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.

Counseling Service Of Addison County, Inc (NPI 1336278985)

Field	Value
Entity Type	Organization
Organization	Counseling Service Of Addison County, Inc
Address	89 Main St
City	Middlebury
State	VT
ZIP	05753
Taxonomy	Clinic/Center
NPI Enumerated	March 2, 2007

Payer Source	Total Paid
Medicaid	$22.1M
Medicare	$0

Key Findings

COUNSELING SERVICE OF ADDISON COUNTY reports $22.1M in lifetime Medicaid revenue and has no Medicare billing on file; the provider is therefore effectively a Medicaid-focused operation. Its NPI was enumerated 2007-03-02 (~19 years ago), indicating an established presence in the state behavioral health network.

Revenue is highly concentrated: the precomputed top 3 Medicaid codes (H0023, H2017, H2015) account for 78.7% of the provider’s total Medicaid revenue. This concentration signals that a small set of behavioral health service lines drives the bulk of the organization’s financial footprint.

H0023 (Behavioral health outreach service) is the single largest revenue source with 11.5K claims, $647 avg paid/claim and $7.5M revenue (33.8% of total); it ranks #3 of 10 in-state (78th percentile). This position indicates significant activity in outreach/planned engagement relative to most peers, but not market dominance within Vermont.

H2017 (Psychosocial rehabilitation, per 15 minutes) and H2015 (Comprehensive community support services, per 15 minutes) together form the other legs of the revenue concentration: H2017 is 65.9K claims, $79 avg paid/claim, $5.2M revenue (23.6%; ranks #8 of 28, 74th percentile) and H2015 is 71.2K claims, $66 avg paid/claim, $4.7M revenue (21.3%; ranks #9 of 19, 56th percentile). Both codes reflect a time-based, high-volume service model focused on psychosocial rehabilitation and community supports rather than episodic medical encounters.

T2025 (Waiver services; NOS) contributes $3.9M (17.5%) from 3.7K claims at a $1033 avg paid/claim and ranks #2 of 5 in-state (75th percentile). The relatively high per-claim payment and strong rank among a small peer set suggest the provider is a notable participant in waiver or high-value episodic support services within Vermont.

Several commonly billed service codes show very low or $0 avg paid/claim in the dataset (examples include H2025, H2023, H2000, S5100, T2016), despite nontrivial claim counts and middling-to-high state ranks. This mixed payment pattern suggests parts of the provider’s service mix may be funded or recorded through non-fee-for-service arrangements, bundled payments, waiver accounting, or otherwise appear with $0 per-claim payments in the claims extract.

90837 (long psychotherapy) stands out as a utilization outlier: 12.5K claims but only $8 avg paid/claim and $100.2K revenue (0.5%), yet it ranks #15 of 666 providers in-state (98th percentile; notably above typical state volume). This signals extensive use of the psychotherapy CPT code relative to peers while contributing little to revenue, implying either low Medicaid unit rates for this code or frequent short/low-reimbursed billing events.

Overall competitive standing is that of an established, regionally important community behavioral health clinic rather than a statewide dominant system actor. Key revenue-driving codes sit in the middle-to-upper percentiles (for example H0023 78th, H2017 74th, H2015 56th), indicating strong activity in targeted service lines but not broad dominance across Vermont’s provider network.

Medicaid: Complete Services Breakdown

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

23 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0023	Alcohol and/or drug outreach	11,550	$650	$7.5M
H2017	Psychosocial rehabilitation services, per 15 minutes	65,870	$80	$5.2M
H2015	Comprehensive community support services, per 15 minutes	71,240	$70	$4.7M
T2025	Waiver services; not otherwise specified (nos)	3,730	$1,030	$3.9M
H0046	Mental health services, not otherwise specified	180	$3,220	$576.2K
H0004	Behavioral health counseling and therapy, per 15 minutes	1,410	$80	$105.8K
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…	12,520	$10	$100.2K
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…	2,570	$10	$18K
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…	790	$20	$15.9K
99215	The provider sees an established 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…	1,210	$10	$12.1K

Showing 1–10 of 23

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

Counseling Service Of Addison County, Inc — 1 of 13 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

23 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0023	Alcohol and/or drug outreach	3	10	6,170	$900	$8.7M
H2015	Comprehensive community support services, per 15 minutes	9	20	64,230	$90	$7.1M
H2017	Psychosocial rehabilitation services, per 15 minutes	8	30	6,730	$110	$4.1M
H0046	Mental health services, not otherwise specified	10	10	330	$1,360	$3.1M
T2025	Waiver services; not otherwise specified (nos)	2	10	1,270	$820	$2.1M
H2014	Skills training and development, per 15 minutes	8	10	7,770	$60	$599.6K
H0004	Behavioral health counseling and therapy, per 15 minutes	10	20	1,410	$80	$247.4K
H0005	Alcohol and/or drug services; group counseling by a clinician	10	10	630	$60	$243.1K
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…	95	320	680	$30	$146.1K
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…	15	670	760	$70	$143.9K

Showing 1–10 of 23

Related Providers

Other providers that share a Tax Identification Number (TIN) with Counseling Service Of Addison County, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jessica Lindert	VT	Psychiatric/Mental Health Nurse Practitioner	$64K	$0
Annamarie Schrader	VT	Psychiatric/Mental Health Nurse Practitioner	$48.4K	$0

Nearby Providers

Other providers in the same ZIP code as Counseling Service Of Addison County, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Specialized Community Care, Inc	VT	Community/Behavioral Health Agency	$0	$60.9M
Counseling Service Of Addison County	VT	Developmental Disabilities Clinic/Center	$0	$59.6M
Middlebury Pediatric Dentistry, PLLC	VT	Pediatric Dentistry	$0	$2.9M
Rainbow Pediatrics	VT	Pediatric Adolescent Medicine Physician	$0	$1.8M
Middlebury Volunteer Ambulance Association, Inc	VT	Ambulance	$508.9K	$1.3M
Porter Hospital, Inc	VT	Family Medicine Physician	$0	$1.3M
Brian Collins	VT	Pediatric Dentistry	$0	$606.8K
Middlebury Family Health	VT	Health Maintenance Organization	$0	$547.3K
Amy Gregory	VT	Ophthalmology Physician	$306.6K	$0
Elizabeth Keathley	VT	Clinical Psychologist	$0	$303.3K

Counseling Service Of Addison County, Inc — Billing Profile & Reimbursement Data

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Counseling Service Of Addison County, 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