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.

Northeast Kingdom Human Services Inc Ds Waiver (NPI 1538292768)

Field	Value
Entity Type	Organization
Organization	Northeast Kingdom Human Services Inc Ds Waiver
Address	154 Duchess Ave
City	Newport
State	VT
ZIP	05855
Taxonomy	Developmental Disabilities Clinic/Center
NPI Enumerated	March 14, 2007

Payer Source	Total Paid
Medicaid	$204.7M
Medicare	$0

Key Findings

This provider is effectively single-payer Medicaid-focused: there is no Medicare billing on file and lifetime Medicaid revenue is $204.7M, indicating Medicaid is the sole reported source of fee-for-service revenue for this entity. The NPI was enumerated on 2007-03-14 (~19 years ago), showing long-tenured participation in state programs.

Revenue is highly concentrated in a very small number of codes: the precomputed top 3 Medicaid codes account for 100.0% of the provider's total Medicaid revenue, with 99199 alone representing $144.1M (70.4% of Medicaid revenue) and H2022 representing $60.6M (29.6% of Medicaid revenue). This concentration means the provider’s financial footprint in Medicaid is driven almost entirely by a specific set of services rather than a broad mix of low-dollar encounters.

99199 appears to be the dominant revenue driver and pays at a much higher level per encounter relative to other major codes: the code 99199 shows 19.5K claims with $7409 avg paid/claim and $144.1M revenue, and it ranks #2 of 16 providers in-state (93th percentile; typical, unremarkable volume for this code). The description for 99199 (other medicine services or procedures with no specific code) suggests the provider is using this catch-all to bill high-dollar, nonstandard or bundled services that account for the majority of its Medicaid receipts.

H2022 (Community-based wrap-around services, per diem) is the second-largest revenue source with 62.8K claims, $966 avg paid/claim, and $60.6M revenue, ranking #5 of 14 providers in-state (69th percentile; typical, unremarkable volume for this code). The combination of H2022 per-diem wraparound services plus high-dollar 99199 claims points to an operational model centered on community-based developmental disability supports augmented by sizable supplemental payments captured under non-specific procedure coding.

Several high-volume service codes appear with substantial claim counts but report $0 avg paid/claim and $0 revenue (examples include H2025: 30.2K claims, T1016: 143.8K claims, T2033: 34.6K claims, and S5140: 197.7K claims). Many of these zero-paid, high-volume items also rank at or near the top statewide (for example, T2033 ranks #1 of 6 providers in-state at the 100th percentile and S5140 ranks #1 of 11 at the 100th percentile), suggesting these lines are significant operational activities but may be reimbursed through bundled payments, managed arrangements, or reported separately from the Medicaid paid-claim dataset.

Competitive standing is mixed across service lines: the provider is a leading in-state participant for several high-volume waiver/respite/foster-care codes (e.g., T2033 and S5140 both rank #1 of peers at the 100th percentile), is a strong performer for 99199 (rank #2 of 16, 93th percentile), and holds a mid-level position for H2022 (rank #5 of 14, 69th percentile). This pattern indicates market prominence in certain developmental-disability waiver programs and high relative activity for particular service buckets, rather than uniform dominance across all Medicaid service categories.

The code mix and associated descriptions (including H2022 wrap-around services, T2016/T2017/T2021 habilitation and day habilitation codes, T2033 residential care, S5150/S5151 respite, and H2025/H2023 employment supports) are consistent with an operational profile of a Developmental Disabilities Clinic/Center providing community-based supports, residential habilitation, employment supports, and respite/foster-care services. Together with the large Medicaid revenue base ($204.7M) and the concentration in a small set of billable codes, this suggests the organization functions as a regional provider of comprehensive waiver and community-based developmental services.

Medicaid: Complete Services Breakdown

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

18 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	19,450	$7,410	$144.1M
H2022	Community-based wrap-around services, per diem	62,760	$970	$60.6M
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…	210	$0	$0
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…	40	$0	$0
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…	60	$0	$0
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	150	$0	$0
H2011	Crisis intervention service, per 15 minutes	70	$0	$0
H2023	Supported employment, per 15 minutes	880	$0	$0
H2025	Ongoing support to maintain employment, per 15 minutes	30,190	$0	$0
S5150	Unskilled respite care, not hospice; per 15 minutes	46,730	$0	$0

Showing 1–10 of 18

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

Northeast Kingdom Human Services Inc Ds Waiver — 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

18 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	2	20	6,570	$6,270	$59.7M
H2022	Community-based wrap-around services, per diem	5	10	18,970	$620	$35.6M
T2033	Residential care, not otherwise specified (nos), waiver; per diem	1	10	16,040	$90	$1.5M
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…	278	320	680	$30	$146.1K
H2011	Crisis intervention service, per 15 minutes	18	20	1,680	$20	$96.2K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	58	110	170	$70	$38.6K
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…	132	170	360	$20	$35.9K
T1016	Case management, each 15 minutes	2	40	3,900	$1	$31.1K
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…	57	110	260	$20	$19.5K
T2021	Day habilitation, waiver; per 15 minutes	2	10	28,170	$1	$210

Showing 1–10 of 18

Nearby Providers

Other providers in the same ZIP code as Northeast Kingdom Human Services Inc Ds Waiver, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Baart Behavioral Health Services, Inc.	VT	Substance Use Disorder Rehabilitation Clinic/Center	$85.8K	$17.6M
Northeast Kingdom Human Services Inc Sbs	VT	Adolescent and Children Mental Health Clinic/Center	$0	$8.3M
Autism Advocacy And Intervention, LLC	VT	Behavior Analyst	$0	$7.8M
Newport Ambulance Service Inc.	VT	Land Ambulance	$743.2K	$2.9M
North Country Hospital & Health Center Inc	VT	Internal Medicine Physician	$0	$3.2M
North East Kingdom Community Action, Inc.	VT	Public Health or Welfare Agency	$0	$2.8M
Northeast Kingdom Human Services Inc Mh Children	VT	Adolescent and Children Mental Health Clinic/Center	$0	$2.7M
North Country Hospital & Health Center Inc	VT	Pediatrics Physician	$0	$2.2M
James V. Wyllie, Dds P.C.	VT	General Practice Dentistry	$0	$1.8M
Keene Medical Products, LLC	VT	Durable Medical Equipment & Medical Supplies	$0	$1.7M

Northeast Kingdom Human Services Inc Ds Waiver — Billing Profile & Reimbursement Data

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Northeast Kingdom Human Services Inc Ds Waiver — 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