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

Why is the Medicaid comparison limited to Rhode Island 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. Rhode Island (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.

Community Care Alliance (NPI 1437191061)

Field	Value
Entity Type	Organization
Organization	Community Care Alliance
Address	800 Clinton St
City	Woonsocket
State	RI
ZIP	02895
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	June 11, 2006

Payer Source	Total Paid
Medicaid	$46.4M
Medicare	$0

Key Findings

COMMUNITY CARE ALLIANCE reports $46.4M in Medicaid revenue and has no Medicare billing on file, making it effectively a single-payer (Medicaid-focused) operation. Its NPI was enumerated 2006-06-11 (~20 years ago), indicating roughly two decades of activity under its current registration. This combination of long tenure and Medicaid concentration implies its business footprint is built primarily on state behavioral-health reimbursement streams rather than Medicare-covered services.

Revenue is highly concentrated: the top three Medicaid billing codes (H0037, H0019, H0040) collectively account for 65.4% of the provider's Medicaid revenue. Those individual contributions are H0037 $14.5M (31.6%), H0019 $8.5M (18.7%), and H0040 $6.9M (15.1%), which shows that a handful of per-diem community and residential service lines drive most of the organization’s Medicaid receipts.

The code mix for the top revenue drivers (H0037, H0019, H0040) points to an operational focus on intensive community and residential behavioral-health services: community psychiatric supportive treatment per diem, long-term residential per diem, and assertive community treatment per diem. This suggests the provider offers sustained, programmatic care for populations with serious behavioral-health needs rather than a purely outpatient, one-off visit model.

Alongside per-diem programs, the provider shows exceptionally high outpatient psychotherapy and evaluation volume. Notable examples include 90834 (24.5K claims, $1.4M revenue; ranked #4 of 751, labeled an extreme outlier), 90833 (12.4K claims, $248.2K revenue; ranked #2 of 197, extreme outlier), 90791 (5.3K claims, $221.4K revenue; ranked #3 of 293, extreme outlier), and 99213 (18.8K claims, $581.8K revenue; ranked #17 of 2046, extreme outlier), indicating a substantial outpatient psychotherapy and intake/evaluation footprint in addition to per-diem programming.

Certain service lines stand out versus in‑state peers for intensity of delivery: S9485 (crisis intervention) generated $3.9M (8.5% of Medicaid revenue) and ranks #2 of 25 (96th percentile; notably above typical state volume), while H0005 (group counseling) is ranked #1 of 6 (100th percentile; notably above typical state volume). These placements show the provider is an above-typical statewide deliverer of crisis and group-based substance use services.

High-frequency, low-unit codes further characterize day-to-day operations: H0036 appears as 92.4K claims at $28/claim for $2.6M (5.7% of Medicaid revenue) and ranks #4 of 89 (97th percentile; labeled typical), and other high-claim codes such as X0377 (11.8K claims, $740.3K) reflect many brief, repeated patient contacts consistent with community-based supportive models. This pattern signals intensive, repeated engagements (often per 15-minute or per-contact billing) as a core delivery modality.

Competitive standing is mixed: for the three largest per-diem revenue codes the provider sits in upper-but-not-dominant positions among state peers (H0037 #5 of 69, 94th percentile; H0019 #9 of 25, 67th percentile; H0040 #6 of 20, 74th percentile) and is characterized in the data as typical or unremarkable volume for those per‑diem services. Conversely, several outpatient E/M and psychotherapy codes place the provider as an outlier versus peers (multiple codes at the 99–100th percentile labeled extreme outlier), indicating it is a major statewide provider of psychotherapy and evaluation services even if its per-diem footprint is not uniquely dominant.

From an operational and payer-risk perspective, the combination of Medicaid-only billing and reliance on a small set of per-diem service lines (65.4% of Medicaid revenue from H0037/H0019/H0040) means the provider’s revenue is tightly linked to Medicaid program policies and per-diem reimbursement structures for behavioral health and residential care. Any changes to those Medicaid rates, program definitions, or contracting arrangements would therefore have outsized implications for the organization’s revenue mix.

Medicaid: Complete Services Breakdown

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

47 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0037	Community psychiatric supportive treatment program, per diem	37,440	$390	$14.5M
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	4,540	$1,880	$8.5M
H0040	Assertive community treatment program, per diem	6,270	$1,100	$6.9M
S9485	Crisis intervention mental health services, per diem	7,160	$540	$3.9M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	92,380	$30	$2.6M
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…	24,470	$60	$1.4M
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	570	$2,410	$1.4M
T1027	Family training and counseling for child development, per 15 minutes	7,670	$110	$835.5K
H2023	Supported employment, per 15 minutes	10,870	$70	$771.8K
X0377	N/A	11,750	$60	$740.3K

Showing 1–10 of 47

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Rhode Island Distribution

Community Care Alliance — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Rhode Island

Full comparison — all codes billed, vs. Rhode Island median

47 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	9	30	1,530	$360	$9.7M
H0040	Assertive community treatment program, per diem	6	20	350	$640	$6.3M
H0037	Community psychiatric supportive treatment program, per diem	5	70	190	$380	$3.2M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	4	10	220	$740	$2.6M
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	2	10	6,920	$340	$2.3M
T2031	Assisted living; waiver, per diem	24	30	810	$1,890	$2.3M
H0047	Alcohol and/or other drug abuse services, not otherwise specified	18	20	1,280	$220	$1.6M
T1041	Medicaid certified community behavioral health clinic services, per month	9	10	1,080	$1,040	$1.5M
T1024	Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter	28	90	510	$160	$975K
X0377	N/A	2	10	6,470	$50	$842.5K

Showing 1–10 of 47

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Care Alliance	RI	Community/Behavioral Health Agency	$0	$2M
Community Care Alliance	RI	Mental Health Counselor	$0	$1.9M
Richard Crino	RI	Registered Nurse	$0	$1.8M
Anna Flaherty	RI	Family Nurse Practitioner	$0	$493.1K
Omer Cermik	RI	Psychiatry Physician	$3.7K	$447.1K
Sripriya Srinivasan	RI	Psychiatry Physician	$4.6K	$400.8K
Benjamin Lederer	RI	Child & Adolescent Psychiatry Physician	$10.1K	$379.4K
Michael Coburn	RI	Addiction Medicine (Psychiatry & Neurology) Physician	$0	$339.2K
R Bhawani Prasad	IN	Psychiatry Physician	$24.1K	$52.3K

Nearby Providers

Other providers in the same ZIP code as Community Care Alliance, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Prime Healthcare Services Landmark LLC	RI	General Acute Care Hospital	$0	$26.2M
R.i.s.a.t., LLC	RI	Methadone Clinic	$306K	$21.6M
Thundermist Health Center	RI	Dental Clinic/Center	$0	$18.6M
Thundermist Health Center	RI	Federally Qualified Health Center (FQHC)	$0	$15.8M
Action Based Enterprises	RI	Developmentally Disabled Services Day Training Agency	$0	$15.2M
Woonsocket Education Department	RI	Local Education Agency (LEA)	$0	$9.5M
Woonsocket Housing Authority	RI	Assisted Living Facility	$0	$7M
Beata Nelken	RI	Pediatrics Physician	$0	$4.2M
Tmed Holdings, Inc.	RI	Durable Medical Equipment & Medical Supplies	$0	$3.8M
Maha Alamad	RI	General Practice Dentistry	$0	$3.5M

Community Care Alliance — Billing Profile & Reimbursement Data

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Community Care Alliance — 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