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

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

Legacy Behavioral Health Center Inc (NPI 1568439685)

Field	Value
Entity Type	Organization
Organization	Legacy Behavioral Health Center Inc
Address	15818 Sw Warfield Blvd
City	Indiantown
State	FL
ZIP	34956
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	March 7, 2006

Payer Source	Total Paid
Medicaid	$44.7M
Medicare	$0

Key Findings

LEGACY BEHAVIORAL HEALTH CENTER INC is effectively a Medicaid-focused provider: there is no Medicare billing on file and all documented government revenue is Medicaid, totaling $44.7M. This makes the organization functionally single-payer in the claims dataset and concentrates its reimbursement exposure on Medicaid policy and rate changes rather than dual-payer dynamics.

Revenue concentration is very high: the precomputed top 3 Medicaid codes by revenue account for 83.8% of this provider's total Medicaid revenue, indicating the business is heavily dependent on a small set of service lines for the majority of its collections. That level of concentration suggests operational and financial sensitivity if utilization or reimbursement for these codes shifts.

H2019 (Therapeutic behavioral services, per 15 minutes) is the single largest revenue driver at $24M and 53.6% of Medicaid revenue; the provider ranks #3 of 1879 in-state (100th percentile; extreme outlier, far above typical state volume for this code). This dominance on H2019 signals that the organization’s core service model is high-volume, time-based behavioral therapy delivered in 15-minute increments.

T1017 (Targeted case management, each 15 minutes) generates $9.7M and 21.6% of Medicaid revenue, with the provider ranking #14 of 560 in-state (98th percentile; notably above typical state volume for this code). Strong performance on targeted case management indicates substantial care coordination and casework activity as a central operational function alongside direct therapeutic services.

T1015 (Clinic visit/encounter, all-inclusive) contributes $3.8M and 8.6% of Medicaid revenue, ranking #8 of 682 in-state (99th percentile; extreme outlier, far above typical state volume for this code). This high-volume clinic-visit billing complements the per-15-minute therapy and case management mix and reinforces the profile of a high-throughput community mental health clinic.

Additional mental-health-specific codes also appear at very high state percentiles: H0032 (service plan development) is $2.8M and ranks #5 of 1134 (100th percentile; extreme outlier), while H0031 (mental health assessment) is $1.6M and ranks #2 of 1163 (100th percentile; extreme outlier). These patterns collectively underscore a comprehensive non-physician behavioral health operation that performs assessments, care planning, and high-volume therapy and case management.

Clinical medical E/M and procedure codes are negligible in revenue, for example 99214 and 99213 together account for only a few thousand dollars, and 96372 shows $0 revenue. That distribution suggests limited physician-led medical management or procedural services and supports the interpretation that care is delivered primarily by non-physician behavioral health staff in time-based service models.

The provider has an established presence with an NPI enumerated on 2006-03-07 (~20 years ago), which combined with the concentrated high-volume Medicaid billing profile suggests a long-standing community behavioral health operation that has scaled around Medicaid-funded therapy, case management, and clinic-encounter services. The concentration in a few high-volume Medicaid codes makes the organization a major state-level player for those services but also concentrates payer risk in Medicaid policy changes affecting those specific codes.

Medicaid: Complete Services Breakdown

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2019	Therapeutic behavioral services, per 15 minutes	319,790	$80	$24M
T1017	Targeted case management, each 15 minutes	155,790	$60	$9.7M
T1015	Clinic visit/encounter, all-inclusive	113,190	$30	$3.8M
H0032	Mental health service plan development by non-physician	46,720	$60	$2.8M
H2000	Comprehensive multidisciplinary evaluation	9,990	$180	$1.7M
H0031	Mental health assessment, by non-physician	62,150	$30	$1.6M
H2017	Psychosocial rehabilitation services, per 15 minutes	12,390	$60	$768.4K
H2010	Comprehensive medication services, per 15 minutes	15,610	$30	$405.8K
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…	1,020	$10	$5.1K
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…	340	$1	$680

Showing 1–10 of 11

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Florida Distribution

Legacy Behavioral Health Center Inc — 7 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Florida

Full comparison — all codes billed, vs. Florida median

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1017	Targeted case management, each 15 minutes	14	560	7,680	$50	$1.5M
H2017	Psychosocial rehabilitation services, per 15 minutes	297	980	4,890	$100	$1.3M
H2019	Therapeutic behavioral services, per 15 minutes	3	1,880	1,010	$70	$544.5K
T1015	Clinic visit/encounter, all-inclusive	8	680	680	$50	$308.4K
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…	3,261	5,930	460	$40	$169.3K
H2000	Comprehensive multidisciplinary evaluation	7	400	110	$150	$162.7K
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…	2,214	6,380	430	$50	$139.3K
H0032	Mental health service plan development by non-physician	5	1,130	110	$60	$91.7K
H0031	Mental health assessment, by non-physician	2	1,160	210	$40	$87.3K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	547	790	260	$20	$28.9K

Showing 1–10 of 11

Legacy Behavioral Health Center Inc — Billing Profile & Reimbursement Data

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Legacy Behavioral Health Center Inc — 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

Frequently Asked Questions

References