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

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

Omni Community Health, Inc. (NPI 1881024172)

Field	Value
Entity Type	Organization
Organization	Omni Community Health, Inc.
Address	4709 Papermill Dr Ste 100
City	Knoxville
State	TN
ZIP	37909
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	November 22, 2013

Payer Source	Total Paid
Medicaid	$77.7M
Medicare	$0

Key Findings

This provider is effectively single‑payer: OMNI COMMUNITY HEALTH, INC. reports no Medicare billing on file and $77.7M in lifetime Medicaid revenue, indicating its operating footprint is concentrated in the Medicaid space rather than dual Medicare/Medicaid billing. The NPI has been enumerated since 2013-11-22 (~13 years ago), so the Medicaid revenue profile reflects roughly a decade of activity under the current enrollment window.

Revenue is highly concentrated in a small set of programmatic codes: the precomputed top three Medicaid codes by revenue account for 75.5% of total Medicaid revenue. In particular S0280 alone generates $49.4M (63.5% of Medicaid revenue; 316.6K claims, $156 avg paid/claim), H0036 generates $5.8M (7.5%; 1.5K claims, $3862 avg paid/claim), and T1041 generates $3.5M (4.5%; 741 claims, $4683 avg paid/claim).

The code mix points to a care‑coordination and community behavioral health operating model: large S0280 billing (Medical home program, comprehensive care coordination and planning) plus T1041 (CCBHC monthly services) and H0036 (community psychiatric supportive treatment) indicate OMNI delivers ongoing care coordination, certified community behavioral health clinic services, and frequent psychiatric support sessions rather than one‑off procedural care. High claim volumes for psychotherapy and E/M codes further show the business relies on recurring outpatient behavioral health encounters.

Competitive standing is mixed by code: for the Medicaid medical home program S0280 the provider ranks #6 of 40 in-state (87th percentile), which represents substantial statewide placement but not outright domination. For CCBHC monthly services T1041 it ranks #1 of 2 (100th percentile), indicating it is a leading filer for that specific program in Tennessee, while H0036 ranks #8 of 13 (42nd percentile), a modest state share for face‑to‑face community psychiatric supportive treatment.

High-volume psychotherapy and outpatient evaluation/management activity bolster the behavioral health profile: OMNI reports 62.4K claims for 90834 ($47 avg paid/claim, $2.9M, 3.8%) and 39.4K claims for 90837 ($76 avg paid/claim, $3.0M, 3.8%), and 72.2K claims for 99214 ($39 avg paid/claim, $2.8M, 3.6%). Several of these codes rank at or near the top of statewide volumes (90837 #6 of 436, 99th percentile; 90834 #10 of 360, 97th percentile; 99214 #39 of 3759, 99th percentile), signaling heavy outpatient psychotherapy and complex E/M throughput relative to peers.

Payment profile shows a mix of high per‑claim program fees and high‑volume lower‑unit services: programmatic codes such as T1041 ($4683 avg paid/claim) and H0036 ($3862 avg paid/claim) contribute disproportionately to revenue on a per‑claim basis despite lower claim counts, while S0280 combines very high claim volume (316.6K claims) with a moderate per‑claim average ($156) to dominate total Medicaid revenue. This indicates the provider’s revenue streams depend both on scaled care‑coordination encounters and on episodic higher‑value program payments.

Several specific codes are statistical outliers or notably above typical state volume, highlighting operational specializations. Notably above typical state volume flags include 99214 (99th percentile), 90847 (95th percentile), and 90791 (97th percentile), which together imply above‑average billing for complex outpatient visits, family psychotherapy with the patient present, and psychiatric evaluations compared with in‑state peers.

Operational implications: because a single programmatic code (S0280) accounts for the majority of Medicaid revenue (63.5%) and the top three codes together account for 75.5% of Medicaid revenue, OMNI’s financial performance appears concentrated in sustained care‑coordination and CCBHC‑style funding streams. That concentration suggests the organization’s revenue is sensitive to program enrollment, state policy changes to medical‑home/CCBHC payment models, or contract-level adjustments affecting those specific codes.

Medicaid: Complete Services Breakdown

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

32 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S0280	Medical home program, comprehensive care coordination and planning, initial plan	316,590	$160	$49.4M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	1,500	$3,860	$5.8M
T1041	Medicaid certified community behavioral health clinic services, per month	740	$4,680	$3.5M
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…	39,370	$80	$3M
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…	62,410	$50	$2.9M
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…	72,230	$40	$2.8M
G9002	Coordinated care fee, maintenance rate	13,140	$160	$2.1M
H0037	Community psychiatric supportive treatment program, per diem	17,510	$100	$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…	22,480	$60	$1.3M
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…	36,180	$30	$1.2M

Showing 1–10 of 32

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Omni Community Health, Inc. — 8 of 23 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

32 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S0280	Medical home program, comprehensive care coordination and planning, initial plan	6	40	22,180	$140	$21.3M
H0037	Community psychiatric supportive treatment program, per diem	9	20	20,260	$150	$19.4M
H0043	Supported housing, per diem	15	20	69,350	$180	$18.6M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	8	10	2,040	$430	$7.7M
T2022	Case management, per month	5	20	1,370	$240	$5.5M
G9002	Coordinated care fee, maintenance rate	5	10	13,140	$80	$3.5M
T1041	Medicaid certified community behavioral health clinic services, per month	1	10	400	$4,680	$1.9M
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…	10	360	350	$50	$414.4K
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…	6	440	530	$70	$282.3K
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…	15	300	480	$30	$221.2K

Showing 1–10 of 32

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Omni Community Health	TN	Social Worker	$0	$18.2M
Travis Richardson	TN	Clinical Cardiac Electrophysiology Physician	$162.8K	$0
Valorie Marlow	KY	Psychiatric/Mental Health Nurse Practitioner	$89.8K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Summit Medical Group, PLLC	TN	Internal Medicine Physician	$0	$44.5M
Allergy Associates, P.A.	TN	Specialist	$0	$26.5M
Knoxville Pediatric Dentistry, PLLC	TN	General Practice Dentistry	$0	$11.2M
The Florence Crittenton Agency Inc	TN	Community/Behavioral Health Agency	$0	$10.7M
Bsp Enterprises, LLC	TN	In Home Supportive Care Agency	$0	$8M
Associated Pain Specialists, PC	TN	Pain Medicine Physician	$0	$6.8M
Jeremiah Bivins	TN	Allergy & Immunology Physician	$419.4K	$4.6M
Westbrook Medical Center, PLLC	TN	Family Medicine Physician	$0	$4M
James Miller	TN	Retina Specialist (Ophthalmology) Physician	$3.9M	$0
Nicholas Anderson	TN	Retina Specialist (Ophthalmology) Physician	$3M	$0

Omni Community Health, Inc. — Billing Profile & Reimbursement Data

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Omni Community Health, 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