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

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

Gavin Foundation, Inc. (NPI 1750895413)

Field	Value
Entity Type	Organization
Organization	Gavin Foundation, Inc.
Address	43 Old Colony Ave
City	Quincy
State	MA
ZIP	02170
Taxonomy	Mental Illness Community Based Residential Treatment Facility
NPI Enumerated	November 16, 2017

Payer Source	Total Paid
Medicaid	$6.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

11 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	18,650	$170	$3.1M
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	4,820	$250	$1.2M
H2016	Comprehensive community support services, per diem	1,240	$530	$655.1K
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	1,210	$520	$631.3K
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…	4,400	$90	$386.8K
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…	4,280	$70	$316.9K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	1,170	$130	$146.3K
99404	At an encounter separate from a preventive medicine visit, the provider offers counseling related to subjects appropriate for the patient’s age, family history, and areas of concern. The subjects…	120	$160	$19.6K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	290	$30	$9.6K
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…	100	$50	$5.4K

Showing 1–10 of 11

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

Gavin Foundation, Inc. — 0 of 11 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

11 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	22	80	5,200	$370	$8.4M
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	14	30	1,210	$760	$3.9M
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	10	30	1,910	$480	$3.5M
H2016	Comprehensive community support services, per diem	54	80	4,550	$30	$1.6M
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…	20	60	2,800	$110	$659.4K
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…	256	1,620	580	$80	$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…	4,074	5,040	200	$70	$209.5K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	97	600	90	$110	$106.8K
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…	402	570	400	$40	$106.7K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	174	290	490	$30	$79K

Showing 1–10 of 11

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gavin Foundation	MA	Clinic/Center	$0	$50.8M

Gavin Foundation, Inc. — Billing Profile & Reimbursement Data

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Gavin Foundation, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Frequently Asked Questions

References