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.

Lamoille County Health Mental Health Services (NPI 1144347824)

Field	Value
Entity Type	Organization
Organization	Lamoille County Health Mental Health Services
Address	520 Washington Hwy
City	Morrisville
State	VT
ZIP	05661
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	March 26, 2007

Payer Source	Total Paid
Medicaid	$42.7M
Medicare	$0

Key Findings

LAMOILLE COUNTY HEALTH MENTAL HEALTH SERVICES is effectively a single-payer Medicaid provider in the available claims data: there is no Medicare revenue on file and its lifetime Medicaid revenue is reported as $42.7M. This makes Medicaid the exclusive recorded source of billed federal-program revenue in the dataset and frames any commercial/Medicare comparison as not applicable from the claims here.

Revenue is extremely concentrated in a very small set of Medicaid codes: the precomputed top-three codes account for 100.0% of the provider's total Medicaid revenue, led by 99199 at $33.6M (78.7%) and H2022 at $9.1M (21.3%), with H2017 contributing $32.2K (0.1%). This concentration means most of the provider’s financial footprint in Medicaid rests on these two high-dollar codes rather than a broad mix of procedure-level billing.

The top revenue-driving codes imply an operational focus on community behavioral health wraparound and broadly coded ‘‘other’’ medicine services. H2022 (community-based wrap-around services, per diem) at $9.1M reflects a per-diem, programmatic service line consistent with community mental health supports, while the dominant 99199 ($33.6M) is an other/unspecified medicine services code, suggesting substantial use of catch-all billing for services that lack a more specific procedure code.

Competitive standing within Vermont is modest for the largest revenue codes: 99199 ranks #9 of 16 providers in-state (47th percentile) and is characterized in the source as typical, unremarkable volume; H2022 ranks #11 of 14 (23th percentile) and likewise shows typical, unremarkable volume. Neither code places the provider among statewide leaders for those services, so the organization appears to be a mid- to lower-tier participant on its largest Medicaid lines rather than a dominant statewide provider.

Several high-claim-volume codes in the Medicaid extract show $0 avg paid/claim and $0 recorded revenue despite large claim counts (examples include T1016 with 45.2K claims, T2021 with 28.2K claims, S5150 with 11.3K claims and S5151 with 9.3K claims). This pattern indicates sizeable claim activity in the dataset that did not translate to paid Medicaid dollars as reported here; analysts should treat those high-volume, zero-paid lines as operational or reporting features to investigate (e.g., claim routing, bundled payments, or non-fee-for-service arrangements) rather than as revenue drivers in this extract.

The provider’s Medicaid code-level ranks for smaller revenue codes are consistent with ‘‘typical, unremarkable volume’’ language across many lines (for example, H2017 ranks #17 of 28, 41th percentile). A number of niche codes are present but contribute negligible revenue, reinforcing that the provider’s financial exposure in Medicaid is concentrated in a narrow set of billing categories rather than broadly distributed across many reimbursed services.

The NPI tenure indicates an established presence: the provider’s NPI was enumerated on 2007-03-26 (approximately 19 years ago). That duration supports interpreting the current concentrated billing pattern as a sustained operational profile rather than a very recent coding anomaly; analysts should combine tenure with contract and encounter-level detail to assess whether the concentration in 99199 and H2022 is structural to the provider’s service model.

Medicaid: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	4,830	$6,950	$33.6M
H2022	Community-based wrap-around services, per diem	4,200	$2,170	$9.1M
H2017	Psychosocial rehabilitation services, per 15 minutes	1,610	$20	$32.2K
H2015	Comprehensive community support services, per 15 minutes	390	$20	$8.1K
H2023	Supported employment, per 15 minutes	4,020	$0	$0
H2025	Ongoing support to maintain employment, per 15 minutes	15,530	$0	$0
S5150	Unskilled respite care, not hospice; per 15 minutes	11,350	$0	$0
T1016	Case management, each 15 minutes	45,230	$0	$0
HW015	N/A	50	$0	$0
HW151	N/A	10	$0	$0

Showing 1–10 of 15

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

Lamoille County Health Mental Health Services — 0 of 4 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

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	9	20	6,570	$6,270	$59.7M
H2022	Community-based wrap-around services, per diem	11	10	18,970	$620	$35.6M
H2015	Comprehensive community support services, per 15 minutes	17	20	64,230	$90	$7.1M
H2017	Psychosocial rehabilitation services, per 15 minutes	17	30	6,730	$110	$4.1M
T1016	Case management, each 15 minutes	6	40	3,900	$1	$31.1K
T2021	Day habilitation, waiver; per 15 minutes	7	10	28,170	$1	$210
H2023	Supported employment, per 15 minutes	3	20	1,490	$0	$0
H2025	Ongoing support to maintain employment, per 15 minutes	5	20	3,440	$0	$0
S5150	Unskilled respite care, not hospice; per 15 minutes	10	10	27,240	$0	$0
HW015	N/A	1	10	50	$0	$0

Showing 1–10 of 15

Nearby Providers

Other providers in the same ZIP code as Lamoille County Health Mental Health Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Green Mountain Support Services Inc.	VT	Case Manager/Care Coordinator	$0	$25.9M
Lamoille County Mental Health Services	VT	Community/Behavioral Health Agency	$0	$22.2M
Lamoille Health Partners, Inc	VT	Cognitive & Behavioral Psychologist	$0	$10.5M
Lamoille Health Partners, Inc	VT	Federally Qualified Health Center (FQHC)	$0	$5.4M
Lamoille Family Center Inc	VT	Public Health or Welfare Agency	$0	$5.2M
Lamoille Health Partners, Inc	VT	Pediatrics Physician	$0	$4.6M
Lamoille Health Partners, Inc	VT	Dentist	$0	$1.7M
Maple Leaf Family Dentistry	VT	General Practice Dentistry	$0	$1.2M
Tamarack Family Medicine	VT	Clinic/Center	$0	$1.1M
Copley Hospital, Inc.	VT	Critical Access Hospital	$0	$525.5K

Lamoille County Health Mental Health Services — Billing Profile & Reimbursement Data

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Lamoille County Health Mental Health 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