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.

Riverside Community Care, Inc. (NPI 1780791467)

Field	Value
Entity Type	Organization
Organization	Riverside Community Care, Inc.
Address	190 Lenox St
City	Norwood
State	MA
ZIP	02062
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	August 25, 2006

Payer Source	Total Paid
Medicaid	$108.4M
Medicare	$0

Key Findings

RIVERSIDE COMMUNITY CARE is effectively a Medicaid-focused provider with $108.4M in lifetime Medicaid revenue and no Medicare billing on file; the NPI was enumerated on 2006-08-25 (~20 years ago), indicating long-standing presence in the state Medicaid market. This payer concentration makes Medicaid policy and rate changes especially material to the organization’s financial profile.

Revenue is highly concentrated: the top three Medicaid codes (90834, S9485, T1040) together account for 50.3% of the provider’s total Medicaid revenue. Specifically, 90834 accounts for $19.7M (18.2%), S9485 for $18.6M (17.2%), and T1040 for $16.1M (14.9%), which signals reliance on a small set of high-volume/per‑diem services.

The code mix for the top revenue drivers (90834 psychotherapy, S9485 crisis intervention per diem, and T1040 certified community behavioral health clinic per diem) points to an operation built around outpatient psychotherapy, crisis response, and clinic-based community behavioral health services. This combination suggests RIVERSIDE runs high-volume therapy panels plus per-diem crisis/clinic programs rather than being primarily an inpatient or medical-subspecialty practice.

On competitive standing, RIVERSIDE is a dominant statewide provider for psychotherapy volume: 90834 ranks #9 of 1617 providers in-state (100th percentile) and is labeled an extreme outlier, indicating substantially higher psychotherapy throughput than typical peers. That same outsized behavioral therapy footprint is reinforced by 90832 (rank #7 of 565, 99th percentile; extreme outlier) and 90837 (rank #11 of 1019, 99th percentile; notably above typical), showing elevated volumes across short, standard and long psychotherapy codes.

The provider also ranks highly for crisis and clinic per‑diem services: S9485 is #8 of 113 providers in-state (94th percentile; notably above typical state volume) and T1040 is #6 of 167 (97th percentile; notably above typical state volume). These ranks indicate RIVERSIDE is a major regional player in crisis intervention and Medicaid-certified community behavioral health clinic delivery.

RIVERSIDE reports substantial activity in high-volume outreach and support codes consistent with community-based care: H0023 (251K claims, $13.3M, 12.3% of revenue) shows very large encounter counts and is ranked #8 of 37 in-state (81th percentile; typical, unremarkable volume), while H2019 (79.2K claims, $9.7M, 8.9% of revenue) ranks #20 of 294 (94th percentile; typical, unremarkable volume). Together these entries underscore a broad service footprint that includes outreach, therapeutic behavioral services, and per‑diem community supports.

Non‑per‑diem E/M and longer psychotherapy codes also contribute meaningfully: 99214 generates $3.8M (3.5%) and ranks #42 of 5039 (99th percentile; extreme outlier), while 90837 contributes $3.7M (3.4%) and ranks #11 of 1019 (99th percentile; notably above typical). Those placements indicate RIVERSIDE maintains sizeable clinic-based evaluation/management capacity in addition to therapy and crisis services.

Operationally, the provider’s dependence on a handful of high-revenue codes (top three = 50.3% of Medicaid revenue) means revenue sensitivity to changes in reimbursement, prior authorization, or program eligibility that affect psychotherapy per‑visit rates or crisis/CCBHC per‑diem payments. Analysts should monitor state rate-setting and CCBHC policy updates, as shifts there would disproportionately affect RIVERSIDE’s financials.

Medicaid: Complete Services Breakdown

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

55 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	265,690	$70	$19.7M
S9485	Crisis intervention mental health services, per diem	31,000	$600	$18.6M
T1040	Medicaid certified community behavioral health clinic services, per diem	75,110	$210	$16.1M
H0023	Alcohol and/or drug outreach	251,000	$50	$13.3M
H2019	Therapeutic behavioral services, per 15 minutes	79,210	$120	$9.7M
H2011	Crisis intervention service, per 15 minutes	49,110	$140	$6.7M
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…	65,970	$60	$3.8M
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…	38,040	$100	$3.7M
H2016	Comprehensive community support services, per diem	159,580	$20	$3M
H2012	Behavioral health day treatment, per hour	28,230	$70	$2M

Showing 1–10 of 55

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

Riverside Community Care, Inc. — 11 of 25 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

55 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0023	Alcohol and/or drug outreach	8	40	127,370	$50	$8.2M
H2015	Comprehensive community support services, per 15 minutes	55	150	7,770	$140	$4.8M
S9485	Crisis intervention mental health services, per diem	8	110	1,250	$540	$3.2M
H2019	Therapeutic behavioral services, per 15 minutes	20	290	3,680	$150	$2.9M
H0040	Assertive community treatment program, per diem	10	20	22,090	$50	$2.8M
T2022	Case management, per month	74	80	7,230	$50	$2.6M
T1024	Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter	39	50	3,060	$240	$2.4M
T1027	Family training and counseling for child development, per 15 minutes	28	130	4,300	$110	$2.1M
H2011	Crisis intervention service, per 15 minutes	3	40	3,970	$140	$2M
T1040	Medicaid certified community behavioral health clinic services, per diem	6	170	950	$200	$1.8M

Showing 1–10 of 55

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Riverside Community Care	MA	State or Local Public Health Clinic/Center	$0	$6.5M
Pamela Hoyt	MA	Psychiatry Physician	$72.3K	$0
Richard Goggin	MA	Clinical Social Worker	$20.7K	$0

Nearby Providers

Other providers in the same ZIP code as Riverside Community Care, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Reliable Respiratory, Inc.	MA	Oxygen Equipment & Supplies (DME)	$0	$39.9M
Seasons Hospice & Palliative Care Of Massachusetts, LLC	MA	Community Based Hospice Care Agency	$0	$30.9M
Steward Norwood Hospital, Inc.	MA	General Acute Care Hospital	$0	$8.5M
Epoch Health Care LLC.	MA	Non-emergency Medical Transport (VAN)	$0	$6.5M
Town Of Norwood	MA	Land Ambulance	$655.7K	$1.5M
Om Diagnostic Laboratories Inc.	MA	Clinical Medical Laboratory	$17.4K	$1M
Anu Jayaraman	MA	Dermatology Physician	$748.5K	$0
Eastern Massachusetts Surgery Center LLC	MA	Ambulatory Surgical Clinic/Center	$667.8K	$3.7K
Niels Krejci	MA	MOHS-Micrographic Surgery Physician	$579.6K	$0
Mmds Of Boston, LLC	MA	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	$386.8K	$154.9K

Riverside Community Care, Inc. — Billing Profile & Reimbursement Data

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Riverside Community Care, 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