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.

Clinical & Support Options, Inc (NPI 1831265115)

Field	Value
Entity Type	Organization
Organization	Clinical & Support Options, Inc
Address	1 Arch Pl
City	Greenfield
State	MA
ZIP	01301
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	November 28, 2006

Payer Source	Total Paid
Medicaid	$147.7M
Medicare	$0

Key Findings

This provider is effectively a single‑payer, Medicaid-focused entity: reported Medicaid revenue is $147.7M and there is no Medicare billing on file. The absence of Medicare activity paired with substantial Medicaid receipts indicates the organization’s operations and revenue depend almost entirely on Medicaid programs rather than dual‑payer mix strategies.

Revenue is highly concentrated: the top three Medicaid codes — 90834 ($37.4M, 25.6%), T1040 ($21.3M, 14.6%), and S9485 ($19.7M, 13.5%) — together account for 53.6% of this provider’s total Medicaid revenue. This concentration shows a reliance on a small set of high‑volume behavioral health services to generate the bulk of receipts.

The code mix points to a large community and behavioral health operation that emphasizes outpatient psychotherapy, crisis services, and therapeutic behavioral supports: high volumes in 90834 (psychotherapy), 90837/90832 (long and short psychotherapy sessions), H2019 (therapeutic behavioral services), and per‑diem community behavioral health clinic services (T1040) reflect both individual therapy and structured, programmatic community treatments. Frequent use of family training (T1027), outreach (H0023), and case management (T1017) further indicates bundled, community‑based care and wraparound supports rather than episodic inpatient care.

On statewide competitive standing, the provider is a major outlier for multiple codes: 90834 ranks #3 of 1617 providers in‑state (100th percentile; extreme outlier, far above typical state volume for this code), T1040 ranks #4 of 167 (98th percentile; extreme outlier), and H2019 ranks #7 of 294 (98th percentile; extreme outlier). Several other codes — including 99214 (rank #35 of 5039, 99th percentile; extreme outlier) and 90837 (rank #20 of 1019, 98th percentile; notably above typical state volume) — confirm that this provider operates at scale relative to most Massachusetts peers.

Beyond the top three, the organization shows sustained high utilization across crisis and community support codes: S9485 (35.3K claims, $19.7M, 13.5%) is ranked #6 of 113 providers (96th percentile; notably above typical state volume), and H2011 (39.1K claims, $6M, 4.1%) and H2015 (66.6K claims, $4.5M, 3.0%) are also prominent. This pattern suggests steady demand for crisis intervention and multi‑disciplinary community support services rather than isolated therapy encounters.

The billing profile indicates a mixed delivery model using both per‑diem and time‑based units: T1040 (per diem CBHC services) and S9485 (per diem crisis intervention) are large revenue drivers alongside 15‑minute unit codes like H2019 and H2014. For payers and network planners, this implies the provider operates programmatic, ongoing service lines (day/per‑diem programs and intensive community supports) that require capacity planning and per‑diem rate structures rather than fee‑for‑service only arrangements.

The provider’s NPI was enumerated on 2006-11-28 (~20 years ago), indicating a long tenure in the market. Coupled with the high Medicaid volumes and repeated top‑percentile ranks, this longevity supports the conclusion that the organization has an established, sustained footprint in Massachusetts Medicaid behavioral health services.

From a contracting and utilization perspective, the provider’s outlier status on several large codes (many labeled “extreme outlier” or “notably above typical state volume”) means payers should treat it as a high‑capacity Medicaid partner for psychotherapy, crisis, and community behavioral health clinic services. Rate setting, utilization management, and network adequacy reviews should prioritize coverage and oversight of per‑diem CBHC, crisis intervention, and therapeutic behavioral services given their disproportionate contribution to the provider’s Medicaid revenue.

Medicaid: Complete Services Breakdown

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

40 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…	505,400	$70	$37.4M
T1040	Medicaid certified community behavioral health clinic services, per diem	97,730	$220	$21.3M
S9485	Crisis intervention mental health services, per diem	35,290	$560	$19.7M
H2019	Therapeutic behavioral services, per 15 minutes	153,540	$120	$18.6M
T1027	Family training and counseling for child development, per 15 minutes	83,340	$90	$7.1M
H0023	Alcohol and/or drug outreach	130,620	$50	$6.7M
H2011	Crisis intervention service, per 15 minutes	39,080	$150	$6M
H2015	Comprehensive community support services, per 15 minutes	66,600	$70	$4.5M
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…	76,940	$60	$4.3M
H2014	Skills training and development, per 15 minutes	18,850	$180	$3.4M

Showing 1–10 of 40

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

Clinical & Support Options, Inc — 15 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

40 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0023	Alcohol and/or drug outreach	18	40	127,370	$50	$8.2M
H2015	Comprehensive community support services, per 15 minutes	14	150	7,770	$140	$4.8M
S9485	Crisis intervention mental health services, per diem	6	110	1,250	$540	$3.2M
T1012	Alcohol and/or substance abuse services, skills development	2	10	720	$350	$3.2M
H2014	Skills training and development, per 15 minutes	108	190	21,080	$110	$3M
H2019	Therapeutic behavioral services, per 15 minutes	7	290	3,680	$150	$2.9M
H0040	Assertive community treatment program, per diem	13	20	22,090	$50	$2.8M
T1027	Family training and counseling for child development, per 15 minutes	7	130	4,300	$110	$2.1M
H2011	Crisis intervention service, per 15 minutes	7	40	3,970	$140	$2M
T1040	Medicaid certified community behavioral health clinic services, per diem	4	170	950	$200	$1.8M

Showing 1–10 of 40

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Fabiola Cancino Ticona	MA	Psychiatry Physician	$240.5K	$0
Adam Lau	MA	Psychiatry Physician	$224.5K	$0
Dean Singer	MA	Family Medicine Physician	$212.4K	$0
Cheryl Pascucci	MA	Family Nurse Practitioner	$7.8K	$0

Nearby Providers

Other providers in the same ZIP code as Clinical & Support Options, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Baystate Franklin Medical Center	MA	General Acute Care Hospital	$0	$29.1M
Lifepath, Inc.	MA	Adult Care Home Facility	$0	$19.7M
Lifepath, Inc.	MA	Case Management Agency	$0	$18.7M
Valley Medical Group, P.C.	MA	Family Medicine Physician	$0	$9.9M
Community Health Center Of Franklin County Incorporated	MA	Federally Qualified Health Center (FQHC)	$0	$9.4M
Lifepath, Inc.	MA	Personal Care Attendant	$0	$8.7M
Servicenet Inc	MA	Addiction (Substance Use Disorder) Counselor	$0	$8M
Franklin Mri Center LLC	MA	Magnetic Resonance Imaging (MRI) Clinic/Center	$285.4K	$849.2K
Suzanne Smith	MA	Addiction Medicine (Internal Medicine) Physician	$78.7K	$587.5K
James Arcoleo	MA	Cardiovascular Disease Physician	$617.8K	$44K

Clinical & Support Options, Inc — Billing Profile & Reimbursement Data

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Clinical & Support Options, 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