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NPI 1841417292 · Bellows Falls, VT · Adolescent and Children Mental Health Clinic/Center
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Health Care & Rehabilitation Services is a adolescent and children mental health clinic/center provider located in Bellows Falls, Vermont. This profile covers 0 Medicare and 4 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Health Care & Rehabilitation Services |
| Address | 1 Hospital Ct |
| City | Bellows Falls |
| State | VT |
| ZIP | 05101 |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| NPI Enumerated | April 19, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $25.4M |
| Medicare | $0 |
This provider is effectively a Medicaid-focused operation: there is no Medicare billing on file and total Medicaid revenue is $25.4M, so Medicaid is the sole reported public payer driving the organization’s billed activity. The absence of any Medicare revenue indicates the provider’s business and reimbursement exposure is concentrated in state Medicaid programs rather than the Medicare market.
Revenue is highly concentrated in a very small set of service codes: the top three Medicaid codes account for 97.1% of the provider’s total Medicaid revenue. Those three are H2015 (53.0% of Medicaid revenue), H0023 (24.1% of Medicaid revenue), and H2017 (19.9% of Medicaid revenue), showing that a few community behavioral health services produce nearly all reported Medicaid dollars.
The code mix points to a community-based adolescent and children behavioral health model: H2015 (Comprehensive community support services, per 15 minutes), H0023 (Behavioral health outreach service), and H2017 (Psychosocial rehabilitation services, per 15 minutes) together dominate revenue, which suggests the provider delivers time-based, outreach and rehabilitation-oriented services in the community rather than short episodic clinic visits. High claim volumes for H2015 (20.5K claims) and H2017 (13.4K claims) further indicate sustained, repeated session work consistent with intensive community support and rehab programs.
Competitive standing across these codes is modest rather than dominant at the statewide level. H2015 ranks #14 of 19 providers in-state (28th percentile; typical, unremarkable volume for this code), H0023 ranks #6 of 10 providers in-state (44th percentile; typical, unremarkable volume for this code), and H2017 ranks #13 of 28 providers in-state (56th percentile; typical, unremarkable volume for this code), which together show the provider operates in the middle-to-lower range of peers for its highest-revenue services.
There is an operational profile of many lower-dollar time units combined with fewer higher-dollar outreach events: average paid per claim is $657 for H2015 (20.5K claims), $1003 for H0023 (6.1K claims), and $378 for H2017 (13.4K claims). This spread suggests a mix of frequent per-15-minute service units and less-frequent, higher-paid outreach encounters, implying resource allocation across both high-volume session delivery and targeted outreach activities.
A small but notable portion of revenue comes from a low-frequency, high-unit-payment code: H0046 generated $745.2K (2.9% of Medicaid revenue) from 101 claims with an average paid per claim of $7378, and it ranks #12 of 13 providers in-state (8th percentile; typical, unremarkable volume for this code). This pattern points to occasional high-dollar episodes or bundled services that are not central to the provider’s volume footprint but materially contribute to nontrivial revenue.
The provider’s revenue profile creates concentration risk because nearly all Medicaid dollars are tied to a narrow set of community behavioral health codes; any changes in reimbursement rates, authorization policies, or utilization for H2015, H0023, or H2017 would materially affect overall revenue given those codes account for 97.1% of Medicaid receipts. The lack of Medicare billing eliminates a potential diversification pathway and increases sensitivity to state Medicaid program changes.
The NPI enumeration date, 2007-04-19 (~19 years ago), indicates the provider has been established in the market for an extended period, which may reflect stable program operations and relationships with state Medicaid systems despite the concentrated code mix and middling competitive ranks on key service lines.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| H2015 | Comprehensive community support services, per 15 minutes | 20,510 | $660 | $13.5M |
| H0023 | Alcohol and/or drug outreach | 6,110 | $1,000 | $6.1M |
| H2017 | Psychosocial rehabilitation services, per 15 minutes | 13,380 | $380 | $5.1M |
| H0046 | Mental health services, not otherwise specified | 100 | $7,380 | $745.2K |
How this provider's Medicaid billing volume and revenue compare to other Vermont providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Vermont median
4 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| H0023 | Alcohol and/or drug outreach | 6 | 10 | 6,170 | $900 | $8.7M |
| H2015 | Comprehensive community support services, per 15 minutes | 14 | 20 | 64,230 | $90 | $7.1M |
| H2017 | Psychosocial rehabilitation services, per 15 minutes | 13 | 30 | 6,730 | $110 | $4.1M |
| H0046 | Mental health services, not otherwise specified | 12 | 10 | 330 | $1,360 | $3.1M |
Other providers in the same ZIP code as Health Care & Rehabilitation Services, ranked by combined Medicare and Medicaid revenue.
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