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

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

Health Affiliates Maine, LLC (NPI 1932413556)

Field	Value
Entity Type	Organization
Organization	Health Affiliates Maine, LLC
Address	306 Rodman Rd
City	Auburn
State	ME
ZIP	04210
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	August 6, 2010

Payer Source	Total Paid
Medicaid	$61.6M
Medicare	$0

Key Findings

HEALTH AFFILIATES MAINE, LLC is effectively a single‑payer Medicaid provider: it reports no Medicare billing on file while reporting $61.6M in lifetime Medicaid revenue. This concentration means analyses and contracting should treat Medicaid as the primary revenue driver and operational focus for this entity.

Revenue is highly concentrated in a small set of procedure codes: the precomputed top three codes account for 90.0% of the provider's Medicaid revenue, driven by H0004 (56.7%, $34.9M), H2015 (26.3%, $16.2M), and H2010 (7.1%, $4.4M). Such concentration implies that changes in reimbursement policy or utilization for these specific service lines would materially affect the provider's financial profile.

The code mix (H0004 – behavioral health counseling and therapy per 15 minutes; H2015 – comprehensive community support services per 15 minutes; H2010 – comprehensive medication services per 15 minutes) indicates core operations are community‑based behavioral health, emphasizing high‑volume, short‑interval clinical encounters and medication management. Claim volumes reinforce that operational model: H0004 has 396.8K claims and H2015 has 179.9K claims, consistent with an outpatient or community support delivery model relying on many brief service units.

High claim counts and per‑15‑minute billing patterns suggest significant service throughput and workforce needs: H0004’s 396.8K claims at $88 avg paid/claim and H2015’s 179.9K claims at $90 avg paid/claim point to large caseloads and optimized scheduling for brief sessions. Operationally, this profile favors staffing models with numerous clinicians and caseworkers and systems that support frequent billing of short encounters.

On competitive standing within Maine, the provider is a dominant statewide player for its two largest codes: H2015 ranks #1 of 71 providers in‑state and is described as an extreme outlier, and H0004 ranks #2 of 290 providers and is also described as an extreme outlier. Those rank/percentile positions indicate market leadership in comprehensive community support and in high‑volume behavioral counseling relative to in‑state peers.

Some secondary service lines further distinguish the provider: T1013 (sign language or oral interpretive services) generated $3M from 38.5K claims and ranks #3 of 54 providers in‑state (96th percentile), labeled notably above typical state volume; T1017 (targeted case management) produced $2.6M from 40.7K claims and ranks #9 of 104 providers (92nd percentile), also notably above typical. These patterns suggest an ability to serve specialized needs (interpretation/accessibility) and to provide case management at scale.

H2010 (comprehensive medication services) is a meaningful but less dominant revenue contributor: it generated $4.4M from 32.1K claims and ranks #4 of 49 providers in‑state (94th percentile), which is characterized as typical or unremarkable volume compared with its dominance in H0004 and H2015. This suggests the organization is stronger in counseling and community support than in medication management as a relative share of its Medicaid portfolio.

The provider has an established presence with NPI enumeration on 2010-08-06 (~16 years ago), and the combination of longevity plus extreme outlier volumes on core codes signals an entrenched behavioral‑health service footprint in Maine. For payers and competitors, that tenure plus code‑level concentration highlights both the provider’s strategic importance for Medicaid behavioral health capacity and its vulnerability to shifts in reimbursement or utilization for a handful of high‑impact codes.

Medicaid: Complete Services Breakdown

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

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0004	Behavioral health counseling and therapy, per 15 minutes	396,830	$90	$34.9M
H2015	Comprehensive community support services, per 15 minutes	179,940	$90	$16.2M
H2010	Comprehensive medication services, per 15 minutes	32,060	$140	$4.4M
T1013	Sign language or oral interpretive services, per 15 minutes	38,470	$80	$3M
T1017	Targeted case management, each 15 minutes	40,740	$60	$2.6M
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…	2,330	$190	$445.2K
H2000	Comprehensive multidisciplinary evaluation	780	$70	$55K
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…	1,970	$20	$45.3K
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…	1,480	$20	$26.6K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	130	$10	$1.3K

Showing 1–10 of 14

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Maine Distribution

Health Affiliates Maine, LLC — 3 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maine

Full comparison — all codes billed, vs. Maine median

14 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2015	Comprehensive community support services, per 15 minutes	1	70	7,120	$100	$1.7M
H2010	Comprehensive medication services, per 15 minutes	4	50	3,690	$130	$1.6M
T1017	Targeted case management, each 15 minutes	9	100	4,690	$90	$1M
H0004	Behavioral health counseling and therapy, per 15 minutes	2	290	860	$80	$805.1K
T2022	Case management, per month	9	40	800	$190	$780.3K
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…	10	30	1,440	$160	$515.5K
T1013	Sign language or oral interpretive services, per 15 minutes	3	50	740	$90	$453.3K
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…	214	460	1,240	$30	$190K
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…	476	480	1,030	$20	$128.9K
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…	41	50	110	$60	$72.1K

Showing 1–10 of 14

Related Providers

Other providers that share a Tax Identification Number (TIN) with Health Affiliates Maine, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Leane Cyr	ME	Family Nurse Practitioner	$15.4K	$0
Kathleen Young	ME	Psychiatric/Mental Health Nurse Practitioner	$7.7K	$0
Michelle Lacombe	ME	Psychiatric/Mental Health Nurse Practitioner	$4.2K	$0

Nearby Providers

Other providers in the same ZIP code as Health Affiliates Maine, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
John F Murphy Homes, Inc.	ME	Nursing Facility/Intermediate Care Facility	$0	$260.1M
Happy Haven, LLC	ME	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$65.3M
Opportunity Enterprises, Inc.	ME	Developmentally Disabled Services Day Training Agency	$0	$47.6M
New Communities, Inc.	ME	Mental Illness Community Based Residential Treatment Facility	$0	$26.4M
Bedard Medical Inc	ME	Durable Medical Equipment & Medical Supplies	$0	$24.6M
Personal Onsite Development	ME	Developmentally Disabled Services Day Training Agency	$0	$9M
Community Clinical Services, Inc.	ME	Federally Qualified Health Center (FQHC)	$0	$5.2M
New England Home Therapies, Inc.	ME	Oxygen Equipment & Supplies (DME)	$0	$4.2M
Maine Oral & Maxillofacial Surgery Associates, P.A.	ME	Oral and Maxillofacial Surgery (Dentist)	$0	$3.5M
City Of Auburn	ME	Land Ambulance	$317.2K	$2.7M

Health Affiliates Maine, LLC — Billing Profile & Reimbursement Data

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Health Affiliates Maine, LLC — 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