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.

Lamoille Family Center Inc (NPI 1518044676)

Field	Value
Entity Type	Organization
Organization	Lamoille Family Center Inc
Address	480 Cadys Falls Rd
City	Morrisville
State	VT
ZIP	05661
Taxonomy	Public Health or Welfare Agency
NPI Enumerated	November 1, 2006

Payer Source	Total Paid
Medicaid	$5.2M
Medicare	$0

Key Findings

LAMOILLE FAMILY CENTER INC reports no Medicare billing on file and $5.2M in lifetime Medicaid revenue, making its active payer footprint effectively single-payer Medicaid rather than a mixed Medicare/Medicaid operation. This concentration means analyses of its financial and service mix should focus on Medicaid program policies and state-level contracting rather than Medicare fee schedules or national Medicare peer dynamics.

Revenue is highly concentrated in a very small set of Medicaid codes: the top three Medicaid codes account for 100.0% of this provider's Medicaid revenue, with T1024 alone representing $4.5M (87.8%) of the $5.2M total. This heavy reliance on a single code for the majority of revenue indicates that changes to reimbursement, eligibility, or utilization patterns for T1024 would materially affect the provider’s financials.

The dominant code T1024 (9.6K claims, $475 avg paid/claim, $4.5M revenue) is described as evaluation and treatment by an integrated, specialty team for multiple or severely handicapped children, which aligns the organization operationally with integrated specialty pediatric disability care and care coordination. Given the Taxonomy listed as Public Health or Welfare Agency, the code mix suggests the organization operates as a community-based specialty team or contracted care coordinator focusing on complex pediatric cases.

S5146 (830 claims, $764 avg paid/claim, $634.1K revenue) is the secondary revenue driver, representing 12.2% of Medicaid revenue and billed as foster care, therapeutic, child, per month. It ranks #5 of 10 providers in-state (56th percentile) and is characterized as typical, unremarkable volume, indicating the provider participates in foster/therapeutic care programs at a modest, in-state competitive level rather than as a top regional provider.

Several commonly billed service codes show nonzero claim counts but $0 in recorded revenue (for example, T1027: 4.4K claims, $0 avg paid/claim, $0 revenue; S9445: 2.4K claims, $0 avg paid/claim, $0 revenue; H2032: 1.3K claims, $0 avg paid/claim, $0 revenue). The presence of substantial claim counts with $0 paid may reflect bundling, contract arrangements, or administrative reimbursement mappings; these patterns warrant operational follow-up but should be interpreted neutrally in analyses of paid revenue.

Competitive standing for the provider’s primary paid code is mid-tier within Vermont: T1024 ranks #4 of 14 providers in-state (77th percentile) and is labeled in the data as typical, unremarkable volume, which positions LAMOILLE FAMILY CENTER as a meaningful but not dominant in-state provider for integrated specialty pediatric services. S5146’s rank of #5 of 10 (56th percentile) further supports characterization as a modest participant across its secondary service lines.

The NPI was enumerated on 2006-11-01 (~20 years ago), indicating long tenure in the market. That sustained presence, combined with a heavily Medicaid-centered revenue profile and specialized code concentration, suggests institutional experience in state-contracted pediatric and foster-care-related services rather than recent market entry or rapid diversification of payers.

Medicaid: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1024	Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter	9,570	$480	$4.5M
S5146	Foster care, therapeutic, child; per month	830	$760	$634.1K
H0024	Behavioral health prevention information dissemination service (one-way direct or non-direct contact with service audiences to affect knowledge and attitude)	400	$0	$0
S9445	Patient education, not otherwise classified, non-physician provider, individual, per session	2,410	$0	$0
T1016	Case management, each 15 minutes	230	$0	$0
T1017	Targeted case management, each 15 minutes	250	$0	$0
T1027	Family training and counseling for child development, per 15 minutes	4,410	$0	$0
H2032	Activity therapy, per 15 minutes	1,310	$0	$0
T1022	Contracted home health agency services, all services provided under contract, per day	1,050	$0	$0

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

Lamoille Family Center Inc — 0 of 2 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

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1024	Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter	4	10	7,720	$560	$4.2M
S5146	Foster care, therapeutic, child; per month	5	10	740	$620	$573.8K
T1027	Family training and counseling for child development, per 15 minutes	2	10	2,700	$80	$213.5K
T1017	Targeted case management, each 15 minutes	16	20	1,580	$30	$102.9K
T1016	Case management, each 15 minutes	30	40	3,900	$1	$31.1K
T1022	Contracted home health agency services, all services provided under contract, per day	4	10	760	$10	$13.8K
S9445	Patient education, not otherwise classified, non-physician provider, individual, per session	2	10	2,050	$1	$730
H0024	Behavioral health prevention information dissemination service (one-way direct or non-direct contact with service audiences to affect knowledge and attitude)	2	10	1,350	$0	$0
H2032	Activity therapy, per 15 minutes	3	10	1,060	$0	$0

Nearby Providers

Other providers in the same ZIP code as Lamoille Family Center Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lamoille County Health Mental Health Services	VT	Community/Behavioral Health Agency	$0	$42.7M
Green Mountain Support Services Inc.	VT	Case Manager/Care Coordinator	$0	$25.9M
Lamoille County Mental Health Services	VT	Community/Behavioral Health Agency	$0	$22.2M
Lamoille Health Partners, Inc	VT	Cognitive & Behavioral Psychologist	$0	$10.5M
Lamoille Health Partners, Inc	VT	Federally Qualified Health Center (FQHC)	$0	$5.4M
Lamoille Health Partners, Inc	VT	Pediatrics Physician	$0	$4.6M
Lamoille Health Partners, Inc	VT	Dentist	$0	$1.7M
Maple Leaf Family Dentistry	VT	General Practice Dentistry	$0	$1.2M
Tamarack Family Medicine	VT	Clinic/Center	$0	$1.1M
Copley Hospital, Inc.	VT	Critical Access Hospital	$0	$525.5K

Lamoille Family Center Inc — Billing Profile & Reimbursement Data

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Lamoille Family Center 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