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.

North East Kingdom Community Action, Inc. (NPI 1578909560)

Field	Value
Entity Type	Organization
Organization	North East Kingdom Community Action, Inc.
Address	70 Main St
City	Newport
State	VT
ZIP	05855
Taxonomy	Public Health or Welfare Agency
NPI Enumerated	May 16, 2013

Payer Source	Total Paid
Medicaid	$2.8M
Medicare	$0

Key Findings

This entity reports no Medicare billing on file; all documented federal fee-for-service revenue is Medicaid-only, with Total Medicaid revenue of $2.8M. The absence of Medicare claims in the dataset indicates the provider operates effectively as a single-payer (Medicaid) billing entity in the available records.

Revenue is highly concentrated in a single service line: the top 3 Medicaid codes account for 100.0% of this provider's total Medicaid revenue, and T1024 alone represents $2.6M (91.0% of Medicaid revenue). That concentration means the provider’s financial picture is driven almost entirely by encounters billed as T1024 (integrated, specialty team evaluation and treatment for multiple or severely handicapped children).

The provider’s code mix and payment profile indicate an organizational focus on specialized pediatric and child welfare services. T1024’s dominance (integrated specialty team services) together with S5146 (Foster care, therapeutic, child; $225.8K, 8.0%) and H2000 (Comprehensive multidisciplinary evaluation; $28K, 1.0%) point to a service model centered on coordinated care for children with complex needs and foster-care-related therapeutic services.

State-level competitive standing on the primary revenue driver is modest rather than dominant: T1024 ranks #9 of 14 providers in-state (38th percentile), described as typical and unremarkable volume for this code. Similarly, S5146 ranks #8 of 10 (22th percentile) and H2000 ranks #10 of 19 (50th percentile), all characterized in the source data as typical volumes — together these rank positions suggest the organization is a steady but not leading in-state participant for these Medicaid services.

Several codes show substantial claim activity but $0 recorded paid amounts, creating an operational pattern where non-revenue-bearing activity is visible in the claims record. Examples include T1022 (763 claims, $0 avg paid/claim, $0 revenue), 99082 (4.4K claims, $0 avg paid/claim, $0 revenue), and multiple behavioral-health CPT lines with claims but $0 paid; these entries do not contribute to the $2.8M Medicaid revenue total but may reflect contracted, non-billed, or reporting-specific activities.

Because a single code (T1024) accounts for 91.0% of Medicaid revenue, the provider has high revenue concentration risk concentrated in that service line. Any changes in payer contracts, authorization patterns, or eligibility for integrated specialty team payments could materially affect the provider’s Medicaid revenue given that the top 3 codes together account for 100.0% of the $2.8M total.

The provider’s organizational tenure is long enough to be established in the market: the NPI was enumerated on 2013-05-16 (~13 years ago), indicating over a decade of enrollment and suggesting the current coding and payer relationships are likely stable and experienced rather than newly formed.

Overall, the billing footprint signals a specialized, Medicaid-focused public health or welfare agency with concentrated revenue streams in integrated specialty pediatric services and foster-care therapeutic support; its statewide rankings place it as a modest, typical-volume participant rather than a dominant competitor for its highest-revenue codes.

Medicaid: Complete Services Breakdown

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1024	Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter	4,350	$590	$2.6M
S5146	Foster care, therapeutic, child; per month	350	$650	$225.8K
H2000	Comprehensive multidisciplinary evaluation	50	$550	$28K
H2017	Psychosocial rehabilitation services, per 15 minutes	110	$0	$0
H2019	Therapeutic behavioral services, per 15 minutes	110	$0	$0
T1016	Case management, each 15 minutes	1,100	$0	$0
T1017	Targeted case management, each 15 minutes	810	$0	$0
T1027	Family training and counseling for child development, per 15 minutes	4,260	$0	$0
99082	The provider travels to facilitate patient care in a way not normally required, such as accompanying a patient in an ambulance or medical flight.	4,400	$0	$0
T1022	Contracted home health agency services, all services provided under contract, per day	760	$0	$0

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

North East Kingdom Community Action, Inc. — 0 of 3 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

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1024	Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter	9	10	7,720	$560	$4.2M
H2017	Psychosocial rehabilitation services, per 15 minutes	25	30	6,730	$110	$4.1M
S5146	Foster care, therapeutic, child; per month	8	10	740	$620	$573.8K
T1027	Family training and counseling for child development, per 15 minutes	3	10	2,700	$80	$213.5K
T1017	Targeted case management, each 15 minutes	13	20	1,580	$30	$102.9K
H2019	Therapeutic behavioral services, per 15 minutes	6	10	260	$50	$34.1K
T1016	Case management, each 15 minutes	26	40	3,900	$1	$31.1K
H2000	Comprehensive multidisciplinary evaluation	10	20	50	$50	$24.3K
T1022	Contracted home health agency services, all services provided under contract, per day	5	10	760	$10	$13.8K
99082	The provider travels to facilitate patient care in a way not normally required, such as accompanying a patient in an ambulance or medical flight.	1	10	1,700	$1	$8.8K

Nearby Providers

Other providers in the same ZIP code as North East Kingdom Community Action, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northeast Kingdom Human Services Inc Ds Waiver	VT	Developmental Disabilities Clinic/Center	$0	$204.7M
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
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

North East Kingdom Community Action, Inc. — Billing Profile & Reimbursement Data

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North East Kingdom Community Action, 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

Nearby Providers

Frequently Asked Questions

References