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

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

Communicare Inc (NPI 1801933247)

Field	Value
Entity Type	Organization
Organization	Communicare Inc
Address	1311 N Dixie Hwy
City	Elizabethtown
State	KY
ZIP	42701
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	February 1, 2007

Payer Source	Total Paid
Medicaid	$49.5M
Medicare	$0

Key Findings

COMMUNICARE INC is effectively a Medicaid-focused provider: there is no Medicare billing on file and the organization reports $49.5M in lifetime Medicaid revenue, making Medicaid the sole reported payer source in the dataset. This single-payer profile means analyses of volume, utilization patterns, and financial exposure should be centered on state Medicaid dynamics rather than Medicare comparators.

Revenue is highly concentrated in a small set of service lines: the top three Medicaid codes (T2023, 90837, 90832) account for 57.8% of the provider’s total Medicaid revenue. Individually, T2023 generated $14.2M (28.7%), 90837 generated $10.9M (22.1%), and 90832 generated $3.5M (7.0%), indicating reliance on targeted case management and psychotherapy services for the bulk of revenue.

The code mix signals a comprehensive community behavioral-health operation: extremely high volumes of psychotherapy codes (90837: 105.9K claims; 90832: 63.2K claims; 90834: 31.6K claims) alongside substantial targeted case management (T2023: 44.6K claims) suggest the provider delivers ongoing outpatient psychotherapy plus coordinated case management at scale. Complementary lines — H0040 assertive community treatment (3.6K claims, $3.1M), S9485 crisis intervention (10.3K claims, $2.5M), and H0038 peer services (62.4K claims, $2M) — indicate an integrated continuum that includes intensive community treatment, crisis response, and peer support.

COMMUNICARE holds a dominant competitive standing in several statewide code categories: T2023 ranks #8 of 525 providers in-state (99th percentile; extreme outlier) and 90837 ranks #11 of 1266 providers in-state (99th percentile; extreme outlier), demonstrating that the organization is a major statewide player for targeted case management and long-session psychotherapy. 90832 also ranks #9 of 603 providers (99th percentile; notably above typical state volume), reinforcing that its high service volumes are well above typical peers.

There are notable intensity and price differences across service types that shape revenue composition: high-per-diem services such as H0040 (avg paid/claim $857, $3.1M revenue) contribute materially to revenue despite far fewer claims, while high-frequency psychotherapy codes (90837 at $103 avg paid/claim and 105.9K claims) drive large revenue through volume. This mix implies the provider’s financials are sensitive both to utilization levels of frequent outpatient psychotherapy and to occupancy/authorization of higher-priced per-diem community services.

Several specialized service lines show atypical statewide positioning beyond routine psychotherapy: 90791 (8.8K claims, $934.8K; ranks #8 of 682, 99th percentile) and 90834 (31.6K claims, $2.5M; ranks #8 of 504, 99th percentile) appear notably above typical state volume, indicating strong capacity for diagnostic evaluations and mid-length therapy sessions as well as high throughput for intake/assessment activity. These patterns suggest capacity for both initial evaluations and ongoing psychotherapy across session lengths.

The provider’s service footprint includes residential and substance-use treatment components as part of its Medicaid mix: H0011 alcohol/drug acute detoxification (6.8K claims, $1.7M) and H0018 short-term residential (3.4K claims, $651.9K) indicate on-site or contracted inpatient/residential programming in addition to outpatient services. This breadth across outpatient therapy, community-based per diems, crisis intervention, and residential care supports a vertically integrated behavioral-health service model within Medicaid.

COMMUNICARE’s operating tenure adds context to its scale: the NPI was enumerated on 2007-02-01 (~19 years ago), suggesting long-standing presence in the state market. Given sustained high volumes and high-percentile ranks across multiple behavioral-health codes, the provider appears to have established referral pathways and program capacity that are entrenched in the state Medicaid network.

Medicaid: Complete Services Breakdown

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

38 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2023	Targeted case management; per month	44,620	$320	$14.2M
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…	105,930	$100	$10.9M
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…	63,250	$60	$3.5M
H0040	Assertive community treatment program, per diem	3,600	$860	$3.1M
S9485	Crisis intervention mental health services, per diem	10,350	$250	$2.5M
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…	31,630	$80	$2.5M
H0038	Self‑help/peer services, per 15 minutes	62,410	$30	$2M
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…	48,550	$40	$1.8M
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	6,770	$250	$1.7M
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…	11,460	$110	$1.2M

Showing 1–10 of 38

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Communicare Inc — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

38 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	38	70	7,180	$270	$6.8M
S9485	Crisis intervention mental health services, per diem	4	10	7,960	$280	$2.5M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	26	50	4,480	$220	$2.4M
H0040	Assertive community treatment program, per diem	3	10	1,230	$670	$1.4M
T2023	Targeted case management; per month	8	530	530	$300	$1.1M
H2021	Community-based wrap-around services, per 15 minutes	8	30	2,140	$130	$1M
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…	124	230	1,750	$110	$793.5K
H0038	Self‑help/peer services, per 15 minutes	15	320	3,070	$50	$678.3K
H2015	Comprehensive community support services, per 15 minutes	76	200	1,610	$80	$585.6K
90887	In this service, the provider interprets or explains the results of psychiatric exams, medical exams, other procedures, or information about the patient’s care to the patient’s family members or…	14	140	460	$70	$475.2K

Showing 1–10 of 38

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Manoj Chandran	KY	Psychiatry Physician	$35.5K	$0
Charlotte Adams	KY	Psychiatric/Mental Health Nurse Practitioner	$16.1K	$0
Cindy Petzke	IN	Psychiatric/Mental Health Nurse Practitioner	$4.8K	$0
Terri Sharp	KY	Psychiatric/Mental Health Nurse Practitioner	$3K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Communicare Inc	KY	Community/Behavioral Health Agency	$0	$205.5M
Baptist Healthcare System Inc	KY	General Acute Care Hospital	$0	$95.7M
Stepworks Recovery Centers LLC	KY	Substance Use Disorder Rehabilitation Clinic/Center	$0	$67.7M
Hardin Memorial Hospital	KY	General Acute Care Hospital	$0	$37.2M
Pinnacle Treatment Centers Ky-1, LLC	KY	Substance Abuse Rehabilitation Facility	$0	$33.6M
Lincoln Trail Area Development District	KY	Supports Brokerage Agency	$0	$31.4M
Astra Behavioral Health LLC	KY	Psychiatry Physician	$0	$26.1M
Renest Recovery Support Services	KY	Community/Behavioral Health Agency	$0	$19.9M
Baptist Health Medical Group Inc	KY	Internal Medicine Physician	$0	$13.7M
Elizabethtown Emergency Physicians, LLC	KY	Emergency Medicine Physician	$0	$11.9M

Communicare Inc — Billing Profile & Reimbursement Data

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Communicare 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