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

Why is the Medicaid comparison limited to Rhode Island 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. Rhode Island (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.

Northeast Behavioral Associates (NPI 1518085505)

Field	Value
Entity Type	Organization
Organization	Northeast Behavioral Associates
Address	2348 Post Rd Ste 107
City	Warwick
State	RI
ZIP	02886
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	March 27, 2007

Payer Source	Total Paid
Medicaid	$20.2M
Medicare	$0

Key Findings

NORTHEAST BEHAVIORAL ASSOCIATES is effectively a single-payer Medicaid provider: there is no Medicare billing on file while lifetime Medicaid revenue totals $20.2M, indicating the organization’s clinical and billing footprint is concentrated entirely within Medicaid programs rather than Medicare fee-for-service activity. This payer concentration suggests operations and revenue depend on state Medicaid policy and managed care arrangements in Rhode Island.

Revenue concentration is highly concentrated in a few service lines: the precomputed top 3 Medicaid codes account for 79.7% of the provider’s total Medicaid revenue, with T1024, T1019, and H0046 alone contributing the vast majority of income. This means business risk and growth prospects are tightly linked to reimbursement and utilization trends for these specific behavioral and care-coordination services.

The code mix indicates the organization operates primarily as a community/behavioral health agency providing intensive integrated team-based and personal care services: T1024 (integrated specialty team evaluation/treatment), T1019 (personal care services per 15 minutes), and H0046 (mental health services, NOS) are the top revenue drivers, consistent with a provider offering coordinated, ongoing behavioral health and personal care supports rather than episodic primary medical care. The presence of substantial T1016 (case management) and T1027 (family training and counseling) volumes further supports a focus on long-term care coordination and developmental/child-centered services.

Competitive standing within the state is strong for several high-volume codes. NORTHEAST BEHAVIORAL ASSOCIATES ranks #3 of 91 providers for T1024 (98th percentile, labeled an extreme outlier) and #3 of 70 for H0046 (97th percentile, notably above typical volume), signaling it is a leading provider in Rhode Island for integrated specialty team evaluations and unspecified mental health services. T1019 ranks #5 of 30 (86th percentile), which is a meaningful but less dominant position among personal care suppliers in-state.

Several codes show unusually large utilization relative to peers and represent statistical outlier status: T1024 is identified as an extreme outlier and T1016, T1027, and H2016 are described as notably above typical state volume. These labels imply the provider’s service mix and scale for care coordination, family training, and community support are well above what is typical in Rhode Island, concentrating both operational expertise and revenue in these Medicaid-covered behavioral health services.

Operational scale and tenure support its role in the market: the NPI was enumerated on 2007-03-27 (~19 years ago), indicating almost two decades of Medicaid participation and time to build referral relationships and program capacity in the state. That tenure helps explain the provider’s elevated ranks on several specialty behavioral health codes.

While psychotherapy session codes (90837, 90834, 90791) appear in the top Medicaid code list, they are relatively small contributors to revenue (for example 90837 is $444.4K or 2.2% of Medicaid revenue) and rank below the provider’s dominant community and personal-care services. This suggests the organization’s core revenue model is centered on team-based and personal care services rather than high-volume individual psychotherapy encounters.

The provider’s revenue profile suggests concentration risk: with nearly 80% of Medicaid revenue tied to three codes, any policy, rate, or utilization shift for integrated team evaluations (T1024), personal care (T1019), or unspecified mental health services (H0046) would materially affect overall revenue. Analysts should flag reimbursement changes to these specific service lines when modeling the provider’s financial sensitivity or forecasting growth potential.

Medicaid: Complete Services Breakdown

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

12 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	46,120	$130	$5.9M
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	45,260	$120	$5.5M
H0046	Mental health services, not otherwise specified	50,190	$100	$4.8M
T1016	Case management, each 15 minutes	75,680	$30	$2.1M
T1027	Family training and counseling for child development, per 15 minutes	14,840	$40	$638.3K
H2016	Comprehensive community support services, per diem	150,170	$1	$600.7K
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…	5,110	$90	$444.4K
H2014	Skills training and development, per 15 minutes	3,310	$70	$218.6K
T1005	Respite care services, up to 15 minutes	440	$80	$36.4K
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…	260	$80	$19.8K

Showing 1–10 of 12

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Rhode Island Distribution

Northeast Behavioral Associates — 4 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Rhode Island

Full comparison — all codes billed, vs. Rhode Island median

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	5	30	9,040	$150	$5.7M
T1005	Respite care services, up to 15 minutes	16	20	2,540	$190	$1.4M
T1024	Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter	3	90	510	$160	$975K
H0046	Mental health services, not otherwise specified	3	70	2,310	$70	$698K
T1027	Family training and counseling for child development, per 15 minutes	8	90	350	$100	$363.8K
H2014	Skills training and development, per 15 minutes	13	30	1,420	$90	$300.3K
T1016	Case management, each 15 minutes	4	180	400	$20	$230.7K
H2016	Comprehensive community support services, per diem	3	40	10,150	$10	$230.4K
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…	411	750	330	$70	$92.5K
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…	15	360	280	$90	$86.4K

Showing 1–10 of 12

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tanille Louis	RI	Psychiatric/Mental Health Nurse Practitioner	$43.6K	$585.8K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
West Bay Residential Services Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$145.8M
Kent County Memorial Hospital	RI	General Acute Care Hospital	$0	$90.8M
Avatar Residential, Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$72.9M
Thrive Behavioral Health, Inc.	RI	Community/Behavioral Health Agency	$0	$71.9M
Bayada Home Health Care, Inc.	RI	Home Health Agency	$0	$69.5M
Community Living Of Rhode Island	RI	Developmentally Disabled Services Day Training Agency	$0	$65.7M
J.arthur Trudeau Memorial Center Conversion Waivers	RI	Developmentally Disabled Services Day Training Agency	$0	$57.1M
Gateways To Change, Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$54.5M
Affinity Physicians LLC.	RI	Internal Medicine Physician	$0	$41.8M
J, Arthur Trudeau Memorial Center	RI	Developmentally Disabled Services Day Training Agency	$0	$33.9M

Northeast Behavioral Associates — Billing Profile & Reimbursement Data

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Northeast Behavioral Associates — 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