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

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

Rappahannock Area Community Services Board (NPI 1790742153)

Field	Value
Entity Type	Organization
Organization	Rappahannock Area Community Services Board
Address	600 Jackson St
City	Fredericksburg
State	VA
ZIP	22401
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	April 28, 2006

Payer Source	Total Paid
Medicaid	$142.5M
Medicare	$0

Key Findings

This provider is effectively single‑payer in scope: there is no Medicare billing on file while lifetime Medicaid revenue totals $142.5M, meaning its entire reported Medicare/Medicaid footprint is driven by Medicaid reimbursement and exposure is concentrated in state Medicaid policy and rates. Analyses of Medicare trends or cross-payer comparisons will not be possible from this profile because Medicare activity is absent.

Revenue is highly concentrated in a small set of Medicaid service lines: the precomputed top three Medicaid codes account for 49.3% of total Medicaid revenue, with H2022 at $38.3M (27.2%), T1017 at $16.7M (11.9%), and T2033 at $14.4M (10.2%). That concentration indicates a heavy dependence on community wrap‑around per diems and targeted case management/residential waiver services for the bulk of receipts.

The code mix is consistent with a community behavioral health agency delivering longitudinal, community‑based supports: H2022 (community‑based wrap‑around per diem), T1017 (targeted case management), T2033 (residential care waiver per diem), H0043 (supported housing per diem), and H0040/H2017 (assertive community treatment and psychosocial rehabilitation) together point to a service model organized around supported housing, case management, residential services, and habilitation rather than acute medical or inpatient care. High revenue from 97150 ($13.5M, 9.6%) further suggests substantial group‑based therapeutic programming delivered at scale.

The provider is a dominant in‑state player for several Medicaid services. H2022 ranks #2 of 136 providers in the state (99th percentile; labelled an extreme outlier) and H0043 ranks #1 of 8 providers (100th percentile; notably above typical state volume), indicating market leadership in wrap‑around services and supported housing respectively; several behavioral health codes (90834 and 90791) are also flagged as extreme outliers or in very high percentiles for psychotherapy and psychiatric evaluation activity.

Other high‑volume codes are consistent with a large operational footprint but not outlier intensity: T1017 and T2033 rank #8 of 46 (84th percentile) and #6 of 43 (88th percentile) respectively — they are material contributors to revenue but described as typical or unremarkable in statewide volume compared with the extreme outliers. Additional habilitation and outreach codes (T2021, H0023, H2017, H0040) appear across the mid‑to‑high percentiles, supporting a broad community services portfolio rather than a narrowly specialized program.

The provider reports very high claim counts on low‑unit E/M and psychotherapy codes, which indicates a large outpatient caseload delivered through frequent, lower‑paid encounters: 99213 has 47.1K claims and $2M revenue and ranks #49 of 4012 providers in‑state (99th percentile; notably above typical state volume), while 90834 has 23.1K claims and $1.5M revenue and ranks #8 of 661 providers (99th percentile; extreme outlier). This pattern signals operational capacity for high‑throughput outpatient behavioral health visits and routine ambulatory management.

The NPI was enumerated on 2006‑04‑28 (~20 years ago), indicating the organization has an established presence and a long tenure in the state Medicaid market; that duration aligns with the scale and depth of Medicaid service lines shown in the billing mix. Historical presence may support entrenched referral networks and longstanding contracts for community behavioral health services.

The combination of high concentration (49.3% of Medicaid revenue in the top three codes) and leadership positions in specific service lines presents both risk and opportunity: the provider is sensitive to reimbursement or policy changes affecting H2022, T1017, T2033, and supported housing payments, but its demonstrated statewide dominance in wrap‑around and supported housing services also creates leverage for negotiations and partnerships with payers and local agencies. Monitoring policy shifts for these specific codes should be a priority for payer/provider analysts.

Medicaid: Complete Services Breakdown

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

43 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2022	Community-based wrap-around services, per diem	117,100	$330	$38.3M
T1017	Targeted case management, each 15 minutes	48,160	$350	$16.7M
T2033	Residential care, not otherwise specified (nos), waiver; per diem	48,320	$300	$14.4M
97150	In this procedure, the provider supervises and directs therapeutic procedures like exercise therapy for a group of patients.	9,900	$1,370	$13.5M
H0043	Supported housing, per diem	47,950	$270	$13M
T2021	Day habilitation, waiver; per 15 minutes	8,530	$810	$6.9M
H0023	Alcohol and/or drug outreach	19,650	$330	$6.5M
H0046	Mental health services, not otherwise specified	9,670	$430	$4.2M
H2017	Psychosocial rehabilitation services, per 15 minutes	68,180	$50	$3.5M
H0040	Assertive community treatment program, per diem	16,670	$210	$3.5M

Showing 1–10 of 43

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Virginia Distribution

Rappahannock Area Community Services Board — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

43 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2033	Residential care, not otherwise specified (nos), waiver; per diem	6	40	6,080	$1,660	$27.6M
H2022	Community-based wrap-around services, per diem	2	140	4,450	$1,150	$15.3M
H0023	Alcohol and/or drug outreach	30	50	33,630	$320	$15M
T1017	Targeted case management, each 15 minutes	8	50	23,860	$330	$9.4M
H0043	Supported housing, per diem	1	10	1,690	$990	$7.3M
H0046	Mental health services, not otherwise specified	196	510	6,100	$190	$2.8M
H0040	Assertive community treatment program, per diem	12	40	10,830	$200	$2.7M
97150	In this procedure, the provider supervises and directs therapeutic procedures like exercise therapy for a group of patients.	40	200	2,840	$320	$2.4M
H0039	Assertive community treatment, face-to-face, per 15 minutes	24	30	2,740	$530	$2M
H2017	Psychosocial rehabilitation services, per 15 minutes	9	100	15,920	$60	$1.9M

Showing 1–10 of 43

Nearby Providers

Other providers in the same ZIP code as Rappahannock Area Community Services Board, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mary Washington Hospital Inc.	VA	General Acute Care Hospital	$0	$80.1M
Paragon Autism Services, LLC	VA	Behavior Analyst	$0	$21.6M
Fredericksburg Emergency Medical Alliance, Inc.	VA	Emergency Medicine Physician	$0	$15M
Mary Washington Healthcare Physicians	VA	Family Medicine Physician	$0	$13.3M
Pedsplus Urgent Care, LLC	VA	Urgent Care Clinic/Center	$0	$11M
Preferred Pediatrics At Snowden	VA	Pediatrics Physician	$0	$6.4M
Sunny Home Care Inc.	VA	Home Health Agency	$0	$6.3M
Thomas Johnson	VA	Retina Specialist (Ophthalmology) Physician	$3.6M	$0
Central Virginia Surgi-center LP	VA	Ambulatory Surgical Clinic/Center	$3.2M	$318.9K
Eric Lee	VA	Retina Specialist (Ophthalmology) Physician	$2.6M	$0

Rappahannock Area Community Services Board — Billing Profile & Reimbursement Data

Sign up for Rappahannock Area Community Services Board — Billing Profile & Reimbursement Data policy alerts

Rappahannock Area Community Services Board — Billing Profile & Reimbursement Data

Sign up for Rappahannock Area Community Services Board — 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