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NPI 1518613215 · 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 13 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 | 231 N Main St |
| City | Rutland |
| State | VT |
| ZIP | 05701 |
| Taxonomy | Federally Qualified Health Center (FQHC) |
| NPI Enumerated | February 22, 2022 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $3.2M |
| Medicare | $0 |
This entity is effectively a single-payer Medicaid operator: there is no Medicare billing on file and all recorded lifetime revenue is Medicaid at $3.2M. The provider’s NPI was enumerated on 2022-02-22 (approximately 4 years ago), indicating a relatively recent enrollment window for public-payer activity.
Revenue is extremely concentrated in a single encounter code: T1015 (Clinic visit/encounter, all-inclusive) accounts for $3.2M and 98.8% of the provider’s Medicaid revenue, and the precomputed top-3 codes together account for 99.3% of total Medicaid revenue. This concentration shows the business is operating predominantly under the FQHC all-inclusive visit model rather than a broad mix of individually billed procedures.
Volume metrics for the primary revenue driver are high: T1015 shows 17.5K claims with an average paid per claim of $182. Despite that high claim count, the provider’s statewide rank on T1015 is #26 of 70 (64th percentile), which the data labels as a typical, unremarkable volume — indicating solid utilization but not dominant market share for the core clinic visit code.
The code mix and presence of FQHC-specific codes (for example G0467 and G0470) align with the provider taxonomy as a Federally Qualified Health Center; G0467 appears with 255 claims and $25 avg paid/claim ($6.4K revenue), and G0470 appears for mental-health FQHC visits. This pattern supports an operational model focused on bundled FQHC visit encounters and integrated primary care/behavioral health services.
Behavioral health services are a clear secondary activity: psychotherapy code 90834 appears with 4.1K claims and $2 avg paid/claim ($8.2K revenue) and is ranked #14 of 165 providers in-state (92th percentile). The data labels this as typical, unremarkable volume, but the combination of thousands of claims and very low average paid/claim suggests many low-dollar psychotherapy encounters are being reported alongside the dominant T1015 clinic visits.
Telehealth and remote-site billing are present but minor: G2025 shows 485 claims at $18 avg paid/claim ($8.7K revenue), accounting for 0.3% of Medicaid revenue and ranking #9 of 26 in-state (68th percentile). This indicates some use of telehealth/RHC distant-site billing by the FQHC, but at a modest scale relative to on-site clinic encounters.
Across the non-dominant codes there is a pattern of high claim counts paired with low per-claim payment amounts (examples include multiple E/M and psychotherapy codes with $1–$2 average paid/claim levels). That combination implies operational volume (many encounters) is driving activity more than high unit pricing, consistent with a community health center delivering frequent, bundled visits under FQHC reimbursement rules.
Competitive standing summary: the provider is not a major statewide leader on its core T1015 code (64th percentile) but it does report substantial visit volume overall. Behavioral health psychotherapy activity ranks relatively high by percentile while still being characterized as typical in the source labels, and telehealth involvement is modest; overall the profile is that of a mid-sized, Medicaid-focused FQHC concentrating almost all revenue in visit-based bundled billing rather than diversified procedure-level revenue.
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.
13 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 17,470 | $180 | $3.2M |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | 490 | $20 | $8.7K |
| 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… | 4,100 | $1 | $8.2K |
| 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… | 7,990 | $1 | $8K |
| 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… | 260 | $30 | $6.4K |
| 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… | 2,580 | $1 | $2.6K |
| 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… | 950 | $1 | $1.9K |
| 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… | 90 | $20 | $1.7K |
| 99212 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,… | 1,300 | $1 | $1.3K |
| 90792 | In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical… | 350 | $1 | $690 |
Showing 1–10 of 13
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
13 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 26 | 70 | 11,650 | $150 | $3.3M |
| 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… | 94 | 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… | 300 | 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… | 47 | 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… | 37 | 50 | 1,020 | $20 | $87.6K |
| 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… | 14 | 170 | 360 | $20 | $35.9K |
| 90847 | A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the… | 17 | 40 | 130 | $40 | $25.3K |
| 90832 | 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… | 62 | 110 | 260 | $20 | $19.5K |
| 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… | 5 | 10 | 110 | $30 | $15.2K |
| 90791 | In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. | 21 | 90 | 60 | $50 | $9.4K |
Showing 1–10 of 13
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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