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

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

Georgia Mountains Community Services (NPI 1114988268)

Field	Value
Entity Type	Organization
Organization	Georgia Mountains Community Services
Address	4331 Thurmond Tanner Rd
City	Flowery Branch
State	GA
ZIP	30542
Taxonomy	Mental Health Counselor
NPI Enumerated	March 29, 2006

Payer Source	Total Paid
Medicaid	$19.2M
Medicare	$0

Key Findings

This provider is effectively a single‑payer Medicaid entity: Total Medicaid revenue is $19.2M while there is no Medicare billing on file (none). The absence of Medicare activity means the organization’s financial exposure and strategic positioning are concentrated entirely within Medicaid programs and related waiver services.

Revenue concentration is high: the precomputed top 3 Medicaid codes by revenue account for 49.4% of the provider’s total Medicaid revenue, driven by T2025 ($4.5M, 52.5K claims, $86 avg paid/claim), 90837 ($2.7M, 31.7K claims, $85 avg paid/claim) and 90832 ($2.3M, 59.8K claims, $38 avg paid/claim). This indicates almost half of Medicaid dollars come from a small set of codes tied to psychotherapy and waiver services.

The code mix signals a community‑focused behavioral health operation: large volumes in psychotherapy codes 90832, 90837 and 90834, together with waiver and community supports such as T2025, H0039 (assertive community treatment), H0038 (self‑help/peer services) and H2017 (psychosocial rehabilitation), point to an organization delivering both outpatient psychotherapy and intensive community support/waiver services. High counts (e.g., 59.8K claims for 90832 and 52.5K claims for T2025) imply substantial ongoing service delivery capacity.

Competitive standing is mixed but notable for psychotherapy: the provider ranks #1 of 138 in-state for 90832 (100th percentile) and #6 of 884 for 90837 (99th percentile), characterizations labeled as "extreme outlier" and therefore reflect a major, statewide presence for psychotherapy delivery. By contrast, T2025 ranks #9 of 30 (72th percentile) and is described as typical, indicating strong dominance in psychotherapy specifically rather than across all waiver service lines.

Several additional codes show meaningful program breadth and above‑typical activity: 90792 (8.7K claims, $996.1K revenue) ranks #3 of 60 in-state (97th percentile) and H0031 (13.6K claims, $1.2M revenue) ranks #6 of 76 (93th percentile), which together suggest the provider performs a high volume of psychiatric evaluations and non‑physician mental health assessments in addition to psychotherapy. These assessment codes support a model centered on diagnosis plus high‑volume therapeutic follow‑up.

There is a clear split in average paid per claim across service types that reflects a mix of shorter and longer sessions: 90832 pays $38 avg per claim while 90837 pays $85 avg per claim, and T2025 pays $86 avg per claim. This payment profile aligns with a service mix that includes many short psychotherapy encounters and a substantial number of longer, higher‑paid sessions and waiver supports.

Operational scale implied by claims volume suggests significant workforce and capacity to deliver frequent outpatient care: tens of thousands of psychotherapy claims (59.8K for 90832 and 31.7K for 90837) indicate sustained high throughput and infrastructure to manage large caseloads, including adjunct services like case management (T1016) and telehealth (Q3014). The presence of both high volume outpatient psychotherapy and community treatment services implies multi‑disciplinary staffing and coordination capabilities.

The provider has an established tenure in the marketplace, with NPI enumeration on 2006-03-29 (~20 years ago), which supports its ability to scale services over time. However, because nearly half of Medicaid revenue is concentrated in the top three codes (49.4%) and the organization reports no Medicare revenue, its financial and operational performance is particularly sensitive to Medicaid rate changes or policy shifts affecting those specific codes.

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
T2025	Waiver services; not otherwise specified (nos)	52,450	$90	$4.5M
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…	31,660	$90	$2.7M
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…	59,770	$40	$2.3M
H0039	Assertive community treatment, face-to-face, per 15 minutes	21,510	$80	$1.7M
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…	18,400	$70	$1.3M
H0031	Mental health assessment, by non-physician	13,580	$90	$1.2M
H0038	Self‑help/peer services, per 15 minutes	16,930	$60	$1.1M
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	8,660	$120	$996.1K
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…	10,350	$80	$817.3K
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…	16,040	$50	$721.9K

Showing 1–10 of 25

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Georgia Distribution

Georgia Mountains Community Services — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Georgia

Full comparison — all codes billed, vs. Georgia median

25 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2025	Waiver services; not otherwise specified (nos)	9	30	15,890	$130	$7.5M
H0039	Assertive community treatment, face-to-face, per 15 minutes	5	10	24,810	$90	$2M
H0038	Self‑help/peer services, per 15 minutes	5	10	14,500	$60	$1.3M
T1016	Case management, each 15 minutes	7	10	4,850	$70	$923.5K
H2017	Psychosocial rehabilitation services, per 15 minutes	9	20	3,800	$70	$896.7K
T2028	Specialized supply, not otherwise specified, waiver	6	20	2,190	$210	$854K
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	2	10	370	$290	$467.8K
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…	67	920	370	$60	$360.6K
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…	70	820	390	$70	$245K
H0031	Mental health assessment, by non-physician	6	80	80	$110	$233.6K

Showing 1–10 of 25

Nearby Providers

Other providers in the same ZIP code as Georgia Mountains Community Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jemin Lee	GA	Dentist	$0	$464.8K
Salman Bhatti	GA	Optometrist	$222.5K	$0
Jeremy Arkfeld	GA	Physical Therapist	$148.3K	$0
Georgia Cvs Pharmacy L.L.C.	GA	Pharmacy	$121.4K	$0
Austin Pearson	GA	Physical Therapist	$93.1K	$0
Jeannette Velazquez	GA	Podiatrist	$15.3K	$0

Georgia Mountains Community Services — Billing Profile & Reimbursement Data

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Georgia Mountains Community Services — 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