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

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

Options Counseling Services Of Oregon (NPI 1548275217)

Field	Value
Entity Type	Organization
Organization	Options Counseling Services Of Oregon
Address	360 E 10th Ave Ste 450
City	Eugene
State	OR
ZIP	97401
Taxonomy	Mental Health Counselor
NPI Enumerated	July 30, 2006

Payer Source	Total Paid
Medicaid	$25.9M
Medicare	$0

Key Findings

OPTIONS COUNSELING SERVICES OF OREGON is effectively a single‑payer Medicaid provider: it has no Medicare billing on file and reported $25.9M in lifetime Medicaid revenue. The absence of Medicare activity means the organization’s scale, contracting exposure, and utilization patterns should be evaluated primarily through its Medicaid footprint rather than a dual‑payer strategy.

Revenue is highly concentrated in psychotherapy and counseling codes: the provider’s top three Medicaid codes (90837, 90834, H0004) together account for 68.8% of its $25.9M Medicaid revenue. Individually, 90837 generated $8.4M (32.5% of Medicaid revenue) and 90834 generated $6M (23.1%), signaling dependency on time‑based psychotherapy services for the bulk of revenue.

Operational profile and service line implications point to a high‑volume outpatient psychotherapy practice: large claim volumes for 90837 (74K claims, $114 avg paid/claim) and 90834 (47.2K claims, $127 avg paid/claim) indicate a sustained focus on individual psychotherapy sessions of differing durations. The sizable H0004 volume (24.5K claims, $139 avg paid/claim) further supports a model that bills both unit‑based counseling and traditional timed psychotherapy, consistent with an organization delivering frequent, scheduled behavioral health visits.

Competitive standing within Oregon is strong for core psychotherapy services: 90834 ranks #1 of 399 providers in-state (100th percentile; labeled an extreme outlier) and 90837 ranks #6 of 1380 providers in-state (100th percentile; labeled an extreme outlier). These rankings identify the provider as a top statewide volume leader for both mid‑length and long psychotherapy sessions, making it a dominant participant in those code lines.

Secondary services and care management components expand the clinical mix: family therapy 90847 produced $2.3M (9.0% of Medicaid revenue) with 14K claims and ranks #3 of 131 providers (98th percentile; extreme outlier), while codes like H2014 (skills training, $1.1M) and T1016 (case management, $328.3K) indicate ancillary rehabilitation and coordination services. This combination suggests the provider offers a broad set of outpatient behavioral health supports beyond one‑to‑one psychotherapy.

Clinical complexity and higher‑level E/M activity are present but less dominant: 99214 accounted for $1.9M (7.4% of Medicaid revenue) across 21.5K claims and ranks in the 95th percentile in-state, and 99215 produced $690.8K (2.7%) with notably above‑typical volume (97th percentile). These E/M volumes imply the provider documents and bills moderate to high complexity outpatient evaluation and management alongside psychotherapy.

Statistical outliers highlight market positioning and operational risk: multiple codes are described as extreme outliers (90834, 90837, 90847), indicating volumes far above typical state peers and concentrated reliance on a small set of high‑revenue codes. That concentration (68.8% of Medicaid revenue coming from the top three codes) creates revenue sensitivity to reimbursement or utilization changes in those specific psychotherapy and counseling CPT/HCPCS codes.

Tenure and continuity: the provider’s NPI was enumerated on 2006-07-30 (~20 years ago), indicating long‑standing presence in the market. Combined with sustained high claim volumes across psychotherapy codes, this tenure suggests an established operation with consistent Medicaid utilization patterns over time.

Medicaid: Complete Services Breakdown

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

33 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	73,970	$110	$8.4M
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…	47,220	$130	$6M
H0004	Behavioral health counseling and therapy, per 15 minutes	24,490	$140	$3.4M
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…	14,010	$170	$2.3M
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…	21,460	$90	$1.9M
H2014	Skills training and development, per 15 minutes	12,950	$90	$1.1M
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…	4,210	$160	$690.8K
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	4,640	$90	$403.8K
T1016	Case management, each 15 minutes	5,210	$60	$328.3K
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…	1,430	$220	$316.9K

Showing 1–10 of 33

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Oregon Distribution

Options Counseling Services Of Oregon — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oregon

Full comparison — all codes billed, vs. Oregon median

33 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0004	Behavioral health counseling and therapy, per 15 minutes	16	270	1,660	$90	$681K
H0038	Self‑help/peer services, per 15 minutes	107	150	1,030	$80	$417.2K
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…	6	1,380	540	$140	$363.3K
H2014	Skills training and development, per 15 minutes	12	120	1,010	$40	$323.2K
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…	71	1,500	650	$70	$312.4K
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…	413	1,590	590	$50	$236.5K
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…	1	400	230	$90	$153.8K
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…	3	130	230	$110	$152K
T1016	Case management, each 15 minutes	26	210	410	$50	$126.4K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	51	140	310	$60	$113.6K

Showing 1–10 of 33

Nearby Providers

Other providers in the same ZIP code as Options Counseling Services Of Oregon, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Peacehealth Medical Group	OR	Family Medicine Physician	$0	$45.3M
Eugene Emergency Physicians PC	OR	Emergency Medicine Physician	$0	$16.9M
Center For Family Development, Inc.	OR	Mental Health Counselor	$0	$15.6M
Laurel Hill Center	OR	Eyewear Supplier	$0	$14M
Looking Glass Community Services	OR	Mental Health Counselor	$0	$13.5M
Peacehealth	OR	General Acute Care Hospital	$0	$13.3M
Addiction Counseling And Education Services Inc.	OR	Mental Health Counselor	$0	$12.8M
Oregon Eye Consultants LLC	OR	Ophthalmology Physician	$0	$9.6M
Ch Mh Services (or), LLC	OR	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$9.4M
Oregon Healthcare Resources, LLC	OR	Multi-Specialty Clinic/Center	$0	$8.8M

Options Counseling Services Of Oregon — Billing Profile & Reimbursement Data

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Options Counseling Services Of Oregon — 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