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.

Health Connect America, Inc (NPI 1730366824)

Field	Value
Entity Type	Organization
Organization	Health Connect America, Inc
Address	508 Autumn Springs Ct Ste 2a
City	Franklin
State	TN
ZIP	37067
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	January 30, 2008

Payer Source	Total Paid
Medicaid	$285.6M
Medicare	$0

Key Findings

HEALTH CONNECT AMERICA, INC is effectively a single-payer Medicaid provider: there is no Medicare billing on file and total Medicaid revenue is $285.6M. The provider’s NPI was enumerated 2008-01-30 (~18 years ago), indicating a long-enough tenure to have established large Medicaid programs and payer relationships at the state level.

Revenue concentration is high: the precomputed top three Medicaid codes account for 63.3% of the provider’s Medicaid revenue. Those top codes are S0280 ($83.1M, 29.7%), H0037 ($75.9M, 27.1%), and 90837 ($18.3M, 6.5%), showing most dollars come from a very small set of service lines.

The code mix signals an integrated behavioral health and care-coordination operation: S0280 (medical home program and comprehensive care coordination), G9002 (coordinated care fee), and T1017 (targeted case management) point to formal care-management and medical-home activities, while H0037 (community psychiatric supportive treatment), H0035 (partial hospitalization), and H0015 (intensive outpatient for substance use) reflect substantial high-intensity behavioral health programming. This combination suggests the provider bills both day/partial-hospital models and ongoing outpatient psychotherapy services rather than being limited to brief office-based encounters.

Several codes show dominant statewide standing: H0037 ranks #1 of 16 providers in-state (100th percentile; extreme outlier) and H0035 ranks #1 of 20 (100th percentile; extreme outlier), indicating volumes far above typical peers for community psychiatric supportive treatment and partial hospitalization. 90837 ranks #2 of 436 providers in-state (100th percentile; extreme outlier), reinforcing that the provider is a major statewide player for long psychotherapy sessions as well.

Operational scale is evidenced by very large claim volumes for core services: H0037 has 872K claims, S0280 has 543.3K claims, and 90837 has 219.9K claims. Those claim counts, together with multiple additional high-volume psychotherapy and family-therapy codes (90834 104.2K claims; 90832 59.1K claims; 90847 30.6K claims; 90846 27.3K claims), indicate high throughput and broad service delivery capacity across both individual and family-focused modalities.

The provider is a consistent outlier across numerous Medicaid behavioral-health codes beyond the top three: several codes rank #1 in-state (for example H0037, H0035, H0015, H2012, H2033, H2015, H2019, H0031, H0035 and others report 100th-percentile or near-100th-percentile standing). These repeated "extreme outlier" and "notably above typical" labels suggest market dominance in specialized community psychiatric and intensive behavioral programs within Tennessee.

There is measurable diversification within behavioral health subservices but also notable concentration risk: while multiple service types are billed (case management, psychotherapy of different durations, partial hospitalization, day treatment, and substance-use intensive outpatient), a small number of codes (the top three) together make up 63.3% of Medicaid revenue. That concentration means changes to reimbursement or program rules affecting S0280, H0037, or 90837 could materially affect overall revenue.

Targeted case management and wraparound components are material parts of the mix, supporting a care-coordination model alongside clinical services: T1017 shows 101.3K claims and $3.2M revenue, T2023 shows 2.3K claims and $2M revenue, and H2022 shows 6.9K claims and $2M revenue. These items reinforce that the provider’s operations include non-clinical coordination and waiver/day-habilitation elements in addition to psychotherapy and day-treatment services.

Medicaid: Complete Services Breakdown

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

52 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S0280	Medical home program, comprehensive care coordination and planning, initial plan	543,350	$150	$83.1M
H0037	Community psychiatric supportive treatment program, per diem	872,010	$90	$75.9M
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…	219,890	$80	$18.3M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	219,590	$80	$18M
G9002	Coordinated care fee, maintenance rate	158,250	$70	$11.7M
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…	109,550	$90	$10M
H2012	Behavioral health day treatment, per hour	67,260	$140	$9.2M
H2033	Multisystemic therapy for juveniles, per 15 minutes	62,000	$130	$8.1M
H2015	Comprehensive community support services, per 15 minutes	114,420	$60	$6.5M
H2019	Therapeutic behavioral services, per 15 minutes	80,950	$50	$4.2M

Showing 1–10 of 52

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

Health Connect America, Inc — 18 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

52 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2023	Targeted case management; per month	10	10	11,790	$410	$75.3M
T2033	Residential care, not otherwise specified (nos), waiver; per diem	90	100	4,520	$320	$31.6M
S0280	Medical home program, comprehensive care coordination and planning, initial plan	3	40	22,180	$140	$21.3M
H0037	Community psychiatric supportive treatment program, per diem	1	20	20,260	$150	$19.4M
H2033	Multisystemic therapy for juveniles, per 15 minutes	1	10	57,870	$280	$16.2M
T2025	Waiver services; not otherwise specified (nos)	14	20	1,030	$570	$13.3M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	3	10	2,040	$430	$7.7M
H2022	Community-based wrap-around services, per diem	2	10	6,900	$840	$6.8M
H2020	Therapeutic behavioral services, per diem	31	40	880	$1,910	$5.9M
H2016	Comprehensive community support services, per diem	2	10	32,860	$130	$4.8M

Showing 1–10 of 52

Related Providers

Other providers that share a Tax Identification Number (TIN) with Health Connect America, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Maxie Gordon	MS	Psychiatry Physician	$76.8K	$0

Nearby Providers

Other providers in the same ZIP code as Health Connect America, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Capitol City Residential Healthcare Tn LLC	TN	Developmentally Disabled Services Day Training Agency	$0	$29.4M
Summit Bhc New Jersey, LLC	TN	Substance Abuse Rehabilitation Facility	$0	$21.9M
Miller Helpers	TN	In Home Supportive Care Agency	$0	$15.3M
Results-ast Jv, LLC	TN	Physical Therapist	$0	$6.9M
Williamson County Hospital District	TN	General Acute Care Hospital	$0	$4.8M
Skin Solutions Dermatology & Skin Cancer Surgery, P.C.	TN	Specialist	$0	$4.4M
Dr. Mark Lynn & Associates, PLLC	TN	Optometrist	$0	$3.2M
Ambulatory Surgery Center Of Cool Springs LLC	TN	Ambulatory Surgical Clinic/Center	$2.5M	$0
Chase Escott	TN	Radiation Oncology Physician	$1.3M	$0
Douglas Kingma	TN	Hematology (Pathology) Physician	$1.2M	$0

Health Connect America, Inc — Billing Profile & Reimbursement Data

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Health Connect America, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References