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

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

Vanderbilt University Medical Center (NPI 1215078027)

Key Findings

Field	Value
Entity Type	Organization
Organization	Vanderbilt University Medical Center
Address	1601 23rd Ave S
City	Nashville
State	TN
ZIP	37232
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	February 12, 2007

Payer Source	Total Paid
Medicaid	$29.1M
Medicare	$0

This provider is effectively single-payer at scale: there is no Medicare billing on file and all reported lifetime federal revenue is Medicaid, totaling $29.1M. That concentration means the organization’s entire Medicare/Medicaid footprint in these data is driven by Medicaid policy and reimbursement dynamics rather than a split payer mix.

Revenue is extremely concentrated in a tiny set of codes: the top three Medicaid codes account for 99.4% of the provider’s total Medicaid revenue, led by T2023 at $20.3M (69.9% of Medicaid revenue) and H0036 at $8.5M (29.1%). The third of the top three, 90832, contributes $97.6K (0.3%), so financially the operation is overwhelmingly dependent on the first two codes.

The code mix indicates an operational emphasis on case management and community-based psychiatric support rather than high-fee, office-based psychotherapy or procedural medicine. T2023 (Targeted case management; per month) and H0036 (Community psychiatric supportive treatment, per 15 minutes) together drive virtually all revenue, which is consistent with a Mental Health Clinic/Center model that bills predominantly for care coordination and brief supportive contacts.

There is a notable volume-versus-payment mismatch across psychotherapy CPTs: 90832 shows 48.8K claims but only $2 avg paid/claim for $97.6K revenue, and 90853 shows 32.2K claims at $1 avg paid/claim for $32.2K revenue. High claim volumes combined with very low per-claim payments mean many therapy services contribute little to topline Medicaid revenue despite heavy utilization.

Competitive standing is mixed by service line: for T2023 the provider ranks #5 of 14 in-state (69th percentile; typical, unremarkable volume for this code), indicating a mid-tier position for targeted case management, while for H0036 it ranks #2 of 13 (92th percentile; typical, unremarkable volume for this code), showing a strong statewide position in community psychiatric supportive treatment. Separately, 90853 is an extreme outlier in volume (rank #2 of 106, 99th percentile) despite low revenue, signaling unusually heavy group-therapy activity relative to peers.

The organization’s Medicaid revenue profile creates concentrated financial exposure: because nearly all Medicaid revenue comes from T2023 and H0036, any state policy, rate, or authorization change affecting these codes would disproportionately affect the provider’s topline. This concentration suggests a need for payers and analysts to monitor reimbursement and program rules for those specific service lines.

Several common outpatient E/M and psychotherapy codes appear with nontrivial claim counts but low revenue impact, for example 99213 (7.4K claims, $4 avg paid/claim, $29.5K revenue), 99214 (24.8K claims, $1 avg paid/claim, $24.8K revenue), and 99215 (719 claims, $1 avg paid/claim, $719 revenue). This pattern suggests E/M encounters and longer psychotherapy codes are used in high volume but generate minimal Medicaid payment per encounter, consistent with a resource model focused on frequent, short-duration contacts and bundled case-management billing.

The provider has longstanding enrollment in NPI: enumerated 2007-02-12 (~19 years ago), indicating an established presence in the state Medicaid market and likely durable referral or programmatic relationships that support its heavy case-management and community-treatment volumes.

Medicaid: Complete Services Breakdown

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

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2023	Targeted case management; per month	72,140	$280	$20.3M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	35,290	$240	$8.5M
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…	48,780	$1	$97.6K
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…	32,230	$1	$32.2K
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…	7,370	$1	$29.5K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	8,840	$1	$26.5K
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…	25,810	$1	$25.8K
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…	24,830	$1	$24.8K
90846	A provider meets with the patient’s family without the patient present to counsel the family on the psychological issues affecting the patient and the family.	3,250	$1	$13K
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…	12,020	$1	$12K

Showing 1–10 of 14

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Vanderbilt University Medical Center — 4 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

14 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2023	Targeted case management; per month	5	10	11,790	$410	$75.3M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	2	10	2,040	$430	$7.7M
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…	19	360	350	$50	$414.4K
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…	22	440	530	$70	$282.3K
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…	10	300	480	$30	$221.2K
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…	126	3,760	610	$40	$202.3K
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…	510	4,050	620	$30	$183.9K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	9	110	450	$50	$182.5K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	20	310	110	$70	$142.8K
90846	A provider meets with the patient’s family without the patient present to counsel the family on the psychological issues affecting the patient and the family.	6	40	230	$60	$122K

Showing 1–10 of 14

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vanderbilt University Medical Center	TN	Internal Medicine Physician	$0	$189.5M
Vanderbilt University Medical Center	TN	General Acute Care Hospital	$0	$137.7M
Vanderbilt University Medical Center	TN	General Acute Care Hospital	$0	$8M
Antonia Kolokythas	TN	Oral and Maxillofacial Surgery (Dentist)	$0	$5.9M
Vanderbilt Integrated Providers, LLC	TN	Family Medicine Physician	$0	$4.3M
Heather Tamez	MD	Retina Specialist (Ophthalmology) Physician	$1.3M	$0
Kenneth Niermann	TN	Radiation Oncology Physician	$625.8K	$0
Stephen Kim	TN	Ophthalmology Physician	$608.9K	$0
Corbin Johnson	TN	Radiation Oncology Physician	$577.1K	$0
Avni Finn	TN	Ophthalmology Physician	$504.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Han-chih Chang	TN	Radiation Oncology Physician	$2.6M	$0
Emily Carpenter	TN	Nurse Practitioner	$747.9K	$0
Dinesh Gupta	TN	Cardiovascular Disease Physician	$397.9K	$80.2K
Dong Kim	TN	Radiation Oncology Physician	$469.4K	$0
Anthony Cmelak	TN	Radiation Oncology Physician	$391.9K	$0
Ryszard Dworski	TN	Allergy & Immunology Physician	$376.5K	$2.4K
Nathan Podoll	TN	Ophthalmology Physician	$363.9K	$0
Brian Thurber	TN	Diagnostic Radiology Physician	$356K	$0
Reagan Leverett	TN	Diagnostic Radiology Physician	$337.1K	$0
Collier King	TN	Diagnostic Radiology Physician	$336.3K	$0

Vanderbilt University Medical Center — 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