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

Why is the Medicaid comparison limited to New Mexico 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. New Mexico (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.

Vanguard Behavioral Health (NPI 1891418661)

Field	Value
Entity Type	Organization
Organization	Vanguard Behavioral Health
Address	3655 Carlisle Blvd Ne
City	Albuquerque
State	NM
ZIP	87110
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	September 26, 2022

Payer Source	Total Paid
Medicaid	$2.1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	7,500	$250	$1.9M
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…	800	$150	$123K
H0038	Self‑help/peer services, per 15 minutes	2,790	$20	$61.3K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	860	$20	$13.7K
H0031	Mental health assessment, by non-physician	80	$180	$13.7K
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…	40	$150	$5.4K
99203	The provider sees a new 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 provider…	40	$120	$5K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	30	$170	$4.9K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Mexico Distribution

Vanguard Behavioral Health — 0 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Mexico

Full comparison — all codes billed, vs. New Mexico median

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	22	50	4,480	$150	$2.7M
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…	878	960	1,010	$90	$490K
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…	465	920	860	$120	$361.9K
H0031	Mental health assessment, by non-physician	23	40	120	$160	$209.6K
H0038	Self‑help/peer services, per 15 minutes	14	50	710	$60	$150K
99203	The provider sees a new 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 provider…	274	360	220	$90	$134.7K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	99	120	130	$130	$79.6K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	51	120	400	$10	$17K

Nearby Providers

Other providers in the same ZIP code as Vanguard Behavioral Health, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
1st Care Of New Mexico LLC	NM	In Home Supportive Care Agency	$0	$86.5M
Community Options, Inc	NM	Child Intellectual and/or Developmental Disabilities Respite Care	$0	$76.7M
Abarim Home Health Care Inc.	NM	Community Based Hospice Care Agency	$0	$66M
New Mexico Department Of Health	NM	Customized Equipment (DME)	$0	$60.4M
Independent Living Resource Center	NM	Personal Care Attendant	$0	$57.7M
Ability First, LLC	NM	Exclusive Provider Organization	$0	$49M
Alta Mira Specialized Family Services, Inc.	NM	Community/Behavioral Health Agency	$0	$46.2M
Southwest Family Guidance Center LLC	NM	Adolescent and Children Mental Health Clinic/Center	$0	$32.7M
Aid Home Health Care Services LLC.	NM	Home Health Agency	$0	$32.4M
Active Solutions Incorporated	NM	Developmentally Disabled Services Day Training Agency	$0	$31.3M

Vanguard Behavioral Health — Billing Profile & Reimbursement Data

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Vanguard Behavioral Health — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References