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NPI 1083832851 · Burlington, VT · Federally Qualified Health Center (FQHC)
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Community Health Centers Of Burlington Inc is a federally qualified health center (fqhc) provider located in Burlington, Vermont. This profile covers 0 Medicare and 48 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Community Health Centers Of Burlington Inc |
| Address | 617 Riverside Ave |
| City | Burlington |
| State | VT |
| ZIP | 05401 |
| Taxonomy | Federally Qualified Health Center (FQHC) |
| NPI Enumerated | April 24, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $39.8M |
| Medicare | $0 |
This provider has no Medicare billing on file and is effectively single-payer in scope: lifetime Medicare revenue is none while lifetime Medicaid revenue is $39.8M. That concentrated payer mix means population risk and reimbursement exposure are primarily tied to Medicaid policy and FQHC payment rules rather than traditional Medicare flows.
The code mix and taxonomy indicate an FQHC operational model: dominance of T1015 (Clinic visit/encounter, all-inclusive) and presence of G0467 (FQHC visit, established patient) point to high-volume, bundled clinic encounters typical of federally qualified health centers delivering comprehensive primary care and wraparound services. This pattern is consistent with the provider’s listed taxonomy as a Federally Qualified Health Center (FQHC).
Competitive standing within Vermont is dominant for the revenue-driving code: T1015 ranks #1 of 70 providers in-state (100th percentile; extreme outlier), making the provider an outlier statewide for clinic-visit revenue. G0467 ranks #2 of 49 (98th percentile; notably above typical state volume) and 99214 ranks #3 of 323 (99th percentile; extreme outlier), indicating strong statewide position across multiple high-volume encounter codes.
There is a marked volume-versus-revenue disconnect on many CPT/HCPCS lines: several high-claim codes show $0 average paid/claim and $0 revenue despite large volumes (for example, 99213 with 95.6K claims, 90833 with 6.6K claims, and multiple vaccine and psychotherapy add-on codes). This suggests that much service activity is either captured within the inclusive T1015/G0467 payment bundles or billed in ways that do not produce separate Medicaid reimbursement for those individual codes.
Telehealth and home-based care appear as explicit service lines: G2025 (telehealth for FQHC) shows 4.1K claims and $45.5K revenue and ranks #1 of 26 providers in-state (100th percentile; extreme outlier), while home-visit codes like 99350 (1.3K claims, $7.6K revenue) rank #1 of 1 provider. These data signal that remote visits and home E/M services are active parts of the care mix and are being captured in the Medicaid claims set.
Preventive and behavioral health activity is present alongside primary care: vaccine administration codes such as 90471 (4.8K claims) and 90480 (373 claims) and psychotherapy codes such as 90834 (5K claims) and 90837 (3K claims) indicate routine immunization and mental health service delivery. The presence of psychiatric evaluation codes (90792 with 1.3K claims) further supports an integrated primary care plus behavioral health model consistent with many FQHCs.
The NPI has long tenure: the provider was enumerated on 2007-04-24 (~19 years ago), indicating an established operational presence in the market. That longevity, combined with a concentrated $39.8M Medicaid revenue base and extreme reliance on T1015 (97.4% of Medicaid revenue), suggests operational stability but also material exposure if Medicaid reimbursement rules for bundled clinic visit payments were to change.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
48 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 222,690 | $170 | $38.7M |
| G0467 | Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which… | 33,070 | $20 | $496K |
| 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… | 97,240 | $1 | $389K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 23,390 | $1 | $70.2K |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | 4,130 | $10 | $45.5K |
| 99350 | The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves high medical decision making or the provider spends at least 60… | 1,270 | $10 | $7.6K |
| 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… | 5,020 | $1 | $5K |
| 99349 | The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least… | 190 | $20 | $3.3K |
| 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… | 1,170 | $1 | $1.2K |
| 0003A | N/A | 20 | $0 | $0 |
Showing 1–10 of 48
How this provider's Medicaid billing volume and revenue compare to other Vermont providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Vermont median
48 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 1 | 70 | 11,650 | $150 | $3.3M |
| 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 | 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… | 145 | 670 | 760 | $70 | $143.9K |
| 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… | 1 | 320 | 760 | $20 | $88.2K |
| G0467 | Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which… | 2 | 50 | 1,020 | $20 | $87.6K |
| 99204 | The provider sees a new 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 provider… | 51 | 50 | 50 | $80 | $50K |
| 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… | 20 | 110 | 170 | $70 | $38.6K |
| 99203 | The provider sees a new 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 provider… | 49 | 70 | 70 | $50 | $36K |
| 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… | 13 | 170 | 360 | $20 | $35.9K |
| 90460 | In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age. | 23 | 40 | 890 | $10 | $32.1K |
Showing 1–10 of 48
Other providers in the same ZIP code as Community Health Centers Of Burlington Inc, ranked by combined Medicare and Medicaid revenue.
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