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 District of Columbia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to District of Columbia 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. District of Columbia (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.

Citycare Health Services, Inc (NPI 1083062871)

Field	Value
Entity Type	Organization
Organization	Citycare Health Services, Inc
Address	508 Kennedy St Nw Ste 207
City	Washington
State	DC
ZIP	20011
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	June 2, 2016

Payer Source	Total Paid
Medicaid	$36.4M
Medicare	$0

Key Findings

CITYCARE HEALTH SERVICES, INC is effectively a Medicaid-focused provider: there is no Medicare billing on file and the provider reports $36.4M in lifetime Medicaid revenue, indicating a single-payer footprint concentrated in state Medicaid business. The absence of Medicare activity means analyses of clinical mix and competitive position should be framed around Medicaid only.

Revenue is highly concentrated in three time- and program-based behavioral-health codes: H0036, H0039 and H0040 together account for 89.8% of the provider's Medicaid revenue. In absolute terms those codes break down to H0036 $20.1M (55.3%), H0039 $11.1M (30.5%), and H0040 $1.5M (4.0%), which creates material business exposure to reimbursement or utilization changes for these specific service lines.

The code mix and descriptions point to an operational model organized around community-based psychiatric care and assertive community treatment (ACT). Heavy use of H0036 (community psychiatric supportive treatment, face-to-face, per 15 minutes) and H0039 (assertive community treatment, face-to-face, per 15 minutes), plus per‑diem billing via H0040 (ACT program, per diem), indicates routine high-frequency, time-based contacts delivered by mobile or community teams rather than a clinic-only, office-visit model.

Claim volume underscores an intensive, contact-driven service delivery pattern: H0036 shows 188.2K claims and H0039 shows 80.4K claims, while H0040 has 1.5K per-diem claims. This combination—large counts on 15-minute face-to-face units plus a smaller number of per-diem program enrollments—aligns with sustained, ongoing engagement of enrolled clients and a billing profile that relies on many short encounters.

Competitive standing across the state is mixed: for its top revenue drivers the provider ranks mid-to-high among peers but is not consistently dominant. H0036 ranks #15 of 56 (75th percentile; described as typical, unremarkable volume), H0039 ranks #8 of 27 (described as typical, unremarkable volume), and H0040 ranks #4 of 7 (50th percentile; typical, unremarkable), so CITYCARE is a meaningful participant in ACT/community psychiatric services but not a clear statewide market leader on those measures.

There is a notable outlier in diagnostic activity: 90791 (psychiatric diagnostic evaluation) generated $577.2K from 4.1K claims and ranks #3 of 80 providers in-state (97th percentile; notably above typical state volume). That elevated ranking for initial diagnostic evaluations suggests CITYCARE may perform intake and assessment work at a higher rate than most peers, which could reflect a capacity for intake throughput or a referral/triage role in the local system of care.

Several E/M and psychotherapy evaluation codes also register above-typical state standing for volume, supporting the view of substantial clinical assessment capacity. Examples include 99214 (3.8K claims, $477.9K revenue; rank and percentiles indicate meaningful outpatient E/M activity) and 99205 (1.2K claims, $307.9K revenue; rank #4 of 42), which together show the organization bills for higher-complexity outpatient evaluation and management in addition to its time-based community services.

A few data signals warrant follow-up: 90834 shows 81 claims with $0 avg paid/claim and $0 revenue, which is anomalous relative to other psychotherapy entries and may reflect reporting quirks, non-covered encounters, or data capture issues rather than usual paid activity. Given the provider's heavy reliance on a small set of codes (89.8% of revenue from the top three), validation of unusual zero‑paid line items and continued monitoring of those three primary codes is important for accurate financial and operational assessment.

Medicaid: Complete Services Breakdown

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

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	188,250	$110	$20.1M
H0039	Assertive community treatment, face-to-face, per 15 minutes	80,410	$140	$11.1M
H0040	Assertive community treatment program, per diem	1,460	$1,010	$1.5M
H0034	Medication training and support, per 15 minutes	7,280	$150	$1.1M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	4,120	$140	$577.2K
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…	3,820	$130	$477.9K
H0004	Behavioral health counseling and therapy, per 15 minutes	4,150	$90	$373.7K
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…	2,790	$130	$365.9K
99205	The provider sees a new 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 provider…	1,220	$250	$307.9K
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	1,240	$220	$277.1K

Showing 1–10 of 17

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. District of Columbia Distribution

Citycare Health Services, Inc — 1 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — District of Columbia

Full comparison — all codes billed, vs. District of Columbia median

17 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	15	60	82,090	$90	$13.9M
H0039	Assertive community treatment, face-to-face, per 15 minutes	8	30	150	$110	$5.8M
H0040	Assertive community treatment program, per diem	4	10	1,460	$970	$2M
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	20	30	1,960	$230	$1.6M
H0034	Medication training and support, per 15 minutes	22	50	5,030	$90	$1M
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…	50	120	1,050	$110	$409.5K
H0004	Behavioral health counseling and therapy, per 15 minutes	33	80	2,570	$60	$403K
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…	62	310	750	$70	$321.6K
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…	203	320	620	$50	$313.6K
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…	17	120	300	$120	$287.3K

Showing 1–10 of 17

Nearby Providers

Other providers in the same ZIP code as Citycare Health Services, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Integrated Community Services, Inc.	DC	Home Health Agency	$0	$145.9M
National Children's Center, Inc.	DC	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$101M
Capital Care, Inc	DC	Home Health Agency	$0	$83.4M
Aba Inc	DC	In Home Supportive Care Agency	$0	$80.8M
Premium Select Home Care Inc	DC	Home Health Agency	$0	$63.9M
Ideal Nursing Services Inc	DC	Home Health Agency	$0	$58M
Total Care Services, Inc.	DC	Developmentally Disabled Services Day Training Agency	$0	$54.7M
Metro Homes Inc	DC	Developmental Disabilities Clinic/Center	$0	$45.1M
Janilcar Inc	DC	Durable Medical Equipment & Medical Supplies	$0	$32.7M
Dc Health Care Inc	DC	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$24.2M

Citycare Health Services, Inc — Billing Profile & Reimbursement Data

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Citycare Health Services, 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