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.

Eliot Community Human Services (NPI 1932271632)

Field	Value
Entity Type	Organization
Organization	Eliot Community Human Services
Address	125 Hartwell Ave
City	Lexington
State	MA
ZIP	02421
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	November 15, 2006

Payer Source	Total Paid
Medicaid	$103.4M
Medicare	$0

Key Findings

ELIOT COMMUNITY HUMAN SERVICES is effectively a Medicaid-centric provider: it has no Medicare billing on file and reports $103.4M in lifetime Medicaid revenue, indicating that Medicaid is the sole payer driving the provider’s recorded billing activity. The organization’s NPI was enumerated on 2006-11-15 (~20 years ago), showing long tenure in the market that likely underpins its program footprint and billing scale.

Revenue is highly concentrated in a small set of community behavioral services: the top three Medicaid codes (T1040, H2016, S9485) together account for 46.2% of the provider’s total Medicaid revenue. Individually those codes produce $18M (T1040, 17.5%), $15.7M (H2016, 15.3%), and $13.9M (S9485, 13.5%), so nearly half of revenue is tied to a few per-diem community and crisis programs.

The code mix signals that this operation is built around community-based, per-diem and outreach programs rather than traditional office-based primary care: the largest single code is T1040 (Medicaid certified community behavioral health clinic services, per diem) at $18M, and H2016 (Comprehensive community support services, per diem) and S9485 (Crisis intervention mental health services, per diem) are also top revenue drivers. High revenue for H0040 (Assertive community treatment program, per diem) at $13M and large psychotherapy volume under 90834 ($13.4M) further indicate a blended model of intensive community treatment, crisis response, and psychotherapy services.

The provider ranks as a statewide leader on several high-revenue codes: H2016 ranks #1 of 75 providers in-state (100th percentile; extreme outlier) and H0040 ranks #1 of 20 providers in-state (100th percentile; notably above typical state volume for this code), while T1040 ranks #5 of 167 (98th percentile; extreme outlier). These rank/percentile placements identify ELIOT as a dominant or major participant in Massachusetts for multiple community mental health service lines.

Operational scale is evident from extremely high claim volumes on core programs: H2016 shows 924.1K claims, H0040 has 316.4K claims, 90834 reports 176.3K claims, and T1040 shows 77.4K claims. Those claim counts—paired with the multi-million dollar revenues attached to each code—suggest large caseload throughput and sustained service delivery capacity across crisis, community support, and outpatient psychotherapy modalities.

Several individual codes are flagged as statistical outliers relative to in-state peers, underlining an atypical service footprint: H2016 and T1040 are described as "extreme outlier" volumes, 90834 is an "extreme outlier," and S9485 is "notably above typical state volume for this code." These labels indicate that ELIOT’s activity levels for certain community and psychotherapy services are well above typical providers in the state.

Because 46.2% of Medicaid revenue is concentrated in T1040, H2016, and S9485—all per-diem or crisis-focused program codes—the provider’s revenue profile is sensitive to changes in Medicaid per-diem reimbursement, program eligibility, or utilization patterns for community behavioral health. This concentration implies that policy or payment shifts targeting community behavioral health could materially affect total revenue.

Beyond the per-diem programs, ELIOT also records high-volume outpatient and case-management activity (for example, 99214 at $4.1M and 121.9K claims for H0023 at $6.6M), indicating a multi-modal service delivery model that includes both clinic encounters and outreach/case-management services. The mix of high-volume community programs plus substantial psychotherapy and E/M billing positions the provider as a comprehensive community mental health operator rather than a narrow specialty clinic.

Medicaid: Complete Services Breakdown

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

45 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1040	Medicaid certified community behavioral health clinic services, per diem	77,360	$230	$18M
H2016	Comprehensive community support services, per diem	924,100	$20	$15.7M
S9485	Crisis intervention mental health services, per diem	25,650	$540	$13.9M
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…	176,330	$80	$13.4M
H0040	Assertive community treatment program, per diem	316,390	$40	$13M
H0023	Alcohol and/or drug outreach	121,880	$50	$6.6M
H2019	Therapeutic behavioral services, per 15 minutes	44,750	$120	$5.5M
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…	59,820	$70	$4.1M
H2015	Comprehensive community support services, per 15 minutes	28,160	$100	$2.9M
H2011	Crisis intervention service, per 15 minutes	10,760	$170	$1.8M

Showing 1–10 of 45

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

Eliot Community Human Services — 9 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

45 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0023	Alcohol and/or drug outreach	20	40	127,370	$50	$8.2M
H2015	Comprehensive community support services, per 15 minutes	48	150	7,770	$140	$4.8M
S9485	Crisis intervention mental health services, per diem	9	110	1,250	$540	$3.2M
H2019	Therapeutic behavioral services, per 15 minutes	34	290	3,680	$150	$2.9M
H0040	Assertive community treatment program, per diem	1	20	22,090	$50	$2.8M
T2022	Case management, per month	67	80	7,230	$50	$2.6M
T1024	Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter	28	50	3,060	$240	$2.4M
T1027	Family training and counseling for child development, per 15 minutes	34	130	4,300	$110	$2.1M
H2011	Crisis intervention service, per 15 minutes	16	40	3,970	$140	$2M
T1040	Medicaid certified community behavioral health clinic services, per diem	5	170	950	$200	$1.8M

Showing 1–10 of 45

Related Providers

Other providers that share a Tax Identification Number (TIN) with Eliot Community Human Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eliot Community Human Services	MA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$36.9M
Cornelius Bela	MA	Adult Health Nurse Practitioner	$252.2K	$0
German Crisostomo	MA	Psychiatry Physician	$42.3K	$0

Nearby Providers

Other providers in the same ZIP code as Eliot Community Human Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eliot Community Human Services	MA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$17.5M
Sheva Khalafbeigi	MA	Anatomic Pathology & Clinical Pathology Physician	$1M	$10K
Nils Becker	MA	Anatomic Pathology & Clinical Pathology Physician	$730.1K	$9.4K
Lisa Cohen	MA	Dermatopathology (Pathology) Physician	$678.2K	$2.5K
Yanlong Zhang	MA	Anatomic Pathology & Clinical Pathology Physician	$479.2K	$0
Jeremy Kieval	MA	Ophthalmology Physician	$340.8K	$0
R. Bohigian	MA	Otolaryngology Physician	$201.2K	$0
Joseph Sanford	MA	Physical Therapist	$124.4K	$0
Li-wei Lin	MA	Ophthalmology Physician	$120K	$0
Briana Gyr	MA	Occupational Therapist	$118.3K	$0

Eliot Community Human Services — Billing Profile & Reimbursement Data

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Eliot Community Human Services — 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