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NPI 1467681114 · Rutland, VT · Federally Qualified Health Center (FQHC)
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Community Health Centers Of The Rutland Region Inc is a federally qualified health center (fqhc) provider located in Rutland, Vermont. This profile covers 0 Medicare and 58 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Community Health Centers Of The Rutland Region Inc |
| Address | 215 Stratton Rd |
| City | Rutland |
| State | VT |
| ZIP | 05701 |
| Taxonomy | Federally Qualified Health Center (FQHC) |
| NPI Enumerated | July 2, 2009 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $20.6M |
| Medicare | $0 |
This provider has effectively a single-payer Medicaid footprint: there is no Medicare billing on file while total Medicaid revenue is $20.6M, indicating heavy reliance on Medicaid as the principal source of claims and payments for its operations. Analysts should treat the entity as Medicaid-centric when modeling payer exposure or negotiating network arrangements.
Revenue is highly concentrated: the precomputed top 3 Medicaid codes account for 96.8% of this provider's total Medicaid revenue. Those top contributors are T1015 ($17.9M, 86.8%), G0467 ($1.7M, 8.3%), and 87637 ($343.5K, 1.7%), which together drive nearly the entire Medicaid revenue base and should be the primary focus for revenue risk or utilization reviews.
The code mix and volumes indicate an FQHC-style primary care and bundled clinic operation: T1015 (109K claims) is the dominant line item and represents all-inclusive clinic visits, while G0467 (81.6K claims) is an established FQHC visit code. These two codes’ high volumes and large shares of revenue are consistent with a federally qualified health center delivering high-throughput, per-encounter bundled services rather than specialty procedural revenue.
State competitive standing is strong for core FQHC visit activity: T1015 ranks #2 of 70 providers in-state (99th percentile; notably above typical state volume) and G0467 ranks #1 of 49 (100th percentile; extreme outlier, far above typical state volume). These ranks show the provider is a major statewide participant for FQHC visit billing and is likely among the largest Medicaid safety-net ambulatory clinics in Vermont for those service lines.
Operational profile shows very high claim volumes with low average paid-per-claim for many E/M codes, a pattern common in FQHC reimbursement. Examples include 99214 (41.9K claims, $6 avg paid/claim, $251.1K revenue) and 99213 (56.5K claims, $1 avg paid/claim, $56.5K revenue); this suggests revenue is driven by visit volume rather than high per-procedure reimbursements, making total revenue sensitive to visit mix and per-encounter rates.
Behavioral health and long-term care services are also present and disproportionately concentrated versus peers: G0470 (mental health established patient) shows 2.5K claims, $26 avg paid/claim, $66.2K revenue and ranks #1 of 8 providers in-state (100th percentile), while nursing facility visit codes such as 99308 (33.5K claims, $1 avg paid/claim, $33.5K revenue) and 99309 (7.2K claims, $4 avg paid/claim, $28.9K revenue) each rank #1 in-state (100th percentile). These patterns point to integrated behavioral health services and a notable presence in nursing facility care for Medicaid patients.
The provider reports substantial utilization of infectious-disease and point-of-care testing consistent with community health needs: 87637 (multiplex SARS–CoV–2/flu/RSV) generated $343.5K on 2.7K claims and ranks #3 of 9 in-state (75th percentile), while 87880 (Strep A immunoassay) shows 5.9K claims, $89.1K revenue and ranks #1 of 47 providers in-state (100th percentile; extreme outlier). These testing volumes indicate operational emphasis on respiratory illness diagnosis alongside routine primary care.
The organization appears established and stable: NPI was enumerated 2009-07-02 (~17 years ago) and its taxonomy is Federally Qualified Health Center (FQHC). Coupled with the concentration in bundled FQHC visit codes and top-state ranks, this tenure supports interpretation of the provider as a long-standing Medicaid safety-net clinic with deep local patient volume rather than a newer or transient billing entity.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
58 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 108,960 | $160 | $17.9M |
| G0467 | Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which… | 81,640 | $20 | $1.7M |
| 87637 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)… | 2,660 | $130 | $343.5K |
| 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… | 41,850 | $10 | $251.1K |
| 87880 | The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab. | 5,940 | $20 | $89.1K |
| G0470 | Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc… | 2,550 | $30 | $66.2K |
| 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… | 56,520 | $1 | $56.5K |
| 99308 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider… | 33,460 | $1 | $33.5K |
| 99309 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider… | 7,220 | $1 | $28.9K |
| 87804 | The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings. | 1,880 | $20 | $28.3K |
Showing 1–10 of 58
How this provider's Medicaid billing volume and revenue compare to other Vermont providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Vermont median
58 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 2 | 70 | 11,650 | $150 | $3.3M |
| 87637 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)… | 3 | 10 | 160 | $120 | $149.2K |
| 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… | 7 | 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… | 211 | 670 | 760 | $70 | $143.9K |
| 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… | 5 | 320 | 760 | $20 | $88.2K |
| G0467 | Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which… | 1 | 50 | 1,020 | $20 | $87.6K |
| 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… | 40 | 50 | 50 | $80 | $50K |
| 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… | 24 | 110 | 170 | $70 | $38.6K |
| 99203 | The provider sees a new 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 provider… | 61 | 70 | 70 | $50 | $36K |
| 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… | 5 | 170 | 360 | $20 | $35.9K |
Showing 1–10 of 58
Other providers in the same ZIP code as Community Health Centers Of The Rutland Region Inc, ranked by combined Medicare and Medicaid revenue.
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