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

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

Department Of Mental Health (NPI 1154549921)

Field	Value
Entity Type	Organization
Organization	Department Of Mental Health
Address	Western Mass Rho
City	Northampton
State	MA
ZIP	01060
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	April 24, 2007

Payer Source	Total Paid
Medicaid	$153M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-only biller: Medicare revenue is listed as none (no Medicare billing on file) while lifetime Medicaid revenue is $153M, so payer mix is overwhelmingly Medicaid rather than a split between Medicare and Medicaid. That concentration implies operational and revenue exposure primarily to state Medicaid policy and reimbursement levels rather than to Medicare fee schedules or populations.

Medicaid revenue is highly concentrated in a very small set of service lines: the precomputed top 3 codes account for 100.0% of this provider's total Medicaid revenue, with two identified codes alone—H2018 (93.2%) and H0019 (6.8%)—driving the entirety of reported Medicaid income. This degree of concentration signals a narrowly focused service portfolio where a single code, H2018, dominates financial performance.

H2018 (Psychosocial rehabilitation services, per diem) is the dominant revenue driver with $142.5M in revenue from 352.7K claims and an average paid per claim of $404. The code’s description and per‑diem billing pattern indicate the organization operates large-scale psychosocial rehabilitation programs or day-per-diem community rehabilitation services rather than brief episodic care.

H0019 (Behavioral health; long-term residential, without room and board, per diem) accounts for $10.5M in revenue across 13.6K claims with an average paid per claim of $769, reflecting a smaller but materially different service line focused on sustained residential treatment stays. The code’s long-term residential description (typically longer than 30 days and billed without room and board) suggests the provider maintains capacity for extended residential treatment episodes in addition to its dominant psychosocial rehab activity.

Competitive standing for H2018 within Massachusetts is modest: the provider ranks #5 of 6 in-state (20th percentile) and the profile labels this volume as typical and unremarkable. Despite very large absolute dollars, the rank indicates other in-state organizations provide similar or greater volumes of psychosocial rehabilitation, so the provider is not a statewide leader in per-capita market position for this code.

For H0019 the provider ranks #29 of 75 in-state (62th percentile), also described as typical and unremarkable, which places it around the middle of state peers for long-term residential per-diem billing. This suggests the organization is a regular, mid-level participant in the in-state long-term residential market rather than a niche specialist or dominant provider.

Payment mix and unit economics differ across the two top codes: H2018 shows a high claim volume with a lower average paid/claim ($404) while H0019 shows far fewer claims with a higher average paid/claim ($769). That profile indicates the provider’s revenue base is driven by high-volume, lower-unit-rate per-diem rehab services, supplemented by a smaller number of higher‑paid long-term residential days.

The provider has a long-established NPI presence, enumerated on 2007-04-24 (~19 years ago), which supports interpretation of these patterns as enduring operational choices rather than a transient billing spike. Given the narrow code mix and Medicaid-only billing, analysts should treat the entity as a mature, Medicaid-focused community/behavioral health agency whose financial and operational risk is closely tied to state Medicaid reimbursement and utilization patterns.

Medicaid: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2018	Psychosocial rehabilitation services, per diem	352,730	$400	$142.5M
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	13,610	$770	$10.5M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

Department Of Mental Health — 0 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2018	Psychosocial rehabilitation services, per diem	5	10	483,500	$330	$139.9M
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	29	80	5,200	$370	$8.4M

Nearby Providers

Other providers in the same ZIP code as Department Of Mental Health, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Commonwealth Of Massachusetts	MA	Case Management Agency	$0	$204.8M
Nonotuck Resource Associates, Inc	MA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$154.6M
Cooley Dickinson Hospital Inc	MA	General Acute Care Hospital	$0	$34.9M
Servicenet Inc	MA	Early Intervention Provider Agency	$0	$10M
Servicenet Inc	MA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$8.5M
Mass General Brigham Medical Group Western Massachusetts Inc	MA	Family Medicine Physician	$0	$8M
City Of Northampton	MA	Land Ambulance	$831.4K	$2.7M
Shields Pet Ct At Cooley Dickinson Hospital LLC	MA	Mobile Radiology Clinic/Center	$685K	$6.7K
Steven Weinsier	MA	Cardiovascular Disease Physician	$338.5K	$400
Derek Davidson	MA	Physical Medicine & Rehabilitation Physician	$331.7K	$0

Department Of Mental Health — Billing Profile & Reimbursement Data

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Department Of Mental Health — 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