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

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

Commonwealth Of Massachusetts (NPI 1235255597)

Field	Value
Entity Type	Organization
Organization	Commonwealth Of Massachusetts
Address	85 E Newton St
City	Boston
State	MA
ZIP	02118
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	March 21, 2007

Payer Source	Total Paid
Medicaid	$153.7M
Medicare	$0

Key Findings

COMMONWEALTH OF MASSACHUSETTS is registered as a Community/Behavioral Health Agency with an NPI enumerated on 2007-03-21 (~19 years ago), indicating long tenure in the Medicaid market and sustained operation as a behavioral health service provider. Its billing footprint is concentrated in state Medicaid rather than fee-for-service Medicare.

This provider has no Medicare billing on file (none below) and reports $153.7M in lifetime Medicaid revenue, making its commercial/payer exposure effectively single-payer Medicaid for the available claims data. Analysts should treat Medicaid reimbursement policy and state program changes as the principal drivers of revenue performance.

Revenue is highly concentrated: the precomputed top 3 Medicaid codes account for 100.0% of the provider's total Medicaid revenue, with H2018 alone representing $148.3M (96.5% of Medicaid revenue). That concentration indicates the organization derives the overwhelming majority of its billing from one service line.

The code-level mix points to an operational focus on per-diem psychosocial and residential services rather than discrete outpatient medical procedures: H2018 (Psychosocial rehabilitation services, per diem) dominates activity with 438.8K claims at an average paid/claim of $338, while H0019 (long-term residential, per diem without room and board) and T2023 (Targeted case management; per month) together make up the remaining Medicaid revenue. This pattern aligns with a community behavioral health model centered on program-based, per-diem service delivery.

Competitive standing by code is modest rather than dominant. For H2018 the provider ranks #4 of 6 in-state (40th percentile; typical, unremarkable volume for this code), for H0019 it ranks #34 of 75 (55th percentile; typical, unremarkable volume for this code), and for T2023 it ranks #57 of 70 (19th percentile; typical, unremarkable volume for this code), indicating middle-to-lower relative positioning across its primary service lines.

Claim and payment profile shows H2018 is extremely high-volume (438.8K claims) with a lower average paid/claim ($338), whereas H0019 and T2023 are much lower-volume (6.9K claims and 807 claims respectively) but have higher average paid/claim amounts ($654 and $1069 respectively). This suggests a mix of high-throughput per-diem programming supplemented by smaller volumes of higher-paid residential and case management services.

The operational and reimbursement implications of this profile are material: because $148.3M (96.5%) of Medicaid revenue is tied to H2018, any rate changes, eligibility shifts, or service-authorization policy changes affecting psychosocial rehabilitation per diems could disproportionately affect overall revenue. Contracting and compliance attention should therefore prioritize H2018 program fidelity, documentation, and state policy monitoring to manage revenue exposure.

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2018	Psychosocial rehabilitation services, per diem	438,810	$340	$148.3M
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	6,880	$650	$4.5M
T2023	Targeted case management; per month	810	$1,070	$862.7K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

Commonwealth Of Massachusetts — 0 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2018	Psychosocial rehabilitation services, per diem	4	10	483,500	$330	$139.9M
T2023	Targeted case management; per month	57	70	8,210	$510	$8.6M
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	34	80	5,200	$370	$8.4M

Nearby Providers

Other providers in the same ZIP code as Commonwealth Of Massachusetts, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Boston Medical Center Corporation	MA	General Acute Care Hospital	$0	$768.7M
Boston Public Health Commission	MA	Ambulance	$5.9M	$67.6M
Boston Emergency Services Team (bupa) Boston	MA	Community/Behavioral Health Agency	$0	$59.2M
Boston Health Care For The Homeless Program, Inc.	MA	Federally Qualified Health Center (FQHC)	$0	$54.8M
Boston Health Care For The Homeless Program, Inc.	MA	Federally Qualified Health Center (FQHC)	$0	$53.1M
Boston University Psychiatry Associates, Inc.	MA	Psychiatry Physician	$0	$40.9M
Evans Medical Foundation, Inc.	MA	Internal Medicine Physician	$0	$37.8M
Child Health Foundation Of Boston, Inc.	MA	Pediatrics Physician	$0	$26.6M
Boston Emergency Physician Foundation, Inc.	MA	Emergency Medicine Physician	$0	$24.3M
Volunteers Of America Of Massachusetts Inc	MA	Substance Abuse Rehabilitation Facility	$0	$21.4M

Commonwealth Of Massachusetts — Billing Profile & Reimbursement Data

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Commonwealth Of Massachusetts — 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