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

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

Department Of Behavioral Health (NPI 1629137575)

Field	Value
Entity Type	Organization
Organization	Department Of Behavioral Health
Address	4441 E Kings Canyon Rd
City	Fresno
State	CA
ZIP	93702
Taxonomy	Clinical Social Worker
NPI Enumerated	December 6, 2006

Payer Source	Total Paid
Medicaid	$164.9M
Medicare	$0

Key Findings

This provider is effectively a single-payer Medicaid operator: there is no Medicare billing on file and lifetime Medicaid revenue is $164.9M. The absence of Medicare activity combined with large Medicaid dollar volume indicates the entity's operational focus is squarely within state-funded behavioral health and substance-use services.

Revenue is highly concentrated: the top three Medicaid codes (H0004, H0020, H0019) together account for 84.9% of the provider's total Medicaid revenue. Individually those codes are $52.9M (H0004, 32.1%), $44.5M (H0020, 27.0%), and $42.6M (H0019, 25.9%), showing that a very small set of service lines drives the bulk of receipts.

The code mix points to a service model built around outpatient counseling, medication-assisted treatment, and long-term residential care. H0004 (behavioral health counseling and therapy, per 15 minutes) and H0020 (methadone administration) are both top revenue drivers, while H0019 (long-term residential, per diem) signals a substantial residential treatment footprint rather than brief outpatient-only care. This combination is consistent with an integrated substance-use treatment and behavioral health program offering both clinic-based dosing and longer-stay residential services.

Claim volumes underline operational scale and throughput: H0020 shows 3M claims and H0004 shows 362.5K claims, with H0019 at 258.4K claims. Those high claim counts for methadone administration and counseling suggest continuous, high-frequency service delivery (e.g., daily or regular dosing and frequent counseling encounters) rather than episodic care, which has implications for staffing, pharmacy handling, and program logistics.

State competitive standing is strong in core lines. The provider ranks #4 of 204 for H0004 (99th percentile; notably above typical state volume for this code) and #4 of 91 for H0020 (97th percentile; notably above typical state volume for this code), and also ranks #3 of 149 for H0005 (99th percentile) — together these placements indicate the provider is a major in-state supplier of outpatient counseling and methadone services. H0019 ranks #6 of 59 (91st percentile; typical, unremarkable volume for this code), indicating the residential per-diem business is large but less exceptionally concentrated versus peers.

The provider shows code-level outlier behavior on certain specialty assessments: G0397 is flagged as an extreme outlier (rank #2 of 70, 99th percentile) despite representing $1.4M and 0.8% of Medicaid revenue. This suggests the organization delivers structured substance misuse assessments and longer intervention assessments at a far higher rate than most peers, which may reflect a systematic screening/assessment protocol embedded in its treatment pathways.

There is modest diversification beyond the three dominant codes but these additional lines are comparatively small. H0005 (group counseling) contributes $12.8M (7.8% of Medicaid revenue) and H0006 (case management) contributes $4.2M (2.5%), while prescription-related codes S5000 and S5001 together add a small share — the profile shows some ancillary and supporting services but the business remains concentrated in counseling, methadone dosing, and residential care.

The provider is long-tenured in the market: its NPI was enumerated on 2006-12-06 (~20 years ago) and the listed taxonomy is Clinical Social Worker. Longevity coupled with the high-volume service lines and top-state rankings implies an established public-behavioral-health operation with institutional experience in Medicaid-funded substance-use and counseling services.

Medicaid: Complete Services Breakdown

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

24 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0004	Behavioral health counseling and therapy, per 15 minutes	362,460	$150	$52.9M
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	2,963,370	$20	$44.5M
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	258,450	$170	$42.6M
H0005	Alcohol and/or drug services; group counseling by a clinician	224,230	$60	$12.8M
H0006	Alcohol and/or drug services; case management	26,890	$160	$4.2M
S5000	Prescription drug, generic	50,580	$30	$1.5M
T1017	Targeted case management, each 15 minutes	5,260	$290	$1.5M
G0397	Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes	4,290	$320	$1.4M
H0012	Behavioral health day treatment, per hour	4,900	$180	$877.6K
S5001	Prescription drug, brand name	26,540	$30	$875.7K

Showing 1–10 of 24

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. California Distribution

Department Of Behavioral Health — 8 of 24 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. California median

24 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	6	60	28,240	$200	$26.1M
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	4	90	25,310	$20	$9.5M
H2017	Psychosocial rehabilitation services, per 15 minutes	209	480	2,310	$220	$6.3M
H0004	Behavioral health counseling and therapy, per 15 minutes	4	200	3,070	$120	$4.5M
T1017	Targeted case management, each 15 minutes	217	630	2,240	$180	$4.2M
H0012	Behavioral health day treatment, per hour	15	30	4,680	$270	$3.5M
H0005	Alcohol and/or drug services; group counseling by a clinician	3	150	4,360	$70	$2.4M
90885	The provider reviews the medical records of the patient pertaining to psychiatric evaluation to help in establishing the diagnosis and treatment plan.	13	30	380	$90	$2M
H0006	Alcohol and/or drug services; case management	7	100	2,030	$90	$1.8M
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	34	50	2,770	$70	$1.2M

Showing 1–10 of 24

Nearby Providers

Other providers in the same ZIP code as Department Of Behavioral Health, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Grace Jackson	CA	Psychiatry Physician	$4.6K	$0

Department Of Behavioral Health — Billing Profile & Reimbursement Data

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Department Of Behavioral Health — 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