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.

Brattleboro Retreat (NPI 1730185232)

Field	Value
Entity Type	Organization
Organization	Brattleboro Retreat
Address	22 Anna Marsh Lane
City	Brattleboro
State	VT
ZIP	05302
Taxonomy	Psychiatric Hospital
NPI Enumerated	June 21, 2005

Payer Source	Total Paid
Medicaid	$7.7M
Medicare	$0

Key Findings

This provider is effectively single-payer in scope: there is no Medicare billing on file and lifetime Medicaid revenue is $7.7M, indicating Medicaid is the sole material public payer reported for BRATTLEBORO RETREAT. Analysts should treat findings below as Medicaid-dominant and not rely on Medicare comparisons for this entity.

Revenue is highly concentrated in a small set of Medicaid codes: the precomputed top three Medicaid codes account for 50.5% of the provider's total Medicaid revenue, led by 99232 ($1.5M, 19.6%) and H0020 ($1.5M, 19.0%), with 99233 contributing $919.6K (12.0%). This concentration means a few service lines drive the majority of revenue and will be high-impact for any contract or utilization review.

The code mix shows a strong inpatient and observation care footprint: high-volume inpatient E/M codes such as 99232 ($1.5M, 19.6%), 99233 ($919.6K, 12.0%), 99223 ($175.6K, 2.3%), 99231 ($173.8K, 2.3%) and discharge code 99239 ($86.1K, 1.1%) indicate the provider operates substantial hospital-based psychiatric inpatient services and spends material capacity on subsequent and high-complexity inpatient encounters. Multiple inpatient codes also rank at the top statewide (for example 99232 ranks #1 of 22 providers in-state (100th percentile; extreme outlier, far above typical state volume for this code)), supporting an inpatient-focused operational profile.

Behavioral health and substance-use treatment represent a second major service line: psychotherapy 90834 generates $852.3K (11.1%) and ranks #3 of 165 providers in-state (99th percentile; extreme outlier), while substance-use treatment codes including H0020 (methadone administration, $1.5M, 19.0%), H0019 (long-term residential, $652.4K, 8.5%) and H0005 (group counseling, $284.9K, 3.7%) make up sizeable shares of Medicaid revenue. Medication-assisted treatment also appears significant with J0574 ($379.1K, 4.9%) and J0575 ($325K, 4.2%) on the top-code list, indicating both pharmacologic and programmatic addiction services.

Competitive standing in-state is strong and concentrated: the provider ranks at or near the top statewide for many inpatient E/M codes (examples include 99232, 99233 and 99223 where it ranks #1 and appears as an outlier or notably above typical state volume), and 90834 places it among the very highest-volume psychotherapy providers in Vermont. At the same time, some addiction codes like H0020 show a more typical peer position (H0020 ranks #8 of 9 providers in-state (13th percentile; typical, unremarkable volume for this code)), suggesting dominance varies by specific service.

Operational implications from the code mix point to integrated inpatient psychiatric care with embedded behavioral and addiction treatment: the concurrent presence of high inpatient E/M volumes, high psychotherapy billing (90834), long-term residential (H0019) and medication administration codes (H0020, J0574/J0575) is consistent with a facility that provides inpatient stabilization plus ongoing substance-use treatment and therapy. Payers should expect utilization profiles that combine long inpatient stays and frequent follow-up E/M visits with bundled behavioral health programs.

Tenure is long-standing: the NPI was enumerated on 2005-06-21 (~21 years ago), indicating BRATTLEBORO RETREAT is an established provider in the market. This longevity, combined with the concentrated Medicaid revenue base, suggests entrenched service lines that are likely important to local behavioral health capacity.

Medicaid: Complete Services Breakdown

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

41 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	33,480	$50	$1.5M
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	3,670	$400	$1.5M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	15,330	$60	$919.6K
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…	20,790	$40	$852.3K
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	3,670	$180	$652.4K
J0574	Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine	2,330	$160	$379.1K
J0575	Buprenorphine/naloxone, oral, greater than 10 mg buprenorphine	1,360	$240	$325K
H0005	Alcohol and/or drug services; group counseling by a clinician	3,130	$90	$284.9K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	1,600	$110	$175.6K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	8,690	$20	$173.8K

Showing 1–10 of 41

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

Brattleboro Retreat — 9 of 25 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

41 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	8	10	17,110	$40	$13.6M
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	2	10	510	$4,230	$6.6M
J0575	Buprenorphine/naloxone, oral, greater than 10 mg buprenorphine	4	10	1,360	$50	$551.1K
J0574	Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine	7	10	6,550	$30	$483.4K
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…	5	10	660	$120	$303.7K
H0004	Behavioral health counseling and therapy, per 15 minutes	17	20	1,410	$80	$247.4K
H0005	Alcohol and/or drug services; group counseling by a clinician	6	10	630	$60	$243.1K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	8	10	16,150	$20	$239.2K
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…	104	320	680	$30	$146.1K
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…	542	670	760	$70	$143.9K

Showing 1–10 of 41

Related Providers

Other providers that share a Tax Identification Number (TIN) with Brattleboro Retreat, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Philip Laplante	VT	Child & Adolescent Psychiatry Physician	$9.9K	$242.6K
Jeffrey Haines	NH	Psychiatry Physician	$115.7K	$0
Scott Robinson	VT	Psychiatric/Mental Health Nurse Practitioner	$0	$54.7K
Dorothea De Gutis	VT	Neurology Physician	$42.4K	$0
Rachael Kandath	VT	Psychiatry Physician	$29.3K	$0
Sara Gilbert	NH	Psychiatric/Mental Health Nurse Practitioner	$28.4K	$0
Marc Laurens	VT	Clinical Social Worker	$27K	$0
Susan Fields	VT	Clinical Social Worker	$25K	$0

Nearby Providers

Other providers in the same ZIP code as Brattleboro Retreat, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Percy Ballantine	VT	Psychiatry Physician	$29.8K	$0
Christopher Snow	VT	Physician Assistant	$24.1K	$0

Brattleboro Retreat — Billing Profile & Reimbursement Data

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Brattleboro Retreat — 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