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

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

Heart Of Texas Community Health Center, Inc (NPI 1164409926)

Field	Value
Entity Type	Organization
Organization	Heart Of Texas Community Health Center, Inc
Address	1600 Providence Dr
City	Waco
State	TX
ZIP	76707
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	December 22, 2005

Payer Source	Total Paid
Medicaid	$92.6M
Medicare	$0

Key Findings

This provider is effectively a single-payer Medicaid operator: there is no Medicare billing on file and reported Medicaid revenue totals $92.6M, indicating heavy reliance on Medicaid as the primary source of fee-for-service revenue. The absence of Medicare activity means payer risk and reimbursement exposure are concentrated almost entirely in the Medicaid program.

Revenue is extremely concentrated in a handful of codes: the precomputed top three Medicaid codes account for 86.3% of the provider's Medicaid revenue, led by T1015 at $67M (72.8% of Medicaid revenue), followed by 99213 at $6.4M (6.9%) and D0999 at $6M (6.5%). This concentration signals that a small set of visit/procedure types drive the majority of financial performance.

T1015 dominance (364.2K claims, $184 avg paid/claim, $67M revenue; ranks #4 of 766 providers in-state, 100th percentile — extreme outlier) aligns with the provider’s FQHC taxonomy and suggests an operational model built around high-volume, bundled clinic visits or encounter-day billing rather than predominantly separate, higher-level fee-for-service E/M codes. The $184 average paid and very large claim volume indicate the organization is delivering large-scale primary care/clinic encounters billed as comprehensive clinic visits.

The provider also reports very high volumes of low- to mid-level E/M office visits: 99213 shows 159.5K claims, $40 avg paid/claim, $6.4M revenue and ranks #25 of 6037 in-state (100th percentile — extreme outlier), while 99214 appears with 64.7K claims, $51 avg paid/claim, $3.3M revenue (3.6% of Medicaid revenue) and ranks in the 99th percentile. These counts point to sustained, high-volume established-patient primary care activity consistent with a community health center serving a stable patient panel.

A substantial portion of non-E/M revenue is flagged under D0999 (26.7K claims, $225 avg paid/claim, $6M revenue; ranks #3 of 176 in-state, 99th percentile — extreme outlier) but the dataset lists no description for that code. The prominence and rank of D0999 suggest significant activity in a dental or miscellaneous procedure category (D-series) that materially contributes to Medicaid revenue, and the lack of a description in the feed warrants targeted review if line-item detail is needed.

Preventive and pediatric care appear to be important service lines: 99391 (22.9K claims, $70 avg paid/claim, $1.6M revenue; ranks #13 of 1362, 99th percentile) plus 99392, 99393 and 99394 all show notable volumes and high state percentiles. The presence of substantial preventive medicine claims for multiple pediatric and adult age bands supports a broad primary care footprint with routine well visits and immunization/preventive workflows.

Behavioral health services are also a meaningful component of the mix: psychotherapy codes 90832 (24K claims, $57 avg, $1.4M revenue; ranks #9 of 475, 98th percentile) and 90834 (9.9K claims, $67 avg, $660.5K revenue; ranks #21 of 813, 98th percentile) indicate integrated mental/behavioral health encounters billed to Medicaid at above-typical state volumes. This pattern is consistent with an FQHC model that provides co-located behavioral health within primary care.

Competitive standing and longevity: the provider’s NPI was enumerated on 2005-12-22 (~21 years ago), indicating long-established operations in the region, and several codes show state-level dominance (T1015 rank #4/766 and G0467 rank #1/146, both 100th percentile — extreme outliers). Taken together, the volume and rank profile identify HEART OF TEXAS COMMUNITY HEALTH CENTER, INC as a dominant Medicaid FQHC in Texas for bundled clinic visit billing and several core primary care and ancillary service lines, but with concentrated revenue exposure to a very small set of codes.

Medicaid: Complete Services Breakdown

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

147 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	364,200	$180	$67M
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…	159,510	$40	$6.4M
D0999	N/A	26,700	$230	$6M
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…	64,670	$50	$3.3M
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	22,900	$70	$1.6M
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…	24,010	$60	$1.4M
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	19,800	$60	$1.2M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	16,130	$70	$1.1M
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	12,340	$70	$888.7K
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…	9,860	$70	$660.5K

Showing 1–10 of 147

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Texas Distribution

Heart Of Texas Community Health Center, Inc — 14 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. Texas median

147 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	4	770	2,990	$170	$2.6M
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	18	120	340	$120	$422K
D0999	N/A	3	180	390	$190	$405.3K
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	88	270	130	$570	$318.8K
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	88	150	170	$30	$302.9K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	242	370	550	$80	$249.6K
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…	25	6,040	710	$40	$232.8K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	176	290	410	$20	$225K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	177	300	410	$20	$223.4K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	17	1,500	880	$80	$185.8K

Showing 1–10 of 147

Related Providers

Other providers that share a Tax Identification Number (TIN) with Heart Of Texas Community Health Center, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Philip Mcdonald	FL	Diagnostic Radiology Physician	$444.3K	$42.8K
Adel Abdalla	FL	Diagnostic Radiology Physician	$259.9K	$6.1K
Amit Sanghi	SC	Diagnostic Radiology Physician	$99.2K	$940
Matthew Porter	TX	Family Medicine Physician	$5.9K	$0
Juanita Castillo	TX	Internal Medicine Physician	$2.6K	$0
Carey Lape	TX	Physician Assistant	$2K	$0
Jeremy Korteweg	TX	Family Medicine Physician	$1.9K	$0
Stephanie Claus	TX	Family Medicine Physician	$1.7K	$0
Latrisha Spain	TX	Family Medicine Physician	$900	$0

Nearby Providers

Other providers in the same ZIP code as Heart Of Texas Community Health Center, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Justin Wray	TX	Radiation Oncology Physician	$1.1M	$0

Heart Of Texas Community Health Center, Inc — Billing Profile & Reimbursement Data

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Heart Of Texas Community Health Center, Inc — 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