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.

Washington County Mental Health Services, Inc. (NPI 1710901939)

Field	Value
Entity Type	Organization
Organization	Washington County Mental Health Services, Inc.
Address	50 Granview Dr
City	Barre
State	VT
ZIP	05641
Taxonomy	Developmental Disabilities Clinic/Center
NPI Enumerated	July 27, 2006

Payer Source	Total Paid
Medicaid	$145M
Medicare	$0

Key Findings

WASHINGTON COUNTY MENTAL HEALTH SERVICES, INC. appears to be effectively a Medicaid-only billing entity in the dataset: total Medicare revenue is none (no Medicare billing on file) while total Medicaid revenue is $145M. Its NPI was enumerated on 2006-07-27 (~20 years ago), indicating long-standing participation in state Medicaid programs.

Revenue is extremely concentrated in a very small set of Medicaid codes: the precomputed top 3 Medicaid codes by revenue account for 99.9% of this provider's total Medicaid revenue. In particular, 99199 accounts for $101.7M (70.1% of total Medicaid revenue) and H2022 accounts for $42.9M (29.6% of total Medicaid revenue), so operational and reimbursement risk is heavily tied to how those codes are paid and audited.

The top revenue-driving codes imply a service model focused on community-based, non-standardized supports rather than fee-for-service medical visits. 99199 (described as “other medicine services or procedures”) is the single largest revenue source and, together with H2022 (Community-based wrap-around services, per diem), suggests the organization primarily delivers wrap-around and other comprehensive community supports consistent with its Developmental Disabilities Clinic/Center taxonomy.

Competitive standing for the largest codes is mixed statewide: 99199 ranks #3 of 16 (87th percentile; typical, unremarkable volume for this code), indicating the provider is among the state’s leaders on revenue for that uncoded/other-services category. H2022 ranks #6 of 14 (62th percentile; typical, unremarkable volume for this code), which positions the provider in the mid-pack for per-diem community wrap-around services rather than as a dominant statewide operator for that code.

Psychotherapy and outpatient E/M services exist but produce a negligible share of revenue: 90837 generated $308.7K (0.2% of total Medicaid revenue) and 99213 generated $2.4K (0.0% of total Medicaid revenue). 90837 ranks #116 of 666 (83th percentile; typical, unremarkable volume for this code), so while behavioral-health therapy is provided, it is not a primary revenue driver relative to the wrap-around and other-service codes.

The claims data include very large claim-volume lines with $0 avg paid/claim and $0 recorded revenue, which likely reflect waiver, residency, or voucher-style services captured in the dataset without direct paid amounts here. Examples include S5140 (131.5K claims), T2021 (61.5K claims), T2017 (41.5K claims), T1016 (56.4K claims) and others; these high-claim, $0-revenue entries indicate substantial non-fee-for-service activity or separately funded waiver/respite/residential programs that appear in claims counts but do not contribute to the $145M revenue total in this file.

There is a notable statistical signal in at least one volume-only code: T2017 is listed as #1 of 10 with the plain-English label “notably above typical state volume for this code,” which flags unusually high state-level utilization for that habilitation/residential waiver line even though it shows $0 recorded revenue in this dataset. Analysts should treat such high-volume, $0-revenue codes as operational activity that may be funded or reported outside traditional paid-claims lines.

Operational and payer-mix implications are clear: the provider is highly dependent on two Medicaid revenue lines (99199 and H2022) for the vast majority of its reported Medicaid receipts, making strategic shifts, reimbursement changes, or coding policy updates for those specific codes a likely major driver of financial impact. Given the absence of Medicare billing, any payer strategy or risk assessment should be centered on Medicaid policy, state waiver rules, and the management of high-volume, low-/no-payment waiver claim categories.

Medicaid: Complete Services Breakdown

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

21 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	16,180	$6,290	$101.7M
H2022	Community-based wrap-around services, per diem	20,840	$2,060	$42.9M
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	3,810	$80	$308.7K
H2017	Psychosocial rehabilitation services, per 15 minutes	1,380	$60	$77.2K
H2015	Comprehensive community support services, per 15 minutes	160	$80	$12.8K
90832	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…	280	$40	$10.8K
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…	130	$70	$8.5K
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…	240	$10	$2.4K
H2023	Supported employment, per 15 minutes	780	$0	$0
H2025	Ongoing support to maintain employment, per 15 minutes	10,850	$0	$0

Showing 1–10 of 21

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

Washington County Mental Health Services, Inc. — 0 of 8 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

21 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	3	20	6,570	$6,270	$59.7M
H2022	Community-based wrap-around services, per diem	6	10	18,970	$620	$35.6M
H2015	Comprehensive community support services, per 15 minutes	18	20	64,230	$90	$7.1M
H2017	Psychosocial rehabilitation services, per 15 minutes	18	30	6,730	$110	$4.1M
T2033	Residential care, not otherwise specified (nos), waiver; per diem	3	10	16,040	$90	$1.5M
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	116	670	760	$70	$143.9K
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…	217	320	760	$20	$88.2K
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…	109	170	360	$20	$35.9K
T1016	Case management, each 15 minutes	5	40	3,900	$1	$31.1K
90832	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…	53	110	260	$20	$19.5K

Showing 1–10 of 21

Nearby Providers

Other providers in the same ZIP code as Washington County Mental Health Services, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Clearchoicemd, PLLC	VT	Urgent Care Clinic/Center	$0	$10.8M
Pride Support Services Inc	VT	Case Management Agency	$0	$4.4M
Town Of Barre	VT	Land Ambulance	$631.7K	$1.6M
Central Vermont Dental Center	VT	Dentist	$0	$2.2M
Gifford Health Care, Inc	VT	Federally Qualified Health Center (FQHC)	$0	$2M
City Of Barre	VT	Land Ambulance	$202.5K	$1.1M
Jennie Holden	VT	Clinical Psychologist	$0	$1.1M
Elevate Youth Services Incorporated	VT	Case Management Agency	$0	$1.1M
Jennie Holden Plc	VT	Clinical Psychologist	$0	$1M
Fischer, Ziegler And Lundberg Orthodontics	VT	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$895.5K

Washington County Mental Health Services, Inc. — Billing Profile & Reimbursement Data

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Washington County Mental Health Services, 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