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

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

Kennebec Valley Mental Health Center (NPI 1679504864)

Field	Value
Entity Type	Organization
Organization	Kennebec Valley Mental Health Center
Address	67 Eustis Pkwy
City	Waterville
State	ME
ZIP	04901
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	July 5, 2006

Payer Source	Total Paid
Medicaid	$143M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-centric operation: there is no Medicare billing on file and the provider reports $143M in lifetime Medicaid revenue, indicating the organization operates almost entirely within the Medicaid program rather than a mixed Medicare/Medicaid payer mix. The absence of Medicare claims suggests benefit design, referral patterns, or licensing that concentrates revenue and patient contacts under Medicaid.

Revenue is highly concentrated in a small set of services: the top 3 Medicaid codes (H0019, H2030, H2010) together account for 70.0% of the provider's total Medicaid revenue. Individually these top codes are H0019 ($44.5M, 31.1%), H2030 ($28M, 19.6%), and H2010 ($27.6M, 19.3%), so a majority of dollars come from a mix of per-diem residential and high-volume per-15-minute community services.

The code mix and volumes point to a service model focused on residential and intensive community mental health care: H0019 is long-term residential per diem (4.2K claims, $10638 avg paid/claim), while H2030 (250.1K claims) and H2010 (220.9K claims) are high-volume, time-based clubhouse and comprehensive medication services billed per 15 minutes. This pattern suggests the center operates both higher-cost residential beds and a large-scale, time-intense community program structure (clubhouse services and medication management) rather than primarily brief office-based E/M care.

Competitive standing is mixed across service lines within the state: the provider is a statewide leader for comprehensive medication services (H2010 ranks #1 of 49 providers, 100th percentile, described as an extreme outlier) and for mental health clubhouse services H2030 (ranks #1 of 2, 100th percentile), indicating dominance in those niches. By contrast, H0019 (long-term residential) ranks #23 of 28 (19th percentile), so the provider is not a leading statewide player in residential long-term services compared with its peers.

Counseling and psychosocial rehab capacity is also a notable revenue driver: H0004 (behavioral health counseling and therapy) produces $13.6M (9.5%) on 174.1K claims and ranks #4 of 290 providers (99th percentile, labeled an extreme outlier). Additional codes such as H2018 (psychosocial rehabilitation, $4.8M, ranks #2 of 8, 86th percentile) and T1017 (targeted case management, $2.3M, ranks #13 of 104, 88th percentile) reinforce that the center provides large-scale therapy, rehab, and case management services in addition to medication management and clubhouse programming.

Several codes are flagged as statewide statistical outliers for unusually high relative volume, which highlights specialized strengths rather than anomalies in billing intensity: in addition to H2010 and H0004 being described as extreme outliers, H2000 (comprehensive multidisciplinary evaluation) ranks #1 of 90 (100th percentile) and 99443 ranks #1 of 50 (100th percentile). These rankings suggest unusually high capacity or focus on multidisciplinary evaluations and certain remote/telephonic services compared with most in-state peers.

The provider has been in the national enrollment file for a long period, with NPI enumeration on 2006-07-05 (~20 years ago), indicating an established organization and sustained presence in the state Medicaid ecosystem. That tenure combined with concentrated Medicaid revenue and multiple top-state rankings is consistent with an entrenched community mental health center that has developed significant scale in select service lines over many years.

Medicaid: Complete Services Breakdown

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
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	4,180	$10,640	$44.5M
H2030	Mental health clubhouse services, per 15 minutes	250,090	$110	$28M
H2010	Comprehensive medication services, per 15 minutes	220,950	$130	$27.6M
H0004	Behavioral health counseling and therapy, per 15 minutes	174,070	$80	$13.6M
H2033	Multisystemic therapy for juveniles, per 15 minutes	13,750	$460	$6.4M
T1020	Personal care services, per diem, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	4,180	$1,330	$5.6M
H2018	Psychosocial rehabilitation services, per diem	56,470	$90	$4.8M
G9012	Other specified case management service not elsewhere classified	40,780	$70	$2.9M
H2021	Community-based wrap-around services, per 15 minutes	14,180	$170	$2.4M
T1017	Targeted case management, each 15 minutes	35,370	$70	$2.3M

Showing 1–10 of 29

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Maine Distribution

Kennebec Valley Mental Health Center — 6 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maine

Full comparison — all codes billed, vs. Maine median

29 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	23	30	13,990	$560	$23.9M
H2030	Mental health clubhouse services, per 15 minutes	1	10	149,910	$110	$16M
T1020	Personal care services, per diem, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	16	20	8,350	$340	$9.2M
H2021	Community-based wrap-around services, per 15 minutes	36	100	8,660	$290	$5.1M
H2018	Psychosocial rehabilitation services, per diem	2	10	28,460	$110	$3.3M
H2033	Multisystemic therapy for juveniles, per 15 minutes	1	10	2,390	$490	$3M
G9012	Other specified case management service not elsewhere classified	20	50	25,820	$80	$3M
H2015	Comprehensive community support services, per 15 minutes	17	70	7,120	$100	$1.7M
H2010	Comprehensive medication services, per 15 minutes	1	50	3,690	$130	$1.6M
T1017	Targeted case management, each 15 minutes	13	100	4,690	$90	$1M

Showing 1–10 of 29

Related Providers

Other providers that share a Tax Identification Number (TIN) with Kennebec Valley Mental Health Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Marin Godsoe	ME	Clinical Psychologist	$21.7K	$0
Karalyn Corbett	ME	Clinical Social Worker	$1.6K	$0

Nearby Providers

Other providers in the same ZIP code as Kennebec Valley Mental Health Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jmpb Inc.	ME	Community/Behavioral Health Agency	$0	$40.2M
Discovery House Of Central Maine, Inc.	ME	Methadone Clinic	$398.8K	$24.5M
Care & Comfort	ME	Mental Health Counselor	$0	$24.8M
Eastern Maine Healthcare Systems Inland Hospital	ME	General Acute Care Hospital	$0	$18.3M
Blue Sky Counseling P.C.	ME	Community/Behavioral Health Agency	$0	$11.6M
Maine General Community Care	ME	Case Management Agency	$0	$11.4M
Delta Ambulance Corp.	ME	Land Ambulance	$985.5K	$9.8M
Paramount Behavioral Services, Inc	ME	Community/Behavioral Health Agency	$0	$9.3M
Waters Edge Therapy, Inc	ME	Community/Behavioral Health Agency	$0	$5.2M
R&k LLC	ME	Community/Behavioral Health Agency	$0	$4.6M

Kennebec Valley Mental Health Center — Billing Profile & Reimbursement Data

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Kennebec Valley Mental Health 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