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

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

Fairfax County, Virginia (NPI 1154356244)

Field	Value
Entity Type	Organization
Organization	Fairfax County, Virginia
Address	12011 Government Center Parkway
City	Fairfax
State	VA
ZIP	22035
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	July 11, 2006

Payer Source	Total Paid
Medicaid	$67.6M
Medicare	$0

Key Findings

This entity is effectively a single-payer Medicaid provider: it reports no Medicare billing on file and $67.6M in lifetime Medicaid revenue, indicating its operating scale and reimbursement exposure are concentrated in state Medicaid programs rather than Medicare. Its NPI was enumerated on 2006-07-11 (~20 years ago), showing a long-tenured presence in Fairfax that aligns with substantial cumulative Medicaid billing activity.

Revenue is highly concentrated in a small set of Medicaid codes: the precomputed top three codes account for 69.8% of total Medicaid revenue, led by H0023 at 41.6%, followed by H0010 at 20.7% and H2018 at 7.5%. This level of concentration means a few service lines are driving the majority of reported Medicaid dollars.

The code mix signals a behavioral health and substance-use disorder specialty operation: H0023 (behavioral health outreach), H0010 (sub-acute detoxification, residential addiction), and H2018 (psychosocial rehabilitation, per diem) are the top revenue drivers, and additional codes such as H2019, H2036, and H0006 point to supported community-based SUD and case management services. Together these codes suggest the provider operates a continuum of care that includes outreach, residential detox, per-diem rehab, and community-based rehabilitation and behavioral support.

Competitive standing varies by service line: for psychosocial rehabilitation H2018 the provider ranks #2 of 35 providers in-state (97th percentile; extreme outlier, far above typical state volume for this code), indicating a dominant statewide position in that per-diem rehab service. By contrast H0023 ranks #8 of 50 (86th percentile; typical) and H0010 ranks #4 of 25 (88th percentile; typical), reflecting high but not uniquely dominant statewide volumes in outreach and residential detox.

Clinical intensity and face-to-face outpatient care are notable relative to peers: the provider reports 76.9K claims and $3.5M revenue for 99214 (5.1% of Medicaid revenue) and 28.2K claims and $2.1M for 90837 (3.1% of Medicaid revenue), with 99214 ranking #28 of 3523 providers in-state (99th percentile; extreme outlier) and 90837 ranking #12 of 1337 (99th percentile; extreme outlier). These rankings indicate unusually large volumes of established-patient E/M visits and long psychotherapy sessions compared with other in-state providers, consistent with sustained outpatient treatment intensity.

The provider shows breadth across SUD program modalities beyond its top three codes: H2036 (alcohol and/or other drug treatment program, per diem) ranks #2 of 13 (92th percentile; notably above typical state volume), H2019 (therapeutic behavioral services) ranks #8 of 122 (94th percentile; notably above typical), and H0006 (case management) ranks #6 of 79 (94th percentile; typical). These placements suggest the organization delivers multiple higher-intensity and supportive services for substance use and behavioral health at markedly higher-than-typical volumes in several areas.

Reliance on a small set of high-revenue codes creates concentration exposure: with H0023 alone representing $28.1M (41.6% of Medicaid revenue) and the top three codes together responsible for 69.8% of revenue, reimbursement or policy changes affecting outreach, residential detoxification, or psychosocial rehabilitation reimbursement could materially affect reported Medicaid revenue. Analysts and payers should treat reimbursement, program eligibility, or utilization-management changes in these specific code families as high-impact levers.

The combination of long tenure (NPI enumerated 2006-07-11 (~20 years ago)), very high state-percentile ranks on multiple service lines (examples include 99214 at the 99th percentile and H2018 at the 97th percentile), and the mix of outreach, residential, per-diem, and intensive outpatient codes indicate an established, high-capacity behavioral health and SUD provider within Virginia’s Medicaid market rather than a small clinic-scale operation. This profile positions the entity as a major Medicaid service provider in several targeted service lines statewide.

Medicaid: Complete Services Breakdown

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

31 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0023	Alcohol and/or drug outreach	88,680	$320	$28.1M
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	67,910	$210	$14M
H2018	Psychosocial rehabilitation services, per diem	8,750	$580	$5M
H2019	Therapeutic behavioral services, per 15 minutes	9,040	$420	$3.8M
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…	76,910	$50	$3.5M
H2036	Alcohol and/or other drug treatment program, per diem	13,060	$260	$3.4M
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…	28,220	$80	$2.1M
H0040	Assertive community treatment program, per diem	10,370	$180	$1.8M
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	5,380	$170	$936.1K
H0006	Alcohol and/or drug services; case management	4,210	$210	$900.9K

Showing 1–10 of 31

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Virginia Distribution

Fairfax County, Virginia — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

31 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0023	Alcohol and/or drug outreach	8	50	33,630	$320	$15M
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	4	30	7,090	$420	$11.5M
H0046	Mental health services, not otherwise specified	370	510	6,100	$190	$2.8M
H0040	Assertive community treatment program, per diem	21	40	10,830	$200	$2.7M
H2036	Alcohol and/or other drug treatment program, per diem	2	10	480	$660	$2.6M
H0039	Assertive community treatment, face-to-face, per 15 minutes	23	30	2,740	$530	$2M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	88	150	5,420	$110	$1.9M
H2017	Psychosocial rehabilitation services, per 15 minutes	78	100	15,920	$60	$1.9M
H2019	Therapeutic behavioral services, per 15 minutes	8	120	1,100	$610	$1.7M
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	38	110	1,830	$220	$1.1M

Showing 1–10 of 31

Related Providers

Other providers that share a Tax Identification Number (TIN) with Fairfax County, Virginia, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Director Of Finance-county Of Fairfax Va	VA	Early Intervention Provider Agency	$0	$19.9M
Director Of Finance-county Of Fairfax Va	VA	Ambulance	$7.9M	$7.3M
Sureshkumar Bhatt	LA	Psychiatry Physician	$205.2K	$544.9K
Michelle Brown	VA	Clinical Social Worker	$1.4K	$0
Suzyn Jacobson	VA	Clinical Social Worker	$870	$0
Nora Rowny	VA	Clinical Social Worker	$870	$0

Nearby Providers

Other providers in the same ZIP code as Fairfax County, Virginia, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Fairfax County, Virginia	VA	Multi-Specialty Clinic/Center	$0	$55.7M

Fairfax County, Virginia — Billing Profile & Reimbursement Data

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Fairfax County, Virginia — 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