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

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

Gavin Foundation (NPI 1396079414)

Field	Value
Entity Type	Organization
Organization	Gavin Foundation
Address	49 L St
City	South Boston
State	MA
ZIP	02127
Taxonomy	Clinic/Center
NPI Enumerated	September 22, 2009

Payer Source	Total Paid
Medicaid	$50.8M
Medicare	$0

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
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	134,430	$150	$20M
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	30,590	$440	$13.6M
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	35,110	$350	$12.3M
H2016	Comprehensive community support services, per diem	4,480	$390	$1.7M
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…	17,400	$100	$1.7M
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…	9,490	$90	$844.4K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	1,840	$120	$226.6K
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…	1,240	$90	$108.8K
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…	690	$120	$80.8K
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…	250	$170	$42.9K

Showing 1–10 of 16

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

Gavin Foundation — 3 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	2	80	5,200	$370	$8.4M
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	1	30	1,210	$760	$3.9M
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	1	30	1,910	$480	$3.5M
H2016	Comprehensive community support services, per diem	39	80	4,550	$30	$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	60	2,800	$110	$659.4K
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…	152	1,620	580	$80	$599.6K
H0004	Behavioral health counseling and therapy, per 15 minutes	19	30	3,380	$50	$460K
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…	1,092	5,040	200	$70	$209.5K
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…	151	670	120	$100	$169.2K
90882	In this service, the provider works with outside agencies, employers, or other healthcare providers regarding the patient’s physical environment to help manage a psychiatric patient’s medical care.	206	250	470	$50	$162.5K

Showing 1–10 of 16

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gavin Foundation, Inc.	MA	Mental Illness Community Based Residential Treatment Facility	$0	$6.4M

Nearby Providers

Other providers in the same ZIP code as Gavin Foundation, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
South Boston Community Health Center	MA	Community Health Clinic/Center	$0	$17.2M
Millard Hennessee	MA	Podiatrist	$95.9K	$27.4K
Elizabeth Tillotson	MA	Family Nurse Practitioner	$3.8K	$0

Gavin Foundation — Billing Profile & Reimbursement Data

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Gavin Foundation — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References