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

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

Natchaug Hospital, Inc. (NPI 1295811321)

Field	Value
Entity Type	Organization
Organization	Natchaug Hospital, Inc.
Address	189 Storrs Road
City	Mansfield Center
State	CT
ZIP	06250
Taxonomy	Psychiatric Hospital
NPI Enumerated	October 31, 2006

Payer Source	Total Paid
Medicaid	$35.8M
Medicare	$0

Key Findings

NATCHAUG HOSPITAL, INC. shows an effectively single-payer footprint: there is no Medicare billing on file while Medicaid revenue totals $35.8M, indicating the provider’s business is overwhelmingly or exclusively supported by Medicaid patients. This concentration in one payer should be treated as the dominant revenue context for any competitive or utilization analysis.

Revenue is highly concentrated in a small set of Medicaid codes: the precomputed top 3 Medicaid codes by revenue account for 87.4% of this provider’s total Medicaid revenue, driven principally by S9480 ($15.7M, 43.9%), H0035 ($10.9M, 30.5%), and H0015 ($4.7M, 13.0%). This degree of concentration implies program-level dependence on intensive outpatient and partial hospitalization services.

The top revenue-driving codes and their descriptions point to an operational model built around intensive behavioral health programs: S9480 is billed as Intensive outpatient psychiatric services (per diem) with 138.1K claims and a $114 avg paid/claim, and H0035 is Mental health partial hospitalization (less than 24 hours) with 62.9K claims and a $174 avg paid/claim. Together with H0015 (intensive outpatient substance use services, 37.6K claims, $124 avg paid/claim), the mix indicates the hospital primarily delivers structured, high-volume outpatient day programs rather than traditional inpatient medical care.

State-level competitive standing is concentrated and pronounced for the highest-volume services: S9480 ranks #1 of 57 providers in-state (100th percentile) and is identified as an extreme outlier, and H0035 ranks #1 of 12 providers in-state (100th percentile) and is described as notably above typical state volume. By contrast, H0015 ranks #4 of 74 (96th percentile) and is characterized as typical; collectively, these rankings mark Natchaug as a dominant statewide provider for intensive outpatient and partial hospitalization behavioral health services.

Beyond the top three codes, the provider also reports substantial volume in psychiatric evaluation and group therapy codes that support its behavioral health program model: 90791 generated $867.7K (9.3K claims) and ranks #16 of 559 providers in-state (97th percentile, notably above typical), while 90853 produced $659.2K (36.6K claims) and ranks #18 of 300 (94th percentile, notably above typical). These high-percentile placements for evaluation and group psychotherapy codes reinforce that the business lines are centered on outpatient behavioral health treatment and therapy services.

Operational throughput is large in absolute claim counts for its dominant services, consistent with the high revenues: S9480 has 138.1K claims, H0035 has 62.9K claims, and H0015 has 37.6K claims, indicating sustained, high-volume program delivery rather than occasional episodic care. Analysts should interpret the provider’s cost and capacity metrics with an expectation of program-scale operations and recurring per-diem/partial-hospitalization billing patterns.

The provider’s NPI tenure provides additional context for competitive positioning: the NPI was enumerated on 2006-10-31 (~20 years ago), indicating long-standing operation in the market which may help explain the scale and high state ranking in intensive outpatient and partial hospitalization service lines. Longevity combined with extreme-state-level volumes suggests established referral pathways or program capacity driving its Medicaid-dominated revenue profile.

Medicaid: Complete Services Breakdown

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

29 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S9480	Intensive outpatient psychiatric services, per diem	138,070	$110	$15.7M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	62,890	$170	$10.9M
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…	37,620	$120	$4.7M
H2012	Behavioral health day treatment, per hour	16,650	$70	$1.2M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	9,330	$90	$867.7K
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…	36,620	$20	$659.2K
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…	4,240	$120	$491.4K
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…	4,770	$70	$310.3K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	1,390	$190	$263.7K
G0410	Group psychotherapy other than of a multiple-family group, in a partial hospitalization or intensive outpatient setting, approximately 45 to 50 minutes	9,770	$20	$185.7K

Showing 1–10 of 29

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Connecticut Distribution

Natchaug Hospital, Inc. — 6 of 24 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Connecticut

Full comparison — all codes billed, vs. Connecticut median

29 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0035	Mental health partial hospitalization, treatment, less than 24 hours	1	10	2,820	$160	$1.6M
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…	4	70	3,710	$120	$1.6M
S9480	Intensive outpatient psychiatric services, per diem	1	60	5,640	$110	$1.3M
H2012	Behavioral health day treatment, per hour	6	10	10,180	$70	$1.1M
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	33	50	3,340	$60	$1M
U0004	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by…	24	30	5,480	$60	$581.1K
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…	684	1,590	740	$50	$331.8K
U0005	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc,…	32	50	4,960	$20	$273.9K
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…	348	1,710	750	$30	$243.3K
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…	71	150	290	$80	$206.3K

Showing 1–10 of 29

Related Providers

Other providers that share a Tax Identification Number (TIN) with Natchaug Hospital, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Aqeel Khan	IL	Psychiatry Physician	$2.2M	$3.5M
Gregory Haman	CT	Internal Medicine Physician	$96.2K	$0
Kristen Wilmot	CT	Medical Physician Assistant	$28.6K	$0
Mary O'malley	ME	Psychiatry Physician	$18.9K	$0
Kemmarie Beal	CT	Nurse Practitioner	$2.4K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lucille Wu-scigliano	CT	Pediatric Dentistry	$0	$2.4M
Mansfield Mental Health And Addiction Medicine	CT	Psychiatry Physician	$0	$1.1M
Ralph Laguardia	CT	Internal Medicine Physician	$105.9K	$0

Natchaug Hospital, Inc. — Billing Profile & Reimbursement Data

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Natchaug Hospital, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References