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

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

Medoptions Of Vermont LLC (NPI 1114479730)

Medoptions Of Vermont LLC is a psychiatry physician provider located in Barre, Vermont. This profile covers 0 Medicare and 12 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Medoptions Of Vermont LLC
Address	100 N Main St
City	Barre
State	VT
ZIP	05641
Taxonomy	Psychiatry Physician
NPI Enumerated	October 31, 2016

Payer Source	Total Paid
Medicaid	$266.4K
Medicare	$0

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	4,800	$20	$91.2K
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…	5,800	$10	$58K
G0407	Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth	4,770	$10	$57.2K
Q3014	Telehealth originating site facility fee	7,810	$1	$23.4K
99484	Clinical staff members spend at least 20 minutes each month coordinating and managing a patient’s behavioral health services under the direction of a physician or other qualified health care…	3,120	$10	$21.9K
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…	280	$10	$3.1K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	200	$10	$2.8K
99310	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends…	130	$20	$2.4K
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…	80	$30	$2.3K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	100	$20	$1.7K

Showing 1–10 of 12

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Vermont Distribution

Medoptions Of Vermont LLC — 3 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Vermont

Full comparison — all codes billed, vs. Vermont median

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	57	320	680	$30	$146.1K
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…	208	320	760	$20	$88.2K
G0407	Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth	1	10	4,770	$10	$55.7K
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…	18	50	50	$80	$50K
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…	2	110	260	$20	$19.5K
99484	Clinical staff members spend at least 20 minutes each month coordinating and managing a patient’s behavioral health services under the direction of a physician or other qualified health care…	1	10	510	$10	$14.8K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	18	20	450	$10	$12.7K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	19	90	60	$50	$9.4K
Q3014	Telehealth originating site facility fee	1	10	120	$1	$7.2K
99310	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends…	4	10	110	$40	$6.8K

Showing 1–10 of 12

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Barbara Spear	VT	Gerontology Clinical Nurse Specialist	$292K	$0
Kerry O'hara	NH	Adult Health Nurse Practitioner	$193.7K	$0
Sabrina Wilkerson	KY	Family Nurse Practitioner	$192.1K	$0
Tatum Siebert	MA	Clinical Psychologist	$94.3K	$0
Angela Cain	VA	Family Nurse Practitioner	$54.2K	$0
Jennifer Davis	CO	Clinical Psychologist	$45.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Washington County Mental Health Services, Inc.	VT	Developmental Disabilities Clinic/Center	$0	$145M
Clearchoicemd, PLLC	VT	Urgent Care Clinic/Center	$0	$10.8M
Pride Support Services Inc	VT	Case Management Agency	$0	$4.4M
Town Of Barre	VT	Land Ambulance	$631.7K	$1.6M
Central Vermont Dental Center	VT	Dentist	$0	$2.2M
Gifford Health Care, Inc	VT	Federally Qualified Health Center (FQHC)	$0	$2M
City Of Barre	VT	Land Ambulance	$202.5K	$1.1M
Jennie Holden	VT	Clinical Psychologist	$0	$1.1M
Elevate Youth Services Incorporated	VT	Case Management Agency	$0	$1.1M
Jennie Holden Plc	VT	Clinical Psychologist	$0	$1M

Medoptions Of Vermont LLC — Billing Profile & Reimbursement Data

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Medoptions Of Vermont LLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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