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.

Behavioral Health Network Inc (NPI 1477582609)

Field	Value
Entity Type	Organization
Organization	Behavioral Health Network Inc
Address	417 Liberty St
City	Springfield
State	MA
ZIP	01104
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	July 1, 2006

Payer Source	Total Paid
Medicaid	$238.6M
Medicare	$0

Key Findings

BEHAVIORAL HEALTH NETWORK INC is effectively a single-payer Medicaid provider: there is no Medicare billing on file while lifetime Medicaid revenue totals $238.6M, indicating the organization’s operations and revenue base are overwhelmingly Medicaid-focused rather than split between Medicare and Medicaid. This payer concentration suggests services and contracts are primarily aligned with Medicaid program requirements and reimbursement models.

Three codes account for a large share of Medicaid revenue and reflect core service lines: 90834, T1040, and S9485 together represent 39.9% of the provider’s Medicaid revenue. This concentration shows the organization’s business is driven by psychotherapy sessions (90834), per-diem community behavioral health clinic services (T1040), and crisis intervention per diem services (S9485), indicating a mix of outpatient psychotherapy, day/per-diem clinic operations, and intensive crisis response capacity.

The provider is a major statewide player for several high-volume behavioral health codes. T1040 ranks #1 of 167 providers in-state and is labeled an extreme outlier, and 90834 ranks #5 of 1617 providers (100th percentile), demonstrating market leadership in Medicaid-funded community behavioral health clinic per-diem services and high-volume psychotherapy delivery. These rank/percentile positions indicate the organization operates at a scale well above typical state providers for these services.

Several additional codes further highlight breadth across service types and intensities: H0019 (long-term residential per diem), H2019 (therapeutic behavioral services), and H0023 (behavioral health outreach) appear among top revenue contributors, reflecting that the provider delivers residential-level care, interval therapeutic behavioral supports, and outreach programs. Together these codes suggest an integrated service model spanning residential, community-based therapeutic, and outreach interventions rather than a narrow outpatient-only clinic.

The provider reports extremely high volumes for multiple psychotherapy and related clinical evaluation codes: 90837 and 90832 both rank at or near the 100th percentile statewide as extreme outliers, and 90791 also ranks highly. These patterns show sustained high throughput for longer psychotherapy sessions and psychiatric evaluations, reinforcing that direct clinical psychotherapy and diagnostic services are a substantial operational focus.

Several high-revenue per-diem codes carry high average payments per claim, indicating significant per-encounter reimbursement at scale: for example, S9485 averages $558 paid/claim and H0011 averages $736 paid/claim. Coupled with large claim counts (e.g., S9485: 46.4K claims; H0019: 116.3K claims), this combination of high unit price and high volume helps explain how relatively few codes contribute a large share of the $238.6M Medicaid revenue.

Operational footprint and tenure: the provider’s NPI was enumerated on 2006-07-01 (approximately 20 years ago), indicating long-standing presence in the Medicaid market which is consistent with its large-scale per-diem and psychotherapy billing patterns and leadership positions on multiple statewide code rankings. This tenure supports institutional capacity to deliver high-volume and multi-modal behavioral health services.

While many of the provider’s code rankings are extreme outliers, some high-volume programmatic codes are characterized as typical or unremarkable in volume statewide (for example H0023 and H2016 are described as typical/unremarkable). This suggests that although the organization dominates in several service lines, other components of its service mix align more closely with normal state provider activity, indicating a mixed competitive profile across different modalities.

Medicaid: Complete Services Breakdown

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

76 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	484,830	$70	$35.4M
T1040	Medicaid certified community behavioral health clinic services, per diem	141,150	$220	$30.5M
S9485	Crisis intervention mental health services, per diem	46,360	$560	$25.9M
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	116,270	$160	$19.1M
H2019	Therapeutic behavioral services, per 15 minutes	125,000	$150	$18.1M
H0023	Alcohol and/or drug outreach	315,360	$50	$16.1M
T1027	Family training and counseling for child development, per 15 minutes	82,120	$110	$9M
H2015	Comprehensive community support services, per 15 minutes	68,990	$120	$8.1M
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…	87,300	$80	$7.3M
H2011	Crisis intervention service, per 15 minutes	45,990	$160	$7.3M

Showing 1–10 of 76

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

Behavioral Health Network Inc — 13 of 25 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

76 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	18	40	26,400	$10	$9.7M
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	3	80	5,200	$370	$8.4M
H0023	Alcohol and/or drug outreach	5	40	127,370	$50	$8.2M
G2067	Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed…	13	30	8,280	$140	$8M
H2036	Alcohol and/or other drug treatment program, per diem	2	10	3,640	$1,120	$7.9M
H2015	Comprehensive community support services, per 15 minutes	12	150	7,770	$140	$4.8M
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	6	30	1,210	$760	$3.9M
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	7	30	1,910	$480	$3.5M
S9485	Crisis intervention mental health services, per diem	2	110	1,250	$540	$3.2M
T1012	Alcohol and/or substance abuse services, skills development	3	10	720	$350	$3.2M

Showing 1–10 of 76

Related Providers

Other providers that share a Tax Identification Number (TIN) with Behavioral Health Network Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Behavioral Health Network, Inc	MA	Methadone Clinic	$1.3M	$108.4M
Behavioral Health Network, Inc	MA	Adult Day Care Clinic/Center	$0	$76.5M
Alice Mary Graham-brown	MA	Psychiatry Physician	$155.1K	$118.4K
Sarah Stout	VT	Psychiatric/Mental Health Nurse Practitioner	$9.7K	$164.3K
Sarah Kells	MA	Family Medicine Physician	$70.8K	$4K

Nearby Providers

Other providers in the same ZIP code as Behavioral Health Network Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gandara Mental Health Center Inc	MA	Mental Health Counselor	$0	$133.1M
The Mercy Hospital Inc	MA	General Acute Care Hospital	$0	$98.9M
American Medical Response Of Massachusetts Inc	MA	Ambulance	$8.7M	$51.7M
Greater Springfield Senior Services, Inc.	MA	Case Management Agency	$0	$55.1M
Viability, Inc.	MA	Adult Care Home Facility	$0	$46.8M
Riverbend Medical Group, Inc.	MA	Internal Medicine Physician	$0	$38.8M
International Health Solutions,inc	MA	Home Health Agency	$0	$27.3M
Greater Springfield Senior Services, Inc.	MA	Case Management Agency	$0	$25.4M
Airline Drug Inc.	MA	Durable Medical Equipment & Medical Supplies	$0	$21.1M
System Coordinated Services, Inc	MA	Clinical Medical Laboratory	$2.1M	$18.5M

Behavioral Health Network Inc — 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