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

Why is the Medicaid comparison limited to Rhode Island 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. Rhode Island (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.

Newport County Community Mental Health Center, Inc (NPI 1093713174)

Field	Value
Entity Type	Organization
Organization	Newport County Community Mental Health Center, Inc
Address	42 Valley Rd
City	Middletown
State	RI
ZIP	02842
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	July 12, 2005

Payer Source	Total Paid
Medicaid	$36.9M
Medicare	$0

Key Findings

NEWPORT COUNTY COMMUNITY MENTAL HEALTH CENTER, INC shows essentially single-payer Medicaid operations: there is no Medicare billing on file while total Medicaid revenue is $36.9M, indicating the provider’s entire documented claims footprint in these data is driven by Medicaid reimbursement. This makes the organization effectively a Medicaid-focused community mental health provider in Rhode Island rather than a mixed Medicare/Medicaid practice.

Revenue concentration is extremely high: the top three Medicaid codes (H0037, H0040, and H0019) together account for 93.1% of this provider’s total Medicaid revenue. This concentration signals that a small set of programmatic services — per diem community psychiatric support, assertive community treatment per diem, and long-term residential behavioral health per diem — constitute the core business model and primary revenue drivers.

The code mix (H0037, H0040, H0019) points to an operational emphasis on intensive, program-based community behavioral health services rather than brief office-based medical visits. Large per-diem programs and long-term residential care dominate billing, which suggests the center operates substantial day-program and residential treatment capacity and likely focuses on sustained community-based treatment and case management.

Competitive standing by code within Rhode Island is solid but not dominant: H0037 revenue ranks #4 of 69 providers (96th percentile) and H0040 ranks #5 of 20 providers (79th percentile), indicating high-volume participation for these programmatic services but not market leadership. H0019 ranks #10 of 25 providers (63rd percentile), a more mid-tier position among the smaller group of residential providers, implying the center is an established regional player for community and assertive treatment but less dominant in long-term residential services.

Several CPT/HCPCS codes commonly associated with office-based care and psychotherapy (e.g., 99214, 90834, 99211) appear among the billed services but contribute only small shares of revenue relative to the top per-diem programs. Notably, 99214 and 90834 are high-percentile volumes in-state (99214 at the 98th percentile, 90834 at the 97th), which suggests the center also maintains a meaningful outpatient E/M and psychotherapy footprint alongside its per-diem programs, supporting integrated care pathways for patients in community programs.

There are signs of extensive use of low-paying or zero-paid encounter codes that reflect non-revenue-bearing activity in the dataset: large claim counts with $0 average paid (e.g., T1016 with 39.9K claims, H0046 with 29.8K claims, H0036 with 71.7K claims showing $1 avg) indicate robust case management, non-billable contact tracking, and high-frequency face-to-face support entries. These volumes imply operational scale and high patient contact intensity that aren’t captured fully in revenue figures but are operationally significant.

The provider’s Medicaid billing pattern includes several codes where its in-state rank is in the top percentiles for volume (for example, 99211 ranks #4 of 239 providers at the 99th percentile and H0036 ranks #5 of 89 providers at the 95th percentile), which indicates a consistent high-volume service delivery across both programmatic per-diem services and frequent lower-acuity encounters. This breadth of high-volume activity across codes suggests deep community reach and high caseload throughput.

The NPI enumeration date (~21 years ago, registered 2005-07-12) indicates long tenure in the market, supporting the interpretation that the organization is an established community mental health center with sustained Medicaid contracting and program delivery over two decades. That longevity combined with concentrated per-diem program revenue suggests institutional experience running community psychiatric support, assertive community treatment, and residential programs.

Medicaid: Complete Services Breakdown

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

25 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0037	Community psychiatric supportive treatment program, per diem	43,430	$380	$16.3M
H0040	Assertive community treatment program, per diem	12,120	$1,040	$12.5M
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	3,730	$1,480	$5.5M
H2023	Supported employment, per 15 minutes	9,870	$120	$1.1M
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…	7,250	$50	$391.3K
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…	6,140	$60	$344K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	9,360	$20	$177.8K
H0044	Supported housing, per month	380	$280	$103.9K
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…	1,700	$50	$84.8K
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	71,740	$1	$71.7K

Showing 1–10 of 25

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Rhode Island Distribution

Newport County Community Mental Health Center, Inc — 5 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Rhode Island

Full comparison — all codes billed, vs. Rhode Island median

25 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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	10	30	1,530	$360	$9.7M
H0040	Assertive community treatment program, per diem	5	20	350	$640	$6.3M
H0037	Community psychiatric supportive treatment program, per diem	4	70	190	$380	$3.2M
H0046	Mental health services, not otherwise specified	10	70	2,310	$70	$698K
H2023	Supported employment, per 15 minutes	3	10	230	$80	$357.1K
T1016	Case management, each 15 minutes	10	180	400	$20	$230.7K
H0004	Behavioral health counseling and therapy, per 15 minutes	52	80	340	$70	$223.7K
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	5	90	510	$10	$187.5K
H0044	Supported housing, per month	5	10	290	$270	$174.6K
H0038	Self‑help/peer services, per 15 minutes	11	20	3,010	$30	$136.6K

Showing 1–10 of 25

Related Providers

Other providers that share a Tax Identification Number (TIN) with Newport County Community Mental Health Center, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Joshua Brown	RI	Psychiatry Physician	$7.5K	$0

Nearby Providers

Other providers in the same ZIP code as Newport County Community Mental Health Center, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Child And Family Services Of Newport County	RI	Clinic/Center	$0	$4.3M
Royal Middletown Nursing Center LLC	RI	Skilled Nursing Facility	$0	$4.2M
Aquidneck Pediatrics LLC	RI	Pediatrics Physician	$0	$2.4M
Newport County Community Mental Health Center	RI	Community/Behavioral Health Agency	$0	$1.9M
Sarah Mcneill	RI	Occupational Therapist	$0	$1.6M
Visiting Nurse Services Of Newport And Bristol Counties	RI	Nursing Care Agency	$0	$1.1M
Jason Michaels	RI	MOHS-Micrographic Surgery Physician	$982.9K	$59.5K
Kenneth Kehew	RI	Dentist	$0	$709.5K
Town Of Middletown	RI	Land Ambulance	$324K	$162.5K
Robert Semco	RI	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$471.3K

Newport County Community Mental Health Center, Inc — Billing Profile & Reimbursement Data

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Newport County Community Mental Health Center, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References