	170	$70	$38.6K
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…	83	170	360	$20	$35.9K

Showing 1–10 of 20

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northeast Kingdom Human Services Inc Ds Waiver	VT	Developmental Disabilities Clinic/Center	$0	$204.7M
Baart Behavioral Health Services, Inc.	VT	Substance Use Disorder Rehabilitation Clinic/Center	$85.8K	$17.6M
Northeast Kingdom Human Services Inc Sbs	VT	Adolescent and Children Mental Health Clinic/Center	$0	$8.3M
Autism Advocacy And Intervention, LLC	VT	Behavior Analyst	$0	$7.8M
Newport Ambulance Service Inc.	VT	Land Ambulance	$743.2K	$2.9M
North Country Hospital & Health Center Inc	VT	Internal Medicine Physician	$0	$3.2M
North East Kingdom Community Action, Inc.	VT	Public Health or Welfare Agency	$0	$2.8M
North Country Hospital & Health Center Inc	VT	Pediatrics Physician	$0	$2.2M
James V. Wyllie, Dds P.C.	VT	General Practice Dentistry	$0	$1.8M
Keene Medical Products, LLC	VT	Durable Medical Equipment & Medical Supplies	$0	$1.7M

Northeast Kingdom Human Services Inc Mh Children — Billing Profile & Reimbursement Data

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Northeast Kingdom Human Services Inc Mh Children — 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