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.

Rutland Mental Health Services (NPI 1235261009)

Field	Value
Entity Type	Organization
Organization	Rutland Mental Health Services
Address	78 S Main St
City	Rutland
State	VT
ZIP	05701
Taxonomy	Developmental Disabilities Clinic/Center
NPI Enumerated	March 9, 2007

Payer Source	Total Paid
Medicaid	$122.1M
Medicare	$0

Key Findings

Medicaid is the sole payer of financial significance for this entity: the provider has no Medicare billing on file and reports Total Medicaid revenue of $122.1M, making it effectively a single-payer (Medicaid-focused) operation in the claims data provided.

Revenue is highly concentrated in three Medicaid codes that together account for 100.0% of the provider's Medicaid revenue; 99199 drives the largest share with $83.1M (68.0% of Medicaid revenue), H2022 contributes $38.9M (31.8%), and 90837 accounts for $127.3K (0.1%).

The top revenue codes point to a services model built around non-specific procedural billing and community-based wrap‑around supports rather than billable psychotherapy or office E/M as primary revenue drivers: 99199 (other medicine services) and H2022 (community-based wrap-around, per diem) dominate receipts, while 90837 (psychotherapy) represents only $127.3K of revenue.

Competitive standing in-state is modest rather than dominant for the highest-revenue codes: 99199 ranks #6 of 16 providers in-state (67th percentile) and is described as typical, unremarkable volume for this code, while H2022 ranks #8 of 14 (46th percentile) and is likewise typical, unremarkable volume for that code. 90837 ranks #301 of 666 providers in-state (55th percentile) and is also labeled typical, unremarkable volume.

Operationally, the provider shows large claim counts for several service categories that report $0 avg paid/claim (for example S5150: 42.8K claims; T2021: 37.3K claims; T1016: 36.1K claims), indicating substantial reporting activity in waiver/habilitation and respite service lines even when those line items do not generate direct Medicaid-paid revenue on the claims extract. This pattern suggests reliance on programmatic or bundled funding arrangements common in developmental-disability service delivery.

The provider’s billing profile is consistent with its taxonomy as a Developmental Disabilities Clinic/Center: the prominence of H2022 (community-based wrap-around services) and numerous waiver/habilitation codes in the claims list aligns with a focus on community supports and long-term habilitation rather than episodic medical care.

Concentration risk is material because a very large share of Medicaid revenue is tied to just two dominant codes (99199 at $83.1M and H2022 at $38.9M); changes in reimbursement policy, prior‑authorization, or state waiver arrangements for those code types could disproportionately impact the provider's revenue given that the top three codes together account for 100.0% of Medicaid revenue.

The provider has an established presence in the data: NPI enumerated 2007-03-09 (~19 years ago), indicating long tenure in the market which may correspond with entrenched contracting or program relationships with state Medicaid programs and managed care organizations.

Medicaid: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	14,170	$5,860	$83.1M
H2022	Community-based wrap-around services, per diem	18,610	$2,090	$38.9M
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…	940	$140	$127.3K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	30	$10	$390
H2023	Supported employment, per 15 minutes	1,490	$0	$0
H2025	Ongoing support to maintain employment, per 15 minutes	15,380	$0	$0
S5150	Unskilled respite care, not hospice; per 15 minutes	42,820	$0	$0
T1016	Case management, each 15 minutes	36,150	$0	$0
S5140	Foster care, adult; per diem	6,110	$0	$0
S5151	Unskilled respite care, not hospice; per diem	8,650	$0	$0

Showing 1–10 of 12

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

Rutland Mental Health Services — 0 of 4 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

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	6	20	6,570	$6,270	$59.7M
H2022	Community-based wrap-around services, per diem	8	10	18,970	$620	$35.6M
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…	301	670	760	$70	$143.9K
T1016	Case management, each 15 minutes	7	40	3,900	$1	$31.1K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	93	110	150	$10	$4.6K
T2021	Day habilitation, waiver; per 15 minutes	6	10	28,170	$1	$210
H2023	Supported employment, per 15 minutes	9	20	1,490	$0	$0
H2025	Ongoing support to maintain employment, per 15 minutes	6	20	3,440	$0	$0
S5150	Unskilled respite care, not hospice; per 15 minutes	3	10	27,240	$0	$0
S5140	Foster care, adult; per diem	9	10	60,820	$0	$0

Showing 1–10 of 12

Related Providers

Other providers that share a Tax Identification Number (TIN) with Rutland Mental Health Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rutland Mental Health Services, Inc.	VT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$17.7M
Lorene Zeif	VT	Community Health Worker	$0	$112.4K
Judith Tietz	VT	Psychiatry Physician	$32.3K	$52.7K
Susan Taggart	VT	Clinical Social Worker	$0	$76.5K
Alecia Armstrong	VT	Mental Health Counselor	$0	$66.5K

Nearby Providers

Other providers in the same ZIP code as Rutland Mental Health Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Health Centers Of The Rutland Region Inc	VT	Federally Qualified Health Center (FQHC)	$0	$20.6M
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
Bradford Psychiatric Associates. LLC	VT	Addiction Medicine (Internal Medicine) Physician	$0	$4.7M
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
Regional Home Care Inc	VT	Oxygen Equipment & Supplies (DME)	$0	$1.8M

Rutland Mental Health Services — Billing Profile & Reimbursement Data

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Rutland Mental Health Services — 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