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.

Richmond Behavioral Health Authority (NPI 1184715328)

Field	Value
Entity Type	Organization
Organization	Richmond Behavioral Health Authority
Address	107 S 5th St
City	Richmond
State	VA
ZIP	23219
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	September 27, 2006

Payer Source	Total Paid
Medicaid	$129.2M
Medicare	$0

Key Findings

RICHMOND BEHAVIORAL HEALTH AUTHORITY is functionally a Medicaid-centric community/behavioral health agency: lifetime Medicaid revenue on file is $129.2M and the provider has no Medicare billing on file, so its operations and reimbursement risk are effectively single‑payer (Medicaid) from the available claims data. The NPI was enumerated 2006-09-27 (~20 years ago), indicating a long-tenured provider in the market.

Revenue is highly concentrated in a small set of Medicaid codes: the precomputed top 3 Medicaid codes by revenue account for 59.2% of the provider’s total Medicaid revenue. Those top three codes are H0023 $39M (30.8%), T1017 $20.5M (16.2%), and H0010 $15.3M (12.1%), which together drive the majority of reported Medicaid receipts.

The top-coded services point to an operational emphasis on outreach, case management, and substance-use residential care. High revenue in H0023 (Behavioral health outreach service), T1017 (Targeted case management), and H0010 (sub-acute detoxification/residential addiction program) indicates the organization runs outreach and case-management programs alongside inpatient/residential addiction services rather than a pure outpatient clinic model. Additional per-diem and program codes such as H2016 $8.2M (Comprehensive community support services, per diem) and H0040 $4.2M (Assertive community treatment program, per diem) further support a program-based, day- or residence-centric service mix.

Competitive standing within Virginia is strong for multiple service lines: H0023 ranks #4 of 50 providers in-state (94th percentile; notably above typical state volume for this code) and T1017 ranks #4 of 46 providers in-state (93th percentile; notably above typical state volume for this code), showing above-typical scale in outreach and targeted case management. The provider is an even clearer leader on several specialty codes — H0006 ranks #1 of 79 (100th percentile; extreme outlier), H2016 ranks #2 of 62 (98th percentile; extreme outlier), and H2011 ranks #1 of 228 (100th percentile; extreme outlier) — signaling dominance in specific programmatic services at the state level.

Across mental-health and substance-use procedure codes the provider shows numerous high-volume and outlier signals, suggesting depth and breadth of programming. Examples include H2019 $3.6M (3rd of 122; 98th percentile; extreme outlier), 90791 $1.4M (1st of 612; 100th percentile; extreme outlier), and 90834 $558.7K (10th of 661; 99th percentile; extreme outlier). These rankings indicate the provider is not only running high-volume outreach and case-management work but also high-volume intake/assessment and therapeutic services relative to in-state peers.

Operational model implications follow from the code mix: large counts of per-diem and per-15-minute codes (for example H2016 84.7K claims, H2017 89K claims, H0039 6.6K claims) point to continuous, programmatic delivery that will require sustained staffing, case-management capacity, and residential or day-program infrastructure. High counts for office/outpatient E/M codes such as 99214 52.7K claims ($2M revenue, 1.6%; ranks #38 of 3523 in-state, 99th percentile) and 99213 49.9K claims ($848.1K revenue, 0.7%; ranks #42 of 4012 in-state, 99th percentile; extreme outlier) also indicate substantial front-line clinical throughput and point-of-contact volume.

From a payer-analysis perspective, the combination of heavy revenue concentration (59.2% from the top three codes) and extreme percentile/rank outlier positions on multiple Medicaid codes suggests monitoring for policy or reimbursement changes that affect H0023, T1017, H0010, and per-diem program codes. Given the provider’s effective single-payer exposure to Medicaid ($129.2M and no Medicare billing on file), changes in state policy, prior-authorizations, or program eligibility for these high-concentration codes would have outsized budget and network impact.

Medicaid: Complete Services Breakdown

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

78 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0023	Alcohol and/or drug outreach	144,450	$270	$39M
T1017	Targeted case management, each 15 minutes	62,210	$330	$20.5M
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	64,900	$240	$15.3M
H2016	Comprehensive community support services, per diem	84,670	$100	$8.2M
H2017	Psychosocial rehabilitation services, per 15 minutes	89,010	$50	$4.5M
H0040	Assertive community treatment program, per diem	29,230	$140	$4.2M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	46,780	$90	$4M
H0006	Alcohol and/or drug services; case management	20,700	$180	$3.7M
H2019	Therapeutic behavioral services, per 15 minutes	19,640	$190	$3.6M
H2018	Psychosocial rehabilitation services, per diem	3,700	$690	$2.6M

Showing 1–10 of 78

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

Richmond Behavioral Health Authority — 11 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

78 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0023	Alcohol and/or drug outreach	4	50	33,630	$320	$15M
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	5	30	7,090	$420	$11.5M
T1017	Targeted case management, each 15 minutes	4	50	23,860	$330	$9.4M
H0046	Mental health services, not otherwise specified	82	510	6,100	$190	$2.8M
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	43	50	274,670	$10	$2.8M
H0040	Assertive community treatment program, per diem	4	40	10,830	$200	$2.7M
H2036	Alcohol and/or other drug treatment program, per diem	5	10	480	$660	$2.6M
H2034	Alcohol and/or drug abuse halfway house services, per diem	4	20	8,970	$160	$2.6M
H0039	Assertive community treatment, face-to-face, per 15 minutes	6	30	2,740	$530	$2M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	16	150	5,420	$110	$1.9M

Showing 1–10 of 78

Related Providers

Other providers that share a Tax Identification Number (TIN) with Richmond Behavioral Health Authority, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Adam Kaul	VA	Psychiatry Physician	$225.4K	$498.9K
Debra Fleshman	VA	Family Nurse Practitioner	$9.4K	$0

Nearby Providers

Other providers in the same ZIP code as Richmond Behavioral Health Authority, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
True Family Services LLC	VA	Community/Behavioral Health Agency	$0	$20.7M
Intensive Community Outreach Services LLC	VA	Preferred Provider Organization	$0	$20.3M
New Hope Wellness, LLC	VA	Community/Behavioral Health Agency	$0	$13M
Hands Of Unity Mental Health Skill Building	VA	Community/Behavioral Health Agency	$0	$10.4M
Tender Love And Care, LLC	VA	In Home Supportive Care Agency	$0	$8.4M
Family Arizen Corp	VA	Community/Behavioral Health Agency	$0	$6.7M
Virginia Department Of Health	VA	Public Health or Welfare Agency	$0	$6.6M
Marcs Agency LLC	VA	Community/Behavioral Health Agency	$0	$6.3M
Dominion Medical Associates, Inc	VA	Internal Medicine Physician	$0	$6.3M
A Better Path Support Services	VA	Community/Behavioral Health Agency	$0	$6.1M

Richmond Behavioral Health Authority — Billing Profile & Reimbursement Data

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Richmond Behavioral Health Authority — 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