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.

Clara Martin Center (NPI 1386710861)

Field	Value
Entity Type	Organization
Organization	Clara Martin Center
Address	11 S Main St
City	Randolph
State	VT
ZIP	05060
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	November 28, 2006

Payer Source	Total Paid
Medicaid	$11.8M
Medicare	$0

Key Findings

CLARA MARTIN CENTER’s Medicaid activity is overwhelmingly community behavioral health–focused: its top revenue drivers are H2017 (Psychosocial rehabilitation services), H2015 (Comprehensive community support services), and H2020 (Therapeutic behavioral services per diem), which respectively appear as 67.5K claims/$4.4M (37.1%), 99.3K claims/$2.8M (23.5%), and 8.7K claims/$2.1M (17.8%). These codes reflect an operational emphasis on per‑15‑minute psychosocial and community support visits plus per‑diem therapeutic behavioral care, indicating the provider delivers high-volume outpatient/community rehab and structured therapeutic programs. The top 3 Medicaid codes account for 78.4% of the provider’s total Medicaid revenue, pointing to concentrated reliance on those service lines.

Revenue concentration is pronounced: the precomputed top‑3 share is 78.4% of Medicaid revenue, and the practice’s entire reported federal billing for lifetime Medicare is none while Medicaid totals $11.8M. That makes CLARA MARTIN CENTER effectively a single‑payer Medicaid provider in the available data, with most of its margins tied to a narrow set of behavioral health CPT/HCPCS codes. This concentration increases exposure to payor policy or rate changes affecting those specific community‑behavioral codes.

Competitive standing across the state is mixed by code. For high‑volume community codes H2017 and H2015 the center ranks #7 in their respective peer groups (78th and 67th percentiles) — characterized in the source as "typical, unremarkable volume" — so the provider is a solid, but not dominant, participant for those services statewide. By contrast H2020 is listed as #3 of 3 providers in‑state at the 0th percentile (also labeled "typical, unremarkable volume" in the file), indicating it is one of only a few billed providers for that per‑diem therapeutic behavioral service but not measured as a market leader by the provided percentile.

One notable statistical outlier in the Medicaid mix is 90837 (long psychotherapy): CLARA MARTIN CENTER reports 33.9K claims generating $304.9K (2.6% of Medicaid revenue) and ranks #2 of 666 providers in‑state (100th percentile, flagged as an "extreme outlier, far above typical state volume"). This combination of very high claim count and a low average paid/claim ($9) suggests unusually granular or frequent psychotherapy billing relative to peers and merits further operational review if payors are evaluating utilization patterns.

The center also bills several high‑average‑payment, low‑volume services: H0046 (96 claims, $140.6K revenue at $1,465 avg paid/claim) and H0023 (1.2K claims, $1.1M revenue at $867 avg paid/claim). These entries indicate provision of targeted, higher‑intensity outreach or NOS mental health services alongside the high‑frequency 15‑minute and per‑diem codes, implying a mix of both intensive episodic interventions and routine rehabilitative contacts.

There are multiple smaller but programmatic revenue lines reported that reflect breadth of community offerings beyond core rehab/support codes: S5146 (foster care, therapeutic, 99 claims/$73.5K), H0040 (assertive community treatment, 125 claims/$54.1K), and H0004 (behavioral health counseling per 15 minutes, 5.6K claims/$535.5K, 4.5%). These items show CLARA MARTIN CENTER operates a diversified set of behavioral health programs (foster care support, ACT, counseling, group and case management) even if each contributes a modest share of total Medicaid revenue.

Operational stability is suggested by tenure: the NPI was enumerated on 2006-11-28 (~20 years ago), indicating long‑standing participation in Medicaid billing streams. For payor and competitive analyses this tenure supports comparisons over multi‑year performance, but the provider’s lack of any Medicare billing on file means state Medicaid patterns will drive most payer negotiations or network decisions.

Medicaid: Complete Services Breakdown

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

28 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2017	Psychosocial rehabilitation services, per 15 minutes	67,480	$70	$4.4M
H2015	Comprehensive community support services, per 15 minutes	99,320	$30	$2.8M
H2020	Therapeutic behavioral services, per diem	8,690	$240	$2.1M
H0023	Alcohol and/or drug outreach	1,220	$870	$1.1M
H0004	Behavioral health counseling and therapy, per 15 minutes	5,580	$100	$535.5K
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…	33,870	$10	$304.9K
H0046	Mental health services, not otherwise specified	100	$1,470	$140.6K
H2011	Crisis intervention service, per 15 minutes	1,300	$60	$75.4K
S5146	Foster care, therapeutic, child; per month	100	$740	$73.5K
H2014	Skills training and development, per 15 minutes	8,540	$10	$68.3K

Showing 1–10 of 28

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

Clara Martin Center — 1 of 24 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

28 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2020	Therapeutic behavioral services, per diem	3	10	60,190	$330	$16.4M
H0023	Alcohol and/or drug outreach	10	10	6,170	$900	$8.7M
H2015	Comprehensive community support services, per 15 minutes	7	20	64,230	$90	$7.1M
H2017	Psychosocial rehabilitation services, per 15 minutes	7	30	6,730	$110	$4.1M
H0046	Mental health services, not otherwise specified	13	10	330	$1,360	$3.1M
H2014	Skills training and development, per 15 minutes	7	10	7,770	$60	$599.6K
S5146	Foster care, therapeutic, child; per month	10	10	740	$620	$573.8K
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…	7	10	660	$120	$303.7K
H0004	Behavioral health counseling and therapy, per 15 minutes	4	20	1,410	$80	$247.4K
H0005	Alcohol and/or drug services; group counseling by a clinician	7	10	630	$60	$243.1K

Showing 1–10 of 28

Related Providers

Other providers that share a Tax Identification Number (TIN) with Clara Martin Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sarah Zwikelmaier	VT	Mental Health Counselor	$0	$86.5K
Rose Ehret	NH	Psychiatry Physician	$72.2K	$0

Nearby Providers

Other providers in the same ZIP code as Clara Martin Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gifford Health Care, Inc	VT	Federally Qualified Health Center (FQHC)	$0	$8.4M
Gifford Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$935.6K
Clara Martin Center	VT	Community/Behavioral Health Agency	$0	$807.8K
Jessica Heney	VT	Family Medicine Physician	$0	$273.6K
Gifford Health Care, Inc	VT	General Practice Physician	$0	$256.1K
Gifford Medical Center Inc.	VT	General Acute Care Hospital	$0	$218.4K
Shana Kotelchuck	VT	Clinical Social Worker	$0	$212.8K
Maxi Green Inc	VT	Community/Retail Pharmacy	$163.2K	$0
Resonant Medicine	VT	Naturopath	$0	$86.5K
Marjorie Crowe	VT	Clinical Social Worker	$27.7K	$51.2K

Clara Martin Center — Billing Profile & Reimbursement Data

Sign up for Clara Martin Center — Billing Profile & Reimbursement Data policy alerts

Clara Martin Center — Billing Profile & Reimbursement Data

Sign up for Clara Martin Center — Billing Profile & Reimbursement Data policy alerts

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