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

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

Grafton School Inc (NPI 1932279072)

Grafton School Inc is a psychiatric residential treatment facility provider located in Winchester, Virginia. This profile covers 0 Medicare and 16 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Grafton School Inc
Address	120 Bellview Ave
City	Winchester
State	VA
ZIP	22601
Taxonomy	Psychiatric Residential Treatment Facility
NPI Enumerated	November 8, 2006

Payer Source	Total Paid
Medicaid	$33M
Medicare	$0

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	88,880	$340	$30.1M
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…	45,360	$30	$1.5M
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…	4,790	$50	$258.7K
99213	The provider sees an established 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…	6,260	$40	$237.9K
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…	3,580	$60	$196.7K
97152	A technician, supervised by a physician or other qualified healthcare professional, provides supporting assessment of a patient’s destructive behavior and behavioral problems by interacting directly…	5,180	$30	$165.6K
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…	3,100	$50	$139.5K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	7,240	$10	$94.2K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	3,390	$30	$91.6K
90846	A provider meets with the patient’s family without the patient present to counsel the family on the psychological issues affecting the patient and the family.	1,240	$50	$63.1K

Showing 1–10 of 16

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Virginia Distribution

Grafton School Inc — 4 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	1	10	50,810	$380	$17.5M
T2022	Case management, per month	54	60	6,000	$130	$1M
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…	633	3,520	370	$70	$280.7K
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…	835	1,340	710	$90	$245K
99213	The provider sees an established 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…	467	4,010	290	$50	$199.8K
97152	A technician, supervised by a physician or other qualified healthcare professional, provides supporting assessment of a patient’s destructive behavior and behavioral problems by interacting directly…	1	10	1,430	$110	$169.5K
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…	4	330	270	$40	$112.2K
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…	86	660	310	$60	$110.9K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	29	170	770	$20	$87.1K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	58	980	140	$70	$70.9K

Showing 1–10 of 16

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Winchester Medical Center	VA	General Acute Care Hospital	$0	$69.9M
Shenandoah Valley Community Residences, Inc.	VA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$17.4M
Compassionate Home Care	VA	In Home Supportive Care Agency	$0	$14.5M
Nova Family Services, Inc.	VA	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$13.5M
Uncle Sam Transportation LLC	VA	Taxi	$0	$12M
National Counseling Group, Inc	VA	Mental Health Counselor	$0	$11.2M
Pediatrix Medical Group PC	VA	Neonatal-Perinatal Medicine Physician	$0	$10.8M
Winchester Medical Center	VA	Obstetrics & Gynecology Physician	$0	$10M
Gaurav Agarwal Dds, Msd, PLLC	VA	Dental Clinic/Center	$0	$8.9M
Valley Regional Enterprises, Inc	VA	Urgent Care Clinic/Center	$0	$8.6M

Grafton School Inc — Billing Profile & Reimbursement Data

Sign up for Grafton School Inc — Billing Profile & Reimbursement Data policy alerts

Grafton School Inc — Billing Profile & Reimbursement Data

Sign up for Grafton School Inc — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References