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NPI 1568424364 · Warrenton, VA · Community/Behavioral Health Agency
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Rappahannock-rapidan Community Services Board is a community/behavioral health agency provider located in Warrenton, Virginia. This profile covers 0 Medicare and 29 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 | Rappahannock-rapidan Community Services Board |
| Address | 340 Hospital Dr |
| City | Warrenton |
| State | VA |
| ZIP | 20186 |
| Taxonomy | Community/Behavioral Health Agency |
| NPI Enumerated | April 5, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $53.4M |
| Medicare | $0 |
This provider is effectively a single‑payer Medicaid organization: there is no Medicare billing on file and total Medicaid revenue is $53.4M, indicating that its reported operations and scale are driven entirely by Medicaid reimbursement. The absence of Medicare activity suggests its services and contracts are focused on state behavioral‑health programs rather than Medicare populations.
Revenue is highly concentrated in a small set of Medicaid codes: the precomputed top three Medicaid codes account for 70.9% of the provider's total Medicaid revenue, with H2022 alone representing 42.1% of Medicaid revenue, 97150 representing 14.6%, and T1017 representing 14.3%. That concentration means a few service lines produce the bulk of cash flow for the organization.
The code mix points to a community behavioral‑health operating model concentrated on intensive community services, group therapeutic supervision, and case management: H2022 (community‑based wrap‑around services, per diem) is the largest single revenue driver, 97150 (supervised group therapeutic procedures) is the second, and T1017 (targeted case management, per 15 minutes) is the third. Additional codes reported — including H0023 (behavioral health outreach) and H0010 (sub‑acute detoxification/residential addiction) — reinforce that the organization provides a continuum of community outreach, case management, group therapy, and addiction services.
For H2022 the provider is a strong in‑state performer: it ranks #6 of 136 providers in Virginia (96th percentile) and is described as notably above typical state volume for that code, indicating a dominant role regionally in delivering wrap‑around per‑diem services. That market position for H2022 makes the provider a key local supplier of intensive community wrap‑around supports.
By contrast, 97150 and T1017 show more typical participation in their respective in‑state peer groups: 97150 ranks #56 of 201 (73rd percentile) and is characterized as unremarkable volume for the code, while T1017 ranks #25 of 46 (47th percentile) and is also typical. These placements suggest the organization is not an outsized state leader for group therapeutic supervision or case management overall, even though both are among its top revenue sources.
The provider is an extreme outlier in volume for psychotherapy code 90834 despite that code representing a modest share of revenue: 90834 produced $933.7K (1.8% of Medicaid revenue) and the provider ranks #15 of 661 in‑state (98th percentile, labeled an "extreme outlier, far above typical state volume"). This pattern indicates the organization delivers very high volumes of 38–52 minute psychotherapy sessions relative to peers, which may reflect service delivery emphasis or local demand for psychotherapy.
The heavy reliance on per‑diem wrap‑around payments and time‑based case management/group codes creates concentration risk: with H2022 at 42.1% of Medicaid revenue and the top three codes totaling 70.9% of revenue, changes to state policies, rate revisions, or utilization controls for those specific codes could materially affect overall revenue. Analysts should treat reimbursement or policy changes to H2022, 97150, or T1017 as high‑impact scenarios for this provider.
The NPI was enumerated on 2006-04-05 (~20 years ago), indicating long tenure in the market; combined with $53.4M in Medicaid revenue and the service mix observed, this suggests an established community/behavioral health agency with sustained Medicaid contracting and service delivery in Virginia.
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.
29 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| H2022 | Community-based wrap-around services, per diem | 68,910 | $330 | $22.5M |
| 97150 | In this procedure, the provider supervises and directs therapeutic procedures like exercise therapy for a group of patients. | 6,440 | $1,210 | $7.8M |
| T1017 | Targeted case management, each 15 minutes | 22,050 | $350 | $7.6M |
| H0023 | Alcohol and/or drug outreach | 17,220 | $300 | $5.2M |
| H0010 | Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient) | 7,070 | $540 | $3.8M |
| T2023 | Targeted case management; per month | 5,280 | $310 | $1.6M |
| H0046 | Mental health services, not otherwise specified | 13,660 | $80 | $1.1M |
| 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… | 15,560 | $60 | $933.7K |
| T2021 | Day habilitation, waiver; per 15 minutes | 1,500 | $410 | $619.1K |
| T2022 | Case management, per month | 4,910 | $130 | $613.6K |
Showing 1–10 of 29
How this provider's Medicaid billing volume and revenue compare to other Virginia providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Virginia median
29 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| H2022 | Community-based wrap-around services, per diem | 6 | 140 | 4,450 | $1,150 | $15.3M |
| H0023 | Alcohol and/or drug outreach | 33 | 50 | 33,630 | $320 | $15M |
| H0010 | Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient) | 14 | 30 | 7,090 | $420 | $11.5M |
| T1017 | Targeted case management, each 15 minutes | 25 | 50 | 23,860 | $330 | $9.4M |
| H0046 | Mental health services, not otherwise specified | 149 | 510 | 6,100 | $190 | $2.8M |
| H2036 | Alcohol and/or other drug treatment program, per diem | 13 | 10 | 480 | $660 | $2.6M |
| S9123 | Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used) | 24 | 30 | 1,000 | $500 | $2.6M |
| 97150 | In this procedure, the provider supervises and directs therapeutic procedures like exercise therapy for a group of patients. | 56 | 200 | 2,840 | $320 | $2.4M |
| H2017 | Psychosocial rehabilitation services, per 15 minutes | 61 | 100 | 15,920 | $60 | $1.9M |
| T2021 | Day habilitation, waiver; per 15 minutes | 55 | 110 | 1,500 | $340 | $1.3M |
Showing 1–10 of 29
Other providers in the same ZIP code as Rappahannock-rapidan Community Services Board, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Fauquier Medical Center LLC | VA | General Acute Care Hospital | $0 | $12.9M |
| Alexandre Gauthier | VA | Ophthalmology Physician | $1.9M | $0 |
| Fauquier County Board Of Supervisors | VA | Ambulance | $853K | $864.1K |
| Sam Mansour | VA | Ophthalmology Physician | $1.5M | $0 |
| Salman Mufti | VA | Diagnostic Radiology Physician | $1.2M | $0 |
| Paul Butros | VA | Diagnostic Radiology Physician | $844.4K | $0 |
| Marena Patronas | VA | Ophthalmology Physician | $744.9K | $0 |
| Alessa Crossan | VA | Retina Specialist (Ophthalmology) Physician | $497.5K | $0 |
| Juan-carlos Caballero | VA | Dermatology Physician | $435K | $0 |
| Steven Von Elten | VA | Family Medicine Physician | $350.2K | $0 |
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