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.

Health Care & Rehabilitation Services (NPI 1376760835)

Field	Value
Entity Type	Organization
Organization	Health Care & Rehabilitation Services
Address	1 Hospital Ct
City	Bellows Falls
State	VT
ZIP	05101
Taxonomy	Developmental Disabilities Clinic/Center
NPI Enumerated	April 19, 2007

Payer Source	Total Paid
Medicaid	$136.1M
Medicare	$0

Key Findings

This provider is effectively single-payer: there is no Medicare billing on file and all documented revenue is Medicaid-based, with total Medicaid revenue of $136.1M. The absence of Medicare activity means payer mix is dominated entirely by state Medicaid programs rather than a split between Medicare and Medicaid.

Revenue is highly concentrated in a very small set of Medicaid codes: 99199 accounts for $97.6M (71.7% of Medicaid revenue) and H2022 accounts for $38.5M (28.3% of Medicaid revenue); the precomputed top 3 codes account for 100.0% of this provider's total Medicaid revenue. This concentration indicates that two encoded service lines drive essentially the entire billed Medicaid dollar volume for the organization.

The code mix and top revenue drivers point to a developmental-disabilities and community-support operational model: 99199 (other medicine services or procedures) is the largest revenue source and H2022 (community-based wrap-around services, per diem) is the second largest, implying heavy reliance on per-diem wrap-around supports and catch-all other services typical for a Developmental Disabilities Clinic/Center. Together these codes suggest the organization bills for broad, often non-specific service packages and daily wrap-around supports rather than discrete episodic medical procedures.

Competitive standing on the largest revenue line is meaningful but not dominant: 99199 ranks #4 of 16 providers in-state (80th percentile) and is labeled as typical, unremarkable volume for this code. That rank indicates the provider is a significant in-state participant for this high-revenue catch-all code, but it is not the statewide leader.

For H2022 (community-based wrap-around), the provider ranks #7 of 14 in-state (54th percentile) with typical, unremarkable volume, indicating a modest market position among peers for per-diem wrap-around services despite the code producing $38.5M in revenue for the provider. This suggests the provider’s heavy H2022 revenue is substantial in absolute dollars but not exceptional relative to the number of competing in-state programs.

Several habilitation, case-management, and respite codes show very high claim counts or top-state ranks while reporting $0 avg paid/claim and $0 revenue (examples include S5140 with 146.3K claims, T1016 with 94.1K claims, T2021 with 82.1K claims, H2032 which ranks #1 of 6 at the 100th percentile and is labeled notably above typical state volume). The pattern of high claim volume paired with $0 reported paid amounts suggests these services may be reported for encounter/administrative tracking, bundled into other payments, or compensated through non-claim mechanisms rather than paid as discrete Medicaid line items.

Operational scale is large by claim volume: 99199 has 15.1K claims and H2022 has 19.3K claims, and several other codes show tens of thousands of claim lines (e.g., S5150 38.5K claims, H2025 28.1K claims). Those claim counts imply substantial ongoing service delivery and administrative capacity to manage high-frequency, per-diem and unit-based supports across the developmental-disabilities population.

The provider has an established presence in the market with an NPI enumeration date of 2007-04-19 (~19 years ago), reinforcing that this is a long-tenured Medicaid service organization focused on developmental-disability supports rather than a recent entrant. Longevity combined with concentrated Medicaid revenue suggests entrenched operations and reliance on state program reimbursements.

Medicaid: Complete Services Breakdown

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

16 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.	15,100	$6,460	$97.6M
H2022	Community-based wrap-around services, per diem	19,320	$1,990	$38.5M
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…	1,140	$0	$0
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…	440	$0	$0
H2011	Crisis intervention service, per 15 minutes	240	$0	$0
H2019	Therapeutic behavioral services, per 15 minutes	2,480	$0	$0
H2023	Supported employment, per 15 minutes	1,900	$0	$0
H2025	Ongoing support to maintain employment, per 15 minutes	28,090	$0	$0
S5150	Unskilled respite care, not hospice; per 15 minutes	38,500	$0	$0
T1016	Case management, each 15 minutes	94,120	$0	$0

Showing 1–10 of 16

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

Health Care & Rehabilitation Services — 0 of 2 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

16 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.	4	20	6,570	$6,270	$59.7M
H2022	Community-based wrap-around services, per diem	7	10	18,970	$620	$35.6M
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…	189	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…	268	670	760	$70	$143.9K
H2011	Crisis intervention service, per 15 minutes	15	20	1,680	$20	$96.2K
H2019	Therapeutic behavioral services, per 15 minutes	1	10	260	$50	$34.1K
T1016	Case management, each 15 minutes	4	40	3,900	$1	$31.1K
T2021	Day habilitation, waiver; per 15 minutes	3	10	28,170	$1	$210
H2023	Supported employment, per 15 minutes	7	20	1,490	$0	$0
H2025	Ongoing support to maintain employment, per 15 minutes	3	20	3,440	$0	$0

Showing 1–10 of 16

Nearby Providers

Other providers in the same ZIP code as Health Care & Rehabilitation Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Health Care & Rehabilitation Services	VT	Adolescent and Children Mental Health Clinic/Center	$0	$25.4M
Springfield Medical Care Systems Inc	VT	Federally Qualified Health Center (FQHC)	$0	$7.8M
Health Care & Rehabilitaion Services	VT	Clinic/Center	$0	$5M
Health Care And Rehabilitation Services Of Southeastern Vermont, Inc.	VT	Developmental Disabilities Clinic/Center	$0	$1M
Sandra Cotter,lcmhc, Ladc,llc	VT	Mental Health Counselor	$0	$509.4K
Health Care And Rehabilitation Services Of Southeastern Vermont, Inc.	VT	Community/Behavioral Health Agency	$0	$507K
Waypoint Counseling LLC	VT	Mental Health Counselor	$0	$368.7K
Jordan River Dental	VT	General Practice Dentistry	$0	$185K
Timothy Johnson	VT	Optometrist	$51.3K	$99.5K
Health Care And Rehabilitation Services Of Southeastern Vermont, Inc.	VT	Substance Use Disorder Rehabilitation Clinic/Center	$0	$131.3K

Health Care & Rehabilitation Services — Billing Profile & Reimbursement Data

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Health Care & Rehabilitation 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

Nearby Providers

Frequently Asked Questions

References