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

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

Midwestern Connecticut Council On Alcoholism, Inc (NPI 1174607253)

Key Findings

Field	Value
Entity Type	Organization
Organization	Midwestern Connecticut Council On Alcoholism, Inc
Address	38 Ridgebury Rd
City	Danbury
State	CT
ZIP	06810
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	October 25, 2006

Payer Source	Total Paid
Medicaid	$39.9M
Medicare	$0

This provider is effectively a Medicaid-focused addiction and behavioral-health operation with no Medicare billing on file and $39.9M in reported Medicaid revenue. The absence of Medicare activity combined with the code mix points to a business model that relies almost entirely on state Medicaid reimbursement rather than dual-payer diversification.

Revenue is highly concentrated in a small set of addiction-treatment codes: H0015, H2036, and H0011 together account for 82.3% of the provider's Medicaid revenue. That concentration—with H0015 alone representing $16.6M (41.5% of Medicaid revenue)—creates material exposure to changes in Medicaid policy or reimbursement for substance-use disorder services.

H0015 (intensive outpatient services) is a core service line: 119.9K claims at $138 avg paid/claim produced $16.6M and ranks #3 of 74 providers in Connecticut (97th percentile), a volume described as notably above typical state volume for this code. This ranking indicates the organization is one of the state’s largest intensive-outpatient providers and likely operates a high-capacity IOP program.

H2036 (per diem substance-use treatment) contributes $11.7M from 33.6K claims and ranks #6 of 20 providers in-state (74th percentile), a position characterized as typical and not exceptional. H0011 (residential acute detoxification) accounts for $4.6M from 9.2K claims but ranks #6 of 7 providers (17th percentile), indicating modest participation in inpatient detox capacity relative to the small pool of in-state competitors.

Beyond addiction-specific codes, the provider reports very high volumes of core behavioral-health services: 90791 generated $2.5M from 21.6K claims and ranks #3 of 559 providers in-state (100th percentile, labeled an extreme outlier). This suggests the organization performs an unusually large number of psychiatric evaluations relative to other Connecticut providers, consistent with integrated assessment workflows tied to SUD treatment.

Group psychotherapy (90853) is also a major activity: 67.1K claims produced $1.5M and the provider ranks #7 of 300 in-state (98th percentile, described as an extreme outlier). High group-therapy volumes alongside intensive outpatient billing imply reliance on group-based treatment modalities to deliver care at scale.

Other psychotherapy and E/M codes (90832, 90834, 90837, 99214) contribute meaningful but smaller shares of revenue and generally sit in high state percentiles (e.g., 90832 at the 88th percentile, 90834 at the 92nd percentile), indicating a substantial ancillary outpatient clinical footprint beyond core SUD per-diem and IOP services. These lines supplement the addiction-focused revenue base and point to a mixed service delivery model that includes individual and group psychotherapy and routine outpatient encounters.

The provider's NPI was enumerated on 2006-10-25 (~20 years ago), indicating longstanding operation in the state. Combined longevity and the high statewide ranks on multiple codes (notably H0015, 90791, and 90853) position the organization as an established, high-volume Medicaid provider in Connecticut for addiction treatment and associated behavioral-health services.

Medicaid: Complete Services Breakdown

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

18 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	119,940	$140	$16.6M
H2036	Alcohol and/or other drug treatment program, per diem	33,610	$350	$11.7M
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	9,210	$500	$4.6M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	21,560	$120	$2.5M
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	67,050	$20	$1.5M
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…	16,060	$50	$771K
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…	12,010	$60	$768.7K
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…	6,890	$100	$654.7K
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…	2,870	$100	$278.6K
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…	3,270	$70	$212.8K

Showing 1–10 of 18

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Connecticut Distribution

Midwestern Connecticut Council On Alcoholism, Inc — 3 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Connecticut

Full comparison — all codes billed, vs. Connecticut median

18 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2036	Alcohol and/or other drug treatment program, per diem	6	20	13,690	$300	$6.9M
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	6	10	15,610	$490	$6.9M
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…	3	70	3,710	$120	$1.6M
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…	228	1,590	740	$50	$331.8K
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…	446	1,710	750	$30	$243.3K
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…	490	2,180	850	$90	$202.1K
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…	53	420	1,230	$20	$199.3K
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…	48	570	410	$50	$197.6K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	7	300	2,660	$20	$181.1K
99203	The provider sees a new 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 provider…	431	480	200	$60	$112.1K

Showing 1–10 of 18

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Danbury Hospital	CT	General Acute Care Hospital	$0	$123.8M
Family And Children's Aid, Inc.	CT	Adolescent and Children Mental Health Clinic/Center	$0	$64M
Connecticut Institute For Communities Inc	CT	Federally Qualified Health Center (FQHC)	$0	$32.8M
Nuvance Health Medical Practice Ct, Inc.	CT	Internal Medicine Physician	$0	$20.2M
Connecticut Institute For Communities Inc	CT	Federally Qualified Health Center (FQHC)	$0	$14.9M
Connecticut Counseling Centers, Inc.	CT	Methadone Clinic	$243.5K	$12.1M
Center For Pediatric Medicine	CT	Pediatrics Physician	$0	$9.4M
Optimum Medical LLC	CT	Pediatrics Physician	$0	$8.9M
Kids Dental Specialists LLC	CT	Pediatric Dentistry	$0	$7.8M
Danbury Public Schools	CT	Local Education Agency (LEA)	$0	$7.3M

Midwestern Connecticut Council On Alcoholism, Inc — Billing Profile & Reimbursement Data

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Midwestern Connecticut Council On Alcoholism, 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

Nearby Providers

Frequently Asked Questions

References