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

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

Fora Health Inc. (NPI 1245378546)

Field	Value
Entity Type	Organization
Organization	Fora Health Inc.
Address	10230 Se Cherry Blossom Dr
City	Portland
State	OR
ZIP	97216
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	February 1, 2007

Payer Source	Total Paid
Medicaid	$54.4M
Medicare	$0

Key Findings

FORA HEALTH INC. reports $54.4M in lifetime Medicaid revenue and has no Medicare billing on file, making its public payer footprint effectively single-payer and heavily Medicaid-dependent. The provider’s NPI was enumerated on 2007-02-01 (~19 years ago), indicating an established presence in the market rather than a recent entrant.

Revenue is extremely concentrated: the precomputed top three Medicaid codes account for 95.6% of the provider’s total Medicaid revenue. Two codes in particular—H0019 ($26.4M, 48.6% of Medicaid revenue) and H0010 ($25M, 46.0% of Medicaid revenue)—together drive the vast majority of receipts, leaving all other codes as relatively small contributors.

The code mix and descriptions indicate FORA HEALTH operates primarily as a residential addiction treatment provider: H0019 is long-term residential behavioral health (without room and board) and H0010 is sub-acute residential detoxification. The presence of H0005 (group counseling, $557.9K) and other outpatient/therapy codes reflects ancillary group counseling and behavioral-health services, but these are minor relative to the residential lines.

FORA is a leading statewide participant for its top residential services: H0019 ranks #2 of 31 providers in-state (97th percentile) and H0010 ranks #2 of 13 providers in-state (92th percentile), both described as notably above typical state volume. Those rank/percentile positions characterize the provider as a major player in Oregon for long-term residential and sub-acute detox services rather than a marginal operator.

Smaller revenue streams show limited clinical/outpatient diversification: H0005 ($557.9K, 1.0%), 99213 ($385.3K, 0.7%) and 99214 ($262.3K, 0.5%) indicate outpatient group counseling and evaluation/management activity, but these lines are relatively modest and do not materially offset the concentration in residential services. Statewide ranks for these codes are typical to unremarkable (for example H0005 ranks #45 of 184, 76th percentile; 99213 ranks #238 of 1591, 85th percentile).

There are a few specialized or unique items in the billing mix: H0013 shows $111K revenue from 100 claims and is reported as rank #1 of 1 providers in-state with no state peer volume comparison available, and J2315 appears in small volume ($36.7K). These entries suggest occasional use of acute or medication-assisted interventions alongside the core residential treatment offering.

The reliance on two high-volume residential codes (H0019 and H0010) creates operational and reimbursement concentration risk: policy changes, coverage decisions, or rate adjustments affecting those specific residential addiction service codes could materially impact FORA HEALTH’s Medicaid revenue. Given the absence of Medicare billing, any disruption to Medicaid reimbursement would have limited offset from other public payers.

Medicaid: Complete Services Breakdown

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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	125,140	$210	$26.4M
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	24,940	$1,000	$25M
H0005	Alcohol and/or drug services; group counseling by a clinician	12,980	$40	$557.9K
H0038	Self‑help/peer services, per 15 minutes	12,500	$40	$487.4K
H0004	Behavioral health counseling and therapy, per 15 minutes	5,350	$90	$481.6K
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…	6,120	$60	$385.3K
H0001	Alcohol and/or drug assessment	2,210	$130	$280K
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…	2,980	$90	$262.3K
T1006	Alcohol and/or substance abuse services, family/couple counseling	1,150	$100	$111.4K
H0013	Alcohol and/or drug services: acute detox (residential addiction program outpatient)	100	$1,110	$111K

Showing 1–10 of 22

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Oregon Distribution

Fora Health Inc. — 2 of 22 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oregon

Full comparison — all codes billed, vs. Oregon median

22 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	2	10	7,740	$1,030	$9M
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	2	30	2,560	$400	$8.9M
H0005	Alcohol and/or drug services; group counseling by a clinician	45	180	3,250	$40	$783.8K
H0004	Behavioral health counseling and therapy, per 15 minutes	75	270	1,660	$90	$681K
H0038	Self‑help/peer services, per 15 minutes	16	150	1,030	$80	$417.2K
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…	576	1,380	540	$140	$363.3K
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…	385	1,500	650	$70	$312.4K
J2315	Injection, naltrexone, depot form, 1 mg	4	10	90	$1,330	$275.3K
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…	238	1,590	590	$50	$236.5K
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…	341	400	230	$90	$153.8K

Showing 1–10 of 22

Nearby Providers

Other providers in the same ZIP code as Fora Health Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Byram Healthcare Centers, Inc.	OR	Durable Medical Equipment & Medical Supplies	$0	$123.8M
Portland Adventist Medical Center	OR	General Acute Care Hospital	$0	$41.8M
Portland Adventist Medical Center	OR	Family Medicine Physician	$0	$12.8M
Portland Adventist Medical Center	OR	Family Medicine Physician	$0	$5.8M
Portland Adventist Medical Center	OR	Emergency Medical Services (Emergency Medicine) Physician	$0	$5M
Cep America LLC	OR	Emergency Medicine Physician	$0	$2.9M
Diagnostic Radiologists PC	OR	Diagnostic Radiology Physician	$0	$2.7M
Jonathan Yoken	OR	Retina Specialist (Ophthalmology) Physician	$1.5M	$0
Rsa - Portland, LLC	OR	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.3M
Brian Chan-kai	OR	Retina Specialist (Ophthalmology) Physician	$1.3M	$0

Fora Health Inc. — Billing Profile & Reimbursement Data

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Fora Health Inc. — 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