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.

Right Choice Health Group LLC (NPI 1457729741)

Right Choice Health Group LLC is a addiction medicine (internal medicine) physician provider located in Springfield, Massachusetts. This profile covers 0 Medicare and 13 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Right Choice Health Group LLC
Address	125 Liberty St
City	Springfield
State	MA
ZIP	01103
Taxonomy	Addiction Medicine (Internal Medicine) Physician
NPI Enumerated	September 3, 2015

Payer Source	Total Paid
Medicaid	$11.9M
Medicare	$0

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	87,310	$70	$6M
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	74,380	$40	$2.8M
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	52,750	$50	$2.4M
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	9,460	$40	$387.7K
99406	The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes.	41,940	$10	$209.7K
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…	530	$130	$71.3K
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	4,000	$10	$24K
T1502	Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit	310	$60	$18.3K
99204	The provider sees a new 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 provider…	50	$110	$4.8K
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	60	$70	$4.5K

Showing 1–10 of 13

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

Right Choice Health Group LLC — 4 of 13 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

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1502	Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit	104	130	34,780	$60	$7.4M
H2015	Comprehensive community support services, per 15 minutes	143	150	7,770	$140	$4.8M
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	287	310	8,710	$40	$1.6M
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	11	370	500	$40	$605.1K
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…	1,566	1,620	580	$80	$599.6K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	6	200	450	$30	$511.5K
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…	31	5,040	200	$70	$209.5K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	270	5,300	230	$60	$164.5K
90832	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…	479	570	400	$40	$106.7K
99204	The provider sees a new 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 provider…	528	870	90	$100	$82K

Showing 1–10 of 13

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Services Institute, Inc.	MA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$32.1M
Metrocare Of Springfield	MA	Home Health Agency	$0	$31.3M
Caring Health Center, Inc.	MA	Federally Qualified Health Center (FQHC)	$0	$23.2M
Baystate Dental Practice, LLC	MA	General Practice Dentistry	$0	$22.5M
A Better Life Homecare LLC	MA	Home Health Agency	$0	$21.8M
Sunrise Behavioral Health Clinic, LLC	MA	Community/Behavioral Health Agency	$0	$19.1M
Allied Health Systems. LLC	MA	Home Health Agency	$0	$17.3M
A Better Life Homecare LLC	MA	Foster Care Agency	$0	$16.7M
Metrocare Of Springfield LLC	MA	Home Health Agency	$0	$16.5M
Latino Counseling Center, Inc	MA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$11.8M

Right Choice Health Group LLC — Billing Profile & Reimbursement Data

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Right Choice Health Group LLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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