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NPI 1922026996 · Berlin, VT · Community/Behavioral Health Agency
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Washington County Mental Health Services, Inc. is a community/behavioral health agency provider located in Berlin, Vermont. This profile covers 0 Medicare and 32 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 | Washington County Mental Health Services, Inc. |
| Address | 174 Hospital Loop |
| City | Berlin |
| State | VT |
| ZIP | 05602 |
| Taxonomy | Community/Behavioral Health Agency |
| NPI Enumerated | July 18, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $99.3M |
| Medicare | $0 |
WASHINGTON COUNTY MENTAL HEALTH SERVICES, INC. is effectively a Medicaid-focused community behavioral health provider: it reports $99.3M in lifetime Medicaid revenue and has no Medicare billing on file. Its NPI was enumerated 2006-07-18 (~20 years ago), indicating roughly two decades of enrollment in federal billing systems.
Revenue is highly concentrated in a small set of community-based service codes: the precomputed top three Medicaid codes (H2015, H2017, H2020) together account for 86.7% of the provider's total Medicaid revenue. Those three codes individually generate $35.3M (35.6%), $32.5M (32.7%), and $18.3M (18.4%) respectively, making them the primary drivers of the organization’s financial footprint.
The dominant code mix (H2015 – Comprehensive community support services; H2017 – Psychosocial rehabilitation services; H2020 – Therapeutic behavioral services) indicates an operational focus on high-volume, community-based rehabilitation and behavioral supports delivered in short-interval (per 15 minutes) and per-diem modalities. This pattern suggests service lines built around intensive psychosocial rehabilitation, wraparound community supports, and behavioral intervention programs rather than office-based medical care.
Statewide competitive standing is strongest for the two per-15-minute community service codes: the provider ranks #1 of 19 for H2015 (100th percentile; notably above typical state volume) and #1 of 28 for H2017 (100th percentile; extreme outlier), marking it as a dominant statewide supplier for those service types. By contrast, H2020 (therapeutic behavioral services) ranks #2 of 3 (50th percentile; typical, unremarkable volume), so the provider’s leadership appears concentrated specifically in community support and psychosocial rehab.
High-volume psychotherapy delivery is also evident: 90837 shows 48.7K claims and $1.2M revenue while ranking #1 of 666 providers in-state (100th percentile; extreme outlier). Paired with a #1 ranking for the intensity add-on 90785 (also an extreme outlier), this combination points to both very large psychotherapy caseloads and frequent use of add-on work-intensity billing in the provider’s clinical mix.
Although the top three codes dominate, a set of secondary codes contribute measurable revenue and reflect broader service offerings: H0023 (behavioral health outreach) accounts for $6.7M (6.8%), H0046 (mental health services, NOS) $3.3M (3.4%), and T2022 (case management, per month) $993.7K (1.0%). These secondary lines suggest the organization also provides outreach, unspecified community mental health services, and targeted case management alongside its core rehabilitation programs.
Unit-payment dynamics show a pattern of high-volume, low-unit payments for many psychotherapy and outpatient codes (for example, 90837 at $24 avg paid/claim and 90834 at $7 avg paid/claim), implying that total revenue is driven by encounter volume rather than high per-encounter reimbursement. This has operational implications for workforce and scheduling models — sustaining revenue requires maintaining large numbers of time-based encounters.
The dataset also shows nontrivial claim counts with $0 avg paid/claim (e.g., T2016, S5101, H2023) which produce zero recorded Medicaid revenue despite appearing in the activity ledger. This discrepancy is an important data signal for analysts: it may reflect reporting of services under alternative payment arrangements, administrative reporting categories, or services billed but not paid in fee-for-service Medicaid, and should prompt follow-up if reconciling provider activity to revenue streams.
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.
32 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| H2015 | Comprehensive community support services, per 15 minutes | 248,670 | $140 | $35.3M |
| H2017 | Psychosocial rehabilitation services, per 15 minutes | 244,170 | $130 | $32.5M |
| H2020 | Therapeutic behavioral services, per diem | 60,190 | $300 | $18.3M |
| H0023 | Alcohol and/or drug outreach | 6,240 | $1,080 | $6.7M |
| H0046 | Mental health services, not otherwise specified | 1,050 | $3,170 | $3.3M |
| 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… | 48,730 | $20 | $1.2M |
| T2022 | Case management, per month | 4,900 | $200 | $993.7K |
| T1017 | Targeted case management, each 15 minutes | 6,230 | $60 | $373.9K |
| H2011 | Crisis intervention service, per 15 minutes | 3,600 | $40 | $147.6K |
| H2014 | Skills training and development, per 15 minutes | 12,150 | $10 | $133.7K |
Showing 1–10 of 32
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
32 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| H2020 | Therapeutic behavioral services, per diem | 2 | 10 | 60,190 | $330 | $16.4M |
| H0023 | Alcohol and/or drug outreach | 5 | 10 | 6,170 | $900 | $8.7M |
| H2015 | Comprehensive community support services, per 15 minutes | 1 | 20 | 64,230 | $90 | $7.1M |
| H2017 | Psychosocial rehabilitation services, per 15 minutes | 1 | 30 | 6,730 | $110 | $4.1M |
| H0046 | Mental health services, not otherwise specified | 4 | 10 | 330 | $1,360 | $3.1M |
| T2022 | Case management, per month | 2 | 10 | 4,290 | $210 | $745.2K |
| H2014 | Skills training and development, per 15 minutes | 4 | 10 | 7,770 | $60 | $599.6K |
| 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… | 39 | 320 | 680 | $30 | $146.1K |
| 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… | 1 | 670 | 760 | $70 | $143.9K |
| T1017 | Targeted case management, each 15 minutes | 7 | 20 | 1,580 | $30 | $102.9K |
Showing 1–10 of 32
Other providers in the same ZIP code as Washington County Mental Health Services, Inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Washington County Family Center | VT | Developmentally Disabled Services Day Training Agency | $0 | $6.7M |
| Treatment Associates, Inc | VT | Mental Health Counselor | $0 | $6.2M |
| Central Vermont Medical Center Inc | VT | Family Medicine Physician | $0 | $4.1M |
| Baart Behavioral Health Services, Inc. | VT | Substance Use Disorder Rehabilitation Clinic/Center | $202.1K | $2.8M |
| Benjamin Newman | VT | Clinical Social Worker | $0 | $1.5M |
| Central Vermont Medical Center Inc | VT | Internal Medicine Physician | $0 | $907.7K |
| Keene Medical Products, LLC | VT | Durable Medical Equipment & Medical Supplies | $0 | $678.6K |
| M Gould | VT | Psychologist | $0 | $574.9K |
| City Of Montpelier Ambulance | VT | Land Ambulance | $190.7K | $378.7K |
| John Lansky | VT | General Practice Dentistry | $0 | $466.9K |
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