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

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

Treatment Associates, Inc (NPI 1508077918)

Field	Value
Entity Type	Organization
Organization	Treatment Associates, Inc
Address	73 Main St
City	Montpelier
State	VT
ZIP	05602
Taxonomy	Mental Health Counselor
NPI Enumerated	May 25, 2007

Payer Source	Total Paid
Medicaid	$6.2M
Medicare	$0

Key Findings

This provider is effectively a single-payer Medicaid billing entity: there is no Medicare billing on file and all reported government revenue is Medicaid-based with lifetime Medicaid revenue of $6.2M. The NPI was enumerated on 2007-05-25 (~19 years ago), indicating a long-tenured presence in the market rather than a recent entrant.

Revenue is highly concentrated in a small set of behavioral health and substance-use codes: the top 3 Medicaid codes (H0005, H0004, 80307) account for 59.8% of this provider’s total Medicaid revenue. Individually those top codes report $1.3M for H0005 (21.9%), $1.3M for H0004 (21.0%), and $1M for 80307 (17.0%), underscoring dependence on group counseling, one-on-one counseling by time unit, and instrumented presumptive drug testing.

The code mix and volumes point to a substance-use treatment and outpatient behavioral health operation: H0005 (group counseling) and H0004 (behavioral health counseling per 15 minutes) together generate ~$2.6M and are the largest revenue drivers, while H0015 ($774.7K, intensive outpatient) further supports a programmatic focus on organized treatment modalities rather than incidental behavioral health visits. This pattern suggests the provider runs scheduled programs (group sessions and intensive outpatient) with repeat visits rather than episodic or rare encounters.

The provider is a dominant in-state performer for several substance-use codes: H0005 ranks #1 of 13 providers in-state (100th percentile; notably above typical state volume for this code) and H0004 ranks #1 of 19 providers in-state (100th percentile; extreme outlier, far above typical state volume for this code). H0006 (case management) also ranks #1 of 8 providers (100th percentile) even though it represents a smaller revenue slice ($83.6K), reinforcing that this entity is a leading statewide provider for multiple addiction-treatment service lines.

Operational volume is substantial and recurring: claim counts are very high for core services (H0005 21.8K claims, H0004 18K claims, 80307 18.7K claims), which aligns with programmatic delivery models that require frequent, scheduled encounters and routine drug screening. The high claim counts paired with per-claim payments ($62 avg for H0005, $72 avg for H0004, $56 avg for 80307) indicate a business model built on many lower-dollar, repeat encounters.

While behavioral health and substance-use codes dominate, general outpatient E&M services also contribute meaningfully to revenue: 99213 accounts for $685.5K (11.1%) and 99214 accounts for $363.8K (5.9%) of Medicaid revenue, with 99213 ranking #37 of 319 providers in-state (89th percentile) and 99214 ranking #70 of 323 providers in-state (79th percentile). This suggests the provider supplements specialty program billing with standard outpatient evaluation-and-management visits for established patients.

Lab testing is an integrated and material component of the revenue mix: 80307 (instrumented presumptive drug test) is the third-largest revenue source at $1M and ranks #3 of 16 providers in-state (87th percentile; typical, unremarkable volume). The presence of both 80307 (18.7K claims) and smaller-volume 80305 indicates routine on-site drug screening workflows supporting the treatment programs.

The dataset includes a single-provider report of a collaborative care code (99492: 27 claims, $3 avg paid/claim, $81 revenue) that ranks #1 of 1 providers in-state (0th percentile; no state peer volume comparison available), signaling an unusual but very low-revenue use of psychiatric collaborative care billing. Although immaterial to total revenue, this suggests the provider has at least experimented with or occasionally bills for CoCM services in addition to its core group- and outpatient-based addiction treatment offerings.

Medicaid: Complete Services Breakdown

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
H0005	Alcohol and/or drug services; group counseling by a clinician	21,750	$60	$1.3M
H0004	Behavioral health counseling and therapy, per 15 minutes	17,960	$70	$1.3M
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.	18,700	$60	$1M
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…	6,800	$110	$774.7K
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…	12,030	$60	$685.5K
T1016	Case management, each 15 minutes	20,800	$20	$499.3K
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…	3,950	$90	$363.8K
H0006	Alcohol and/or drug services; case management	4,400	$20	$83.6K
H0001	Alcohol and/or drug assessment	420	$150	$61.6K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	720	$10	$5K

Showing 1–10 of 13

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Vermont Distribution

Treatment Associates, Inc — 3 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Vermont

Full comparison — all codes billed, vs. Vermont median

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	3	20	2,660	$50	$742.4K
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…	2	10	660	$120	$303.7K
H0004	Behavioral health counseling and therapy, per 15 minutes	1	20	1,410	$80	$247.4K
H0005	Alcohol and/or drug services; group counseling by a clinician	1	10	630	$60	$243.1K
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…	70	320	680	$30	$146.1K
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…	37	320	760	$20	$88.2K
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…	43	70	70	$50	$36K
H0006	Alcohol and/or drug services; case management	1	10	970	$20	$35.5K
H0001	Alcohol and/or drug assessment	2	10	160	$150	$31.2K
T1016	Case management, each 15 minutes	10	40	3,900	$1	$31.1K

Showing 1–10 of 13

Nearby Providers

Other providers in the same ZIP code as Treatment Associates, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Washington County Mental Health Services, Inc.	VT	Community/Behavioral Health Agency	$0	$99.3M
Washington County Family Center	VT	Developmentally Disabled Services Day Training Agency	$0	$6.7M
Central Vermont Medical Center Inc	VT	Family Medicine Physician	$0	$4.1M
Baart Behavioral Health Services, Inc.	VT	Substance Use Disorder Rehabilitation Clinic/Center	$202.1K	$2.8M
Benjamin Newman	VT	Clinical Social Worker	$0	$1.5M
Central Vermont Medical Center Inc	VT	Internal Medicine Physician	$0	$907.7K
Keene Medical Products, LLC	VT	Durable Medical Equipment & Medical Supplies	$0	$678.6K
M Gould	VT	Psychologist	$0	$574.9K
City Of Montpelier Ambulance	VT	Land Ambulance	$190.7K	$378.7K
John Lansky	VT	General Practice Dentistry	$0	$466.9K

Treatment Associates, 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

Nearby Providers

Frequently Asked Questions

References