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

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

Bradford Psychiatric Associates. LLC (NPI 1184747339)

Key Findings

Field	Value
Entity Type	Organization
Organization	Bradford Psychiatric Associates. LLC
Address	199 Stratton Rd Ste 1
City	Rutland
State	VT
ZIP	05701
Taxonomy	Addiction Medicine (Internal Medicine) Physician
NPI Enumerated	April 10, 2007

Payer Source	Total Paid
Medicaid	$4.7M
Medicare	$0

BRADFORD PSYCHIATRIC ASSOCIATES. LLC appears to operate almost exclusively in the Medicaid market: it reports no Medicare revenue on file while recording $4.7M in lifetime Medicaid revenue, making it effectively a single-payer (Medicaid-focused) billing profile. This concentration means any payer or market analysis should treat Medicaid as the primary source of clinical volume and financial risk for this entity.

Revenue concentration is highly focused in a very small set of services: the top 3 Medicaid codes together account for 92.0% of the provider’s total Medicaid revenue. In particular, code 80307 alone represents $2.9M (61.6% of Medicaid revenue), followed by 99213 at $1.1M (23.0%), and 99211 at $343.4K (7.4%), indicating dependence on a narrow set of laboratory and low-intensity outpatient visit services.

The code mix suggests the practice model centers on routine substance-use monitoring and high-volume, low-acuity outpatient visits. 80307 (instrumented presumptive drug testing) is the single largest revenue driver, while 99213 and 99211 are office/outpatient E/M codes for established patients; together these imply a workflow that combines frequent toxicology screening with brief follow-up visits rather than a high proportion of lengthy psychiatric assessments or psychotherapy.

Competitive standing in-state is mixed by service line: for 80307 the provider ranks #2 of 16 in Vermont (93rd percentile), which indicates strong but not singular leadership in instrumented drug testing. For 99213 it ranks #19 of 319 (94th percentile), reflecting high-volume provisioning of low-complexity established-patient visits compared with peers. Conversely, the provider is an extreme outlier for several codes—99211, 90853, and 80305 each rank #1 in-state (100th percentile)—signaling volumes for brief visits, group psychotherapy, and non-instrumented drug screens that are far above typical state peers.

The presence of extreme outlier status on multiple codes (99211, 90853, 80305) suggests a distinctive operational emphasis relative to most Vermont providers: unusually high volumes of minimal-complexity established visits, group psychotherapy sessions, and non-instrumented drug screening. These statistical labels indicate the practice’s service mix is not simply typical outpatient psychiatry but instead tilts heavily toward frequent, brief encounters and routine toxicology testing.

Although the practice bills a range of psychiatric and behavioral codes beyond the top three, those services are a small share of revenue. Examples include 90853 (group psychotherapy) with $165.5K (3.6% of Medicaid revenue), 99214 with $77.4K (1.7%), and other psychotherapy and evaluation codes that together contribute marginally. This distribution implies that longer psychotherapy or higher-complexity evaluations are present but not primary revenue drivers.

Tenure is long-standing: the provider’s NPI was enumerated on 2007-04-10 (approximately 19 years ago), indicating sustained operation in the market. For analysts, that longevity combined with the concentrated Medicaid footprint may reflect an established referral and treatment model focused on substance-use monitoring and frequent follow-ups.

From a payer-management perspective, the profile points to predictable cost drivers and utilization levers: instrumented drug testing (80307) and high-frequency, low-acuity office visits (99213/99211) account for the vast majority of billed Medicaid dollars. Programs targeting utilization management, lab authorization, or visit-scheduling practices for these specific services are likely to have the largest impact on this provider’s Medicaid spend given the 92.0% revenue concentration in the top three codes.

Medicaid: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	50,360	$60	$2.9M
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…	19,130	$60	$1.1M
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	21,460	$20	$343.4K
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…	11,820	$10	$165.5K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	7,300	$10	$80.3K
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…	890	$90	$77.4K
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…	360	$70	$24.5K
99204	The provider sees a new 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 provider…	50	$130	$6.6K
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…	140	$40	$5.9K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	30	$120	$4K

Showing 1–10 of 13

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Vermont Distribution

Bradford Psychiatric Associates. LLC — 3 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Vermont

Full comparison — all codes billed, vs. Vermont median

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	2	20	2,660	$50	$742.4K
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…	150	320	680	$30	$146.1K
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…	544	670	760	$70	$143.9K
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…	19	320	760	$20	$88.2K
99204	The provider sees a new 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 provider…	25	50	50	$80	$50K
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…	21	70	70	$50	$36K
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…	82	110	260	$20	$19.5K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	1	30	140	$10	$15.6K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	1	30	720	$10	$14.5K
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…	1	40	380	$10	$13.8K

Showing 1–10 of 13

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kristen Sheehan	VT	Family Nurse Practitioner	$31K	$0
Frederick Hesse	VT	Addiction Medicine (Family Medicine) Physician	$18.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rutland Mental Health Services	VT	Developmental Disabilities Clinic/Center	$0	$122.1M
Community Health Centers Of The Rutland Region Inc	VT	Federally Qualified Health Center (FQHC)	$0	$20.6M
Rutland Mental Health Services, Inc.	VT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$17.7M
Rutland Hospital, Inc.	VT	Psychiatric Hospital Unit	$396.2K	$13.3M
Community Health Centers Of The Rutland Region, Inc.	VT	Pediatrics Physician	$0	$13.6M
Regional Ambulance Service, Inc	VT	Land Ambulance	$1.4M	$5.3M
Vna & Hospice Of The Southwest Region, Inc	VT	Home Health Agency	$0	$4.8M
Community Health Centers Of The Rutland Region, Inc.	VT	Dentist	$0	$4.4M
Community Health Centers Of The Rutland Region, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$4.3M
Community Health Centers Of The Rutland Region Inc	VT	Federally Qualified Health Center (FQHC)	$0	$3.2M

Bradford Psychiatric Associates. LLC — 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