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

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

Helen Ross Mcnabb Center (NPI 1659330686)

Field	Value
Entity Type	Organization
Organization	Helen Ross Mcnabb Center
Address	205 W Springdale Ave
City	Knoxville
State	TN
ZIP	37917
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	March 20, 2006

Payer Source	Total Paid
Medicaid	$198.7M
Medicare	$0

Key Findings

HELEN ROSS MCNABB CENTER is essentially a Medicaid-focused mental health provider: it reports no Medicare revenue on file and $198.7M in lifetime Medicaid revenue, making it effectively single-payer in the available dataset. This concentration means all utilization and payment patterns on record come from Medicaid programs rather than Medicare fee-for-service.

Revenue is highly concentrated in a very small set of Medicaid service lines: the precomputed top three Medicaid codes account for 65.9% of the provider’s total Medicaid revenue, indicating a business model built around a few high-volume/high-revenue services rather than a broad, even mix of codes.

The single largest revenue code is S0280 (Medical home program, comprehensive care coordination and planning, initial plan), which generates $80.7M or 40.6% of the provider’s Medicaid revenue and ranks the provider #4 of 40 in-state. This emphasizes that the organization operates significant care-coordination and medical-home activity and relies heavily on that program as a revenue driver.

Psychotherapy services also represent a major portion of volume and revenue: 90834 alone brings $32.1M (16.2% of Medicaid revenue) and the provider ranks #2 of 360 in-state, labeled an "extreme outlier." Combined with other psychotherapy codes (90832, 90837, 90847, 90846), the mix points to a large outpatient psychotherapy footprint serving many patients across multiple visit lengths and family therapy modalities.

Per-diem community support and residential services are another key component: H0037 ($18.1M, 9.1%) and H0043 ($12.1M, 6.1%) appear among top revenue sources, and the provider sits in solid state-level percentiles for those codes. The presence of high-dollar per-diem and residential codes such as H0019 ($8.9M) and T2048 ($3M) indicates the organization delivers both community-based support and longer-term residential behavioral health services in addition to outpatient care.

The provider shows multiple extreme or notable outlier rankings in the state for high-volume codes beyond S0280 and 90834: it is 100th percentile for 99213 and 99212 (very high-volume evaluation-and-management visits), 100th percentile for 90847 (family psychotherapy), and 99th percentile for 90791 and 99214. These percentile placements indicate HELEN ROSS MCNABB CENTER is a dominant state-level provider for several core mental-health and outpatient E/M services.

Operational tenure is long-standing: the NPI was enumerated on 2006-03-20 (approximately 20 years ago), supporting the interpretation that the current scale and code mix reflect an established organization with sustained Medicaid activity rather than a short-term billing phenomenon.

Taken together, the code mix suggests an integrated behavioral-health operation that combines medical-home care coordination (S0280), high-volume individual and family psychotherapy (90834, 90847, 90846), routine outpatient evaluation-and-management visits (99213/99214/99212), and per-diem community/residential supports (H0037, H0043, H0019). That combination is consistent with a community mental health center model that delivers both ambulatory therapy and longer-term support services under Medicaid payment streams.

Medicaid: Complete Services Breakdown

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

47 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S0280	Medical home program, comprehensive care coordination and planning, initial plan	524,010	$150	$80.7M
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…	493,860	$70	$32.1M
H0037	Community psychiatric supportive treatment program, per diem	205,440	$90	$18.1M
H0043	Supported housing, per diem	132,020	$90	$12.1M
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	3,160	$2,820	$8.9M
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…	200,590	$40	$7.6M
H2016	Comprehensive community support services, per diem	74,640	$100	$7.2M
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…	86,370	$50	$4.5M
H2015	Comprehensive community support services, per 15 minutes	4,370	$870	$3.8M
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…	56,460	$70	$3.7M

Showing 1–10 of 47

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Helen Ross Mcnabb Center — 11 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

47 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2048	Behavioral health; long-term care residential (non-acute care in a residential treatment program where stay is typically longer than 30 days), with room and board, per diem	12	10	770	$9,920	$22M
S0280	Medical home program, comprehensive care coordination and planning, initial plan	4	40	22,180	$140	$21.3M
H0037	Community psychiatric supportive treatment program, per diem	3	20	20,260	$150	$19.4M
H0043	Supported housing, per diem	5	20	69,350	$180	$18.6M
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	20	1,590	$1,740	$16.5M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	13	10	2,040	$430	$7.7M
H2020	Therapeutic behavioral services, per diem	15	40	880	$1,910	$5.9M
H2016	Comprehensive community support services, per diem	1	10	32,860	$130	$4.8M
H2018	Psychosocial rehabilitation services, per diem	8	10	38,180	$80	$3.3M
H2015	Comprehensive community support services, per 15 minutes	4	10	5,740	$110	$2.4M

Showing 1–10 of 47

Related Providers

Other providers that share a Tax Identification Number (TIN) with Helen Ross Mcnabb Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Anne Greenwald	TN	Certified Registered Nurse Anesthetist	$62.1K	$0

Nearby Providers

Other providers in the same ZIP code as Helen Ross Mcnabb Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Knoxville Hma Physician Management, LLC	TN	Pulmonary Disease Physician	$0	$8.7M
University Of Tn Medical Center Home Care Services, LLC	TN	Community Based Hospice Care Agency	$0	$7.8M
Sertoma Center, Inc.	TN	Developmentally Disabled Services Day Training Agency	$0	$7.4M
Knox County Goverment	TN	Public Health or Welfare Agency	$0	$2.6M
Michael Chavin	TN	Pain Medicine (Anesthesiology) Physician	$38.9K	$1.1M
Nilesh Patel	TN	Radiation Oncology Physician	$329.6K	$0
Srinivas Boppana	TN	Radiation Oncology Physician	$324.8K	$0
Douglas Luttrell	TN	Nurse Practitioner	$145.3K	$0
Robert Hancock	TN	Podiatrist	$129.5K	$0
Heather Sandberg	TN	Podiatrist	$128.7K	$0

Helen Ross Mcnabb Center — Billing Profile & Reimbursement Data

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Helen Ross Mcnabb Center — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References