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.

Health Care & Rehabilitaion Services (NPI 1750508107)

Field	Value
Entity Type	Organization
Organization	Health Care & Rehabilitaion Services
Address	1 Hospital Ct
City	Bellows Falls
State	VT
ZIP	05101
Taxonomy	Clinic/Center
NPI Enumerated	April 19, 2007

Payer Source	Total Paid
Medicaid	$5M
Medicare	$0

Key Findings

HEALTH CARE & REHABILITAION SERVICES presents as a behavioral health–focused clinic: its top revenue-driving codes are H2017 (Psychosocial rehabilitation services, per 15 minutes), H0040 (Assertive community treatment program, per diem), and psychotherapy code 90837. The concentration on H2017 ($4.3M revenue, 81.1K claims, $53 avg paid/claim) and large counts on psychotherapy (90837: 26.2K claims, $367.2K revenue) indicate day-program style psychosocial rehabilitation plus high-intensity outpatient psychotherapy as core services. These code choices and volumes align with community mental health and rehabilitation operations rather than primary medical care.

Revenue is highly concentrated in a very small set of Medicaid codes: the precomputed top-3 Medicaid codes account for 96.2% of the provider's total Medicaid revenue, with H2017 alone representing $4.3M (85.3% of Medicaid revenue). This makes the provider financially dependent on psychosocial rehabilitation billing to Medicaid, with secondary reliance on 90837 ($367.2K, 7.3%) and H0040 ($184.2K, 3.7%) for the remainder of material Medicaid receipts.

Payer mix is effectively single-payer Medicaid: the record shows total Medicare revenue as none and total Medicaid revenue of $5M, so Medicaid accounts for essentially all reported public-payer revenue. Analysts should treat this entity as a Medicaid-centric provider when assessing financial exposure, network contracting, and utilization patterns.

Competitive standing on key codes is mixed. For H2017 the provider ranks #4 of 28 in-state (89th percentile) — a relatively high placement but labeled “typical, unremarkable volume” for that code — while 90837 ranks #5 of 666 providers in-state (99th percentile) and is flagged as an “extreme outlier,” signaling exceptionally large psychotherapy volume relative to peers. For H0040 the provider ranks #1 of 7 (100th percentile) for assertive community treatment per diem, indicating it is the top-billing provider among a small group for that program even though that code’s volume is described as typical.

Beyond the top three, the provider reports top-in-state or notably above-typical volumes on several behavioral codes: 90847 ranks #1 of 35 (100th percentile; notably above typical state volume) and 90846 ranks #2 of 21 (95th percentile). At the same time, common office E/M codes such as 99214 and 99213 appear in the mix but together account for only small shares of Medicaid revenue ($21.9K and $13.2K respectively), underscoring that traditional outpatient medical visits are a minor revenue stream compared with psychosocial and psychotherapy services.

The dataset contains many high-claim-count codes that show $0 avg paid/claim and $0 revenue (for example, H2015 at 110.9K claims, T2016 at 20.7K claims, and H2000 at 2K claims). This pattern suggests multiple service lines are present in claims activity but are not reflected as paid Medicaid revenue in this extract, which may reflect program-specific payment structures, zero-dollar claim submissions, or data capture differences rather than absence of service delivery. Analysts should review claim-level adjudication and payer policies for those program codes before assuming those lines generate no resource use.

The provider has been enumerated for a long period (NPI enumerated 2007-04-19, approximately 19 years ago), and the combination of long tenure plus high absolute claim volumes on core behavioral codes (e.g., H2017 81.1K claims and 90837 26.2K claims) points to an established, high-volume community behavioral health operation in Vermont. This operational longevity combined with Medicaid concentration is relevant for contracting, program continuity, and market-share assessments within the state.

Medicaid: Complete Services Breakdown

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

26 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2017	Psychosocial rehabilitation services, per 15 minutes	81,050	$50	$4.3M
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…	26,230	$10	$367.2K
H0040	Assertive community treatment program, per diem	410	$450	$184.2K
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…	3,320	$20	$49.9K
H2014	Skills training and development, per 15 minutes	8,960	$10	$44.8K
H2011	Crisis intervention service, per 15 minutes	9,160	$1	$36.6K
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…	4,370	$10	$21.9K
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…	1,200	$10	$13.2K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	700	$10	$6.3K
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…	2,760	$1	$5.5K

Showing 1–10 of 26

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

Health Care & Rehabilitaion Services — 3 of 16 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

26 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2015	Comprehensive community support services, per 15 minutes	5	20	64,230	$90	$7.1M
H2017	Psychosocial rehabilitation services, per 15 minutes	4	30	6,730	$110	$4.1M
H0046	Mental health services, not otherwise specified	8	10	330	$1,360	$3.1M
T2033	Residential care, not otherwise specified (nos), waiver; per diem	6	10	16,040	$90	$1.5M
H2014	Skills training and development, per 15 minutes	6	10	7,770	$60	$599.6K
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…	64	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…	5	670	760	$70	$143.9K
H0040	Assertive community treatment program, per diem	1	10	180	$430	$99K
H2011	Crisis intervention service, per 15 minutes	4	20	1,680	$20	$96.2K
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…	134	320	760	$20	$88.2K

Showing 1–10 of 26

Nearby Providers

Other providers in the same ZIP code as Health Care & Rehabilitaion Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Health Care & Rehabilitation Services	VT	Developmental Disabilities Clinic/Center	$0	$136.1M
Health Care & Rehabilitation Services	VT	Adolescent and Children Mental Health Clinic/Center	$0	$25.4M
Springfield Medical Care Systems Inc	VT	Federally Qualified Health Center (FQHC)	$0	$7.8M
Health Care And Rehabilitation Services Of Southeastern Vermont, Inc.	VT	Developmental Disabilities Clinic/Center	$0	$1M
Sandra Cotter,lcmhc, Ladc,llc	VT	Mental Health Counselor	$0	$509.4K
Health Care And Rehabilitation Services Of Southeastern Vermont, Inc.	VT	Community/Behavioral Health Agency	$0	$507K
Waypoint Counseling LLC	VT	Mental Health Counselor	$0	$368.7K
Jordan River Dental	VT	General Practice Dentistry	$0	$185K
Timothy Johnson	VT	Optometrist	$51.3K	$99.5K
Health Care And Rehabilitation Services Of Southeastern Vermont, Inc.	VT	Substance Use Disorder Rehabilitation Clinic/Center	$0	$131.3K

Health Care & Rehabilitaion Services — Billing Profile & Reimbursement Data

Sign up for Health Care & Rehabilitaion Services — Billing Profile & Reimbursement Data policy alerts

Health Care & Rehabilitaion Services — Billing Profile & Reimbursement Data

Sign up for Health Care & Rehabilitaion Services — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References