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

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

Phoenix Group Home, LLC (NPI 1083146013)

Field	Value
Entity Type	Organization
Organization	Phoenix Group Home, LLC
Address	902 Gallia St
City	Portsmouth
State	OH
ZIP	45662
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	March 29, 2017

Payer Source	Total Paid
Medicaid	$98.8M
Medicare	$0

Key Findings

PHOENIX GROUP HOME, LLC is effectively a Medicaid-only billing entity: it has no Medicare billing on file and reports lifetime Medicaid revenue of $98.8M. This concentration makes Medicaid the sole material payer in the available claims history and shapes the provider’s operational and reimbursement risk profile.

Revenue is highly concentrated in three time- and therapy-based behavioral health codes: the top 3 Medicaid codes (H0036, H2019, 90837) account for 79.9% of the provider’s total Medicaid revenue. Individually those codes generated $31.4M (31.8%) for H0036, $29.7M (30.0%) for H2019, and $17.9M (18.1%) for 90837, indicating the business is driven by a narrow set of services.

The code mix points to a large-scale community and behavioral health operation that delivers both high-volume short-interval services and lengthy psychotherapy sessions. H0036 (community psychiatric supportive treatment, per 15 minutes) shows 317K claims at $99 avg paid/claim, H2019 (therapeutic behavioral services, per 15 minutes) shows 241.3K claims at $123 avg paid/claim, and 90837 (psychotherapy, 53+ minutes) shows 178.9K claims at $100 avg paid/claim—a profile consistent with intensive outpatient/community behavioral programming.

PHOENIX GROUP HOME is a dominant statewide provider for several top codes: H0036 ranks #3 of 735 providers in-state and 90837 ranks #5 of 2643 providers in-state, with both labeled as 100th percentile and described as "extreme outlier, far above typical state volume for this code." H2019 also ranks highly (#17 of 840, 98th percentile) and is described as "notably above typical state volume," together indicating major market share in these behavioral service lines.

Beyond the top three, the provider also reports meaningful E/M and psychosocial rehabilitation billing that diversify service delivery: 99214 accounts for $6.3M (6.3%) and is noted as a typical, unremarkable volume for that code; H2017 (psychosocial rehabilitation) contributes $5.5M (5.6%) and ranks #8 of 238 providers in-state (97th percentile; notably above typical). High-percentile ranks on codes such as 99215 (23K claims, $144 avg, $3.3M, 3.4% and described as an extreme outlier) suggest the organization also bills higher-acuity evaluation and management visits.

Operationally and financially, the provider’s model is sensitive to utilization of time-based units and per-claim payment levels because the highest-volume codes are billed in 15-minute increments and long psychotherapy sessions. Given H0036’s $99 avg paid/claim and H2019’s $123 avg paid/claim combined with six-figure to mid-six-figure claim counts, small changes in unit rates or authorization patterns could materially impact revenue.

The provider’s enrollment history shows an NPI enumeration date of 2017-03-29 (~9 years ago), providing a nearly decade-long billing record concentrated in Medicaid that supports the high-volume, specialty behavioral health profile observed across the data.

Medicaid: Complete Services Breakdown

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

27 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	317,020	$100	$31.4M
H2019	Therapeutic behavioral services, per 15 minutes	241,320	$120	$29.7M
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…	178,860	$100	$17.9M
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…	52,160	$120	$6.3M
H2017	Psychosocial rehabilitation services, per 15 minutes	60,720	$90	$5.5M
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…	23,050	$140	$3.3M
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…	20,800	$80	$1.6M
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…	3,750	$210	$786.5K
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…	10,650	$50	$575K
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…	8,130	$70	$561.2K

Showing 1–10 of 27

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Ohio Distribution

Phoenix Group Home, LLC — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. Ohio median

27 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2019	Therapeutic behavioral services, per 15 minutes	17	840	240	$90	$1.8M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	3	740	480	$60	$669.5K
H2017	Psychosocial rehabilitation services, per 15 minutes	8	240	1,090	$50	$509.2K
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…	5	2,640	620	$90	$408.2K
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…	89	4,510	500	$60	$377.8K
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…	345	5,080	560	$40	$323.9K
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…	68	140	140	$160	$266.4K
90846	A provider meets with the patient’s family without the patient present to counsel the family on the psychological issues affecting the patient and the family.	9	70	210	$170	$244.7K
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…	100	1,320	290	$50	$148.6K
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…	96	1,320	450	$40	$139.1K

Showing 1–10 of 27

Nearby Providers

Other providers in the same ZIP code as Phoenix Group Home, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Scioto County Counseling Center, Inc	OH	Addiction (Substance Use Disorder) Counselor	$0	$166.5M
Southern Ohio Medical Center	OH	General Acute Care Hospital	$0	$144.9M
Mahajan Therapeutics, LLC	OH	Community/Behavioral Health Agency	$0	$33.9M
Scioto County Counseling Center, Inc.	OH	Mental Health Counselor	$0	$27.7M
Amazing Grace Center Inc	OH	Methadone Clinic	$349.1K	$26.2M
Somc Medical Care Foundation, Inc.	OH	Family Medicine Physician	$0	$25.3M
Portsmouth Emergency Ambulance Service Inc	OH	Ambulance	$3.6M	$18.7M
Genesis Respiratory Services Inc	OH	Durable Medical Equipment & Medical Supplies	$0	$20.4M
Portsmouth Hospital Corporation	OH	General Acute Care Hospital	$0	$19.7M
Jay Hash LLC	OH	Substance Use Disorder Rehabilitation Clinic/Center	$0	$19.1M

Phoenix Group Home, LLC — Billing Profile & Reimbursement Data

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Phoenix Group Home, LLC — 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