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

Why is the Medicaid comparison limited to New Hampshire 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. New Hampshire (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.

King Healthcare Group LLC (NPI 1255817607)

Field	Value
Entity Type	Organization
Organization	King Healthcare Group LLC
Address	21 Factory St
City	Nashua
State	NH
ZIP	03060
Taxonomy	Substance Use Disorder Rehabilitation Clinic/Center
NPI Enumerated	July 18, 2018

Payer Source	Total Paid
Medicaid	$15.1M
Medicare	$0

Key Findings

Payer mix and scale: KING HEALTHCARE GROUP LLC reports no Medicare billing on file and $15.1M in lifetime Medicaid revenue, making its business effectively single‑payer (Medicaid) based on the available claims data. This concentration means analyses of financial and utilization patterns should focus on Medicaid program rules and contracts rather than Medicare dynamics. The provider’s NPI was enumerated on 2018-07-18 (~8 years ago), indicating roughly eight years of billing history to examine for trend analysis.

Revenue concentration: the provider’s Medicaid revenue is heavily concentrated in a small set of codes — the precomputed top three codes account for 88.8% of total Medicaid revenue. Those top drivers are H2036 ($7.8M, 51.8%), S0201 ($4.2M, 27.6%), and H0015 ($1.4M, 9.4%), so shifts in reimbursement or utilization for any of these three codes would materially affect overall revenue.

Service-line implications: the code mix is consistent with a substance use disorder treatment operation offering structured per‑diem and day‑program care alongside intensive outpatient services. High revenue from H2036 (Alcohol and/or other drug treatment program, per diem), S0201 (Partial hospitalization services, per diem), and H0015 (intensive outpatient) suggests the provider operates multiple levels of SUD care (per‑diem/day programs plus intensive outpatient), supplemented by peer support (H0038) and assessment/brief intervention services. This combination implies capacity for both high-volume daily-program throughput and scheduled multi‑hour outpatient programming.

Competitive standing for top codes: for H2036 the provider ranks #5 of 17 in-state (75th percentile) and the comparative notes classify volume as typical, unremarkable; for H0015 it ranks #3 of 26 in-state (92th percentile) with typical, unremarkable volume; and for S0201 it is listed as #1 of 1 providers in-state (0th percentile) with no state peer volume comparison available. Taken together, these positions indicate the provider is among the more active state participants for intensive outpatient and certain per‑diem services, but not necessarily a dominant statewide monopolist across all SUD service lines.

Peer- and ancillary-service footprint: beyond the top three revenue drivers, the provider reports meaningful activity in self‑help/peer services (H0038: 12.9K claims, $802.7K revenue; ranks #2 of 31, 97th percentile, described as typical, unremarkable volume) and formal assessment codes (H0001: 1.6K claims, $252.7K revenue; ranks #5 of 41, 90th percentile, described as notably above typical state volume for this code). Additional entries for brief intervention (99408), psychiatric evaluations (90792, 90791), routine E/M (99213), and drug testing (80305) show the provider bills a mix of assessment, counseling, and ancillary testing services that support SUD treatment pathways.

Volume indicators and operational scale: claim counts are substantial for core programs (H2036 29.3K claims, S0201 16.7K claims, H0015 11.6K claims, H0038 12.9K claims), indicating high patient throughput and program capacity rather than a boutique or low‑volume operation. These volumes, combined with the $15.1M Medicaid lifetime revenue, point to a sizable state‑level treatment presence focused on day‑program and outpatient SUD services.

Business sensitivity and strategic considerations: because 88.8% of Medicaid revenue is concentrated in the top three codes and the practice reports no Medicare revenue, the provider’s financial performance will be particularly sensitive to Medicaid reimbursement changes, prior‑authorization policies, or shifts in state contracting for H2036, S0201, and H0015. Analysts evaluating network adequacy, contract negotiations, or payment-model pilots should prioritize monitoring utilization trends and payer policies for those specific 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
H2036	Alcohol and/or other drug treatment program, per diem	29,350	$270	$7.8M
S0201	Partial hospitalization services, less than 24 hours, per diem	16,740	$250	$4.2M
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	11,600	$120	$1.4M
H0038	Self‑help/peer services, per 15 minutes	12,950	$60	$802.7K
S9480	Intensive outpatient psychiatric services, per diem	1,500	$250	$374.8K
H0001	Alcohol and/or drug assessment	1,640	$150	$252.7K
H0004	Behavioral health counseling and therapy, per 15 minutes	1,300	$90	$122.6K
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…	460	$130	$59.9K
99408	The provider spends 15 to 30 minutes screening a patient for abuse of alcohol or another non–tobacco substance. The provider then performs a brief intervention at the same session.	970	$30	$33K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	420	$50	$20.9K

Showing 1–10 of 13

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Hampshire Distribution

King Healthcare Group LLC — 2 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Hampshire

Full comparison — all codes billed, vs. New Hampshire median

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S0201	Partial hospitalization services, less than 24 hours, per diem	1	10	16,740	$250	$4.2M
H2036	Alcohol and/or other drug treatment program, per diem	5	20	5,280	$230	$3.6M
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	3	30	500	$110	$455.7K
H0038	Self‑help/peer services, per 15 minutes	2	30	620	$60	$231.9K
99408	The provider spends 15 to 30 minutes screening a patient for abuse of alcohol or another non–tobacco substance. The provider then performs a brief intervention at the same session.	2	10	30	$220	$208.5K
S9480	Intensive outpatient psychiatric services, per diem	1	10	820	$250	$205.9K
H0004	Behavioral health counseling and therapy, per 15 minutes	32	70	1,260	$80	$202.1K
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…	207	400	350	$30	$140.6K
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…	29	30	1,020	$30	$113.7K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	20	70	140	$90	$100.8K

Showing 1–10 of 13

Nearby Providers

Other providers in the same ZIP code as King Healthcare Group LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Council Of Nashua Nh, Inc.	NH	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$75.7M
Harbor Homes, Inc.	NH	Federally Qualified Health Center (FQHC)	$0	$23.4M
Southern New Hampshire Medical Center	NH	General Acute Care Hospital	$0	$22.3M
Life Coping Inc.	NH	Case Management Agency	$0	$17.6M
Plus Co. Inc.	NH	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$13.8M
St Joseph Hospital Of Nashua Nh	NH	General Acute Care Hospital	$0	$13M
Alpha Home Care Solutions, Inc	NH	Home Health Agency	$0	$8.4M
Lamprey Health Care Inc	NH	Federally Qualified Health Center (FQHC)	$0	$8.1M
Nashua Center For The Multiply Handicapped, Inc.	NH	In Home Supportive Care Agency	$0	$6.8M
Foundation Medical Partners Inc	NH	Internal Medicine Physician	$0	$5.8M

King Healthcare Group 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

Nearby Providers

Frequently Asked Questions

References