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.

Department Of Mental Health (NPI 1063630838)

Field	Value
Entity Type	Organization
Organization	Department Of Mental Health
Address	305 Belmont St
City	Worcester
State	MA
ZIP	01604
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	April 24, 2007

Payer Source	Total Paid
Medicaid	$169M
Medicare	$0

Key Findings

This provider reports no Medicare billing on file and $169M in lifetime Medicaid revenue, making its operations effectively single-payer (Medicaid)-focused at present. The absence of Medicare activity suggests payer relationships, clinical programs, and revenue risk are concentrated on Massachusetts Medicaid policy and reimbursement dynamics rather than a mixed Medicare/Medicaid strategy.

Revenue is extremely concentrated in a very small set of Medicaid per-diem codes: the top three codes account for 100.0% of Medicaid revenue, with H2018 alone representing 92.6% of the provider's Medicaid receipts. That concentration indicates the organization’s financial performance is highly dependent on reimbursement and utilization of a single service line.

The code mix and descriptions point to a service model centered on community/behavioral health residential and rehabilitation care: H2018 (Psychosocial rehabilitation services, per diem) is the dominant revenue driver, supported by H0019 (long-term residential, without room and board, per diem) and H0018 (short-term residential, without room and board, per diem). This pattern is consistent with an agency operating high-volume psychosocial rehabilitation programs alongside a smaller portfolio of residential treatment beds.

Operational intensity and unit economics vary sharply across the three codes: H2018 shows very high claim volume (601.9K claims) with a low average paid/claim ($260), H0019 has 20.9K claims at an average $521 paid/claim, and H0018 posts only 559 claims but a much higher average paid/claim ($2853). These contrasts indicate the provider combines a high-throughput, lower-unit-payment rehab/psychosocial model with lower-volume, higher-intensity residential services.

Competitive standing for the dominant code, H2018, is substantial but not statewide dominant: the provider ranks #2 of 6 in-state (80th percentile) for H2018 and the publicly available label characterizes its volume as typical and unremarkable. In plain terms, the organization is one of the larger providers of psychosocial rehabilitation in Massachusetts but operates in a small peer set where its position is notable rather than dominant.

For the other revenue codes, competitive positions diverge: H0019 ranks #20 of 75 in-state (74th percentile) and is described as typical, indicating a mid-to-upper market presence for long-term residential services; H0018 ranks #4 of 4 in-state (0th percentile) and is also labeled typical, which signals a very small absolute presence in short-term residential offerings despite the service being part of the portfolio.

The provider’s NPI was enumerated on 2007-04-24 (~19 years ago), reflecting long-tenured participation in the Medicaid ecosystem. That tenure may correspond to established referral relationships and payer contracts, which are important given the revenue concentration in a few Medicaid per-diem services.

Strategic and risk implications flow from the concentration: with 100.0% of Medicaid revenue tied to three per-diem behavioral health codes and no Medicare revenue to diversify payer mix, the provider is exposed to changes in Medicaid per-diem rates, utilization management, and program eligibility. Analysts should prioritize monitoring policy changes or payer rate adjustments affecting H2018, H0019, and H0018 when assessing future revenue stability.

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
H2018	Psychosocial rehabilitation services, per diem	601,940	$260	$156.5M
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	20,920	$520	$10.9M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	560	$2,850	$1.6M

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

Department Of Mental Health — 0 of 3 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

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2018	Psychosocial rehabilitation services, per diem	2	10	483,500	$330	$139.9M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	4	10	60,540	$1,530	$132.9M
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	20	80	5,200	$370	$8.4M

Nearby Providers

Other providers in the same ZIP code as Department Of Mental Health, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Royale Care	MA	Foster Care Agency	$0	$49M
Century Homecare, LLC	MA	Home Health Agency	$0	$32.1M
Care Alternatives Of Massachusetts, LLC	MA	Community Based Hospice Care Agency	$0	$23.5M
Multicultural Wellness Center Inc	MA	Community/Behavioral Health Agency	$0	$22.1M
Department Of Mental Health	MA	Case Management Agency	$0	$17.6M
Umass Memorial Mri & Imaging Center, LLC	MA	Magnetic Resonance Imaging (MRI) Clinic/Center	$3.8M	$8.1M
Worcester Orthodontics, PC	MA	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$8.9M
Worcester Adult Daycare LLC	MA	Adult Day Care Clinic/Center	$0	$8.2M
Vernon Hill Pediatric Dentistry	MA	Pediatric Dentistry	$0	$6.3M
Dental Dreams LLC	MA	Dentist	$0	$6.2M

Department Of Mental Health — Billing Profile & Reimbursement Data

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Department Of Mental Health — 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