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

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

Rutgers Health - University Behavioral Health Care (NPI 1942217054)

Field	Value
Entity Type	Organization
Organization	Rutgers Health - University Behavioral Health Care
Address	671 Hoes Ln
City	Piscataway
State	NJ
ZIP	08854
Taxonomy	Psychiatric Hospital
NPI Enumerated	August 2, 2006

Payer Source	Total Paid
Medicaid	$110.1M
Medicare	$0

Key Findings

This entity is effectively a Medicaid-focused behavioral health provider: it has no Medicare billing on file and reports $110.1M in lifetime Medicaid revenue, with an NPI enumerated on 2006-08-02 (~20 years ago), indicating long-tenure operations in the state market. The absence of Medicare activity combined with a sizable Medicaid revenue base implies its clinical and payer strategy is concentrated on publicly funded behavioral health services rather than Medicare-covered inpatient or outpatient care.

Revenue is highly concentrated in a small set of outpatient/day-treatment codes: the precomputed top 3 Medicaid codes by revenue account for 79.2% of total Medicaid revenue, led by H0035 at $69.8M (63.5%). That extreme concentration around H0035 means a majority of the provider’s Medicaid dollars derive from partial hospitalization/less-than-24-hour day-treatment programs, making reimbursement changes to that service highly material to overall revenue.

The mix of top codes (H0035 – partial hospitalization; S9480 – intensive outpatient psychiatric services per diem; T2034 – crisis intervention, waiver per diem) indicates the organization operates large-scale partial hospitalization and intensive outpatient (IOP) programs with a significant crisis-intervention component. These codes and accompanying high-volume psychotherapy/E&M codes (e.g., 90832, 90837, 90792) point to a comprehensive ambulatory behavioral health model centered on structured day treatment, group and individual therapy, and timelimited crisis services rather than primarily inpatient psychiatric care.

Competitive standing within New Jersey is dominant for its highest-volume service lines: H0035 ranks #2 of 171 providers in-state (99th percentile; extreme outlier) and S9480 ranks #1 of 29 providers in-state (100th percentile; extreme outlier), while T2034 ranks #3 of 21 (90th percentile; notably above typical state volume). Those rankings position the provider as a major statewide player for partial hospitalization and IOP capacity, suggesting key negotiating leverage for Medicaid managed-care contracts covering those programs.

Clinical throughput is reflected in very large claim counts and elevated state percentiles for psychotherapy and evaluation codes: 90832 (88.1K claims, $5.5M, 5.0% of Medicaid revenue) ranks #2 of 428 providers (100th percentile; extreme outlier), 90837 (22.5K claims, $2.7M, 2.4%) ranks #4 of 194 (98th percentile; extreme outlier), and 90792 (17.7K claims, $2.3M, 2.1%) ranks #3 of 477 (100th percentile; extreme outlier). These volumes corroborate a high-capacity outpatient psychotherapy footprint supporting the day-treatment model.

Medication administration and long-acting injectable use are present but a smaller portion of revenue: J2426 (paliperidone palmitate) shows 911 claims for $744.3K (0.7% of Medicaid revenue) and J0401 (aripiprazole) shows 434 claims for $363.3K (0.3%), while procedure 96372 (therapeutic injection) appears at 11.2K claims for $636.9K (0.6%). This pattern suggests in-house medication management and depot injection services support outpatient care but are not the primary revenue drivers.

From a payer and network planning perspective, the provider’s dependence on a few high-value day-treatment codes (top 3 = 79.2%) creates concentration risk: changes to Medicaid reimbursement policy, utilization management for partial hospitalization/IOP, or shifts in program authorization could materially affect the provider’s revenue. Conversely, given its state-leading ranks on H0035 and S9480, the provider is strategically important for maintaining behavioral health capacity in New Jersey and should be considered a priority partner for Medicaid behavioral health networks.

Operational breadth beyond core day-treatment is evident in group and family therapy and telehealth activity: 90853 (group psychotherapy) has 28.9K claims for $1.2M (1.1% of Medicaid revenue) and 90847 (family with patient present) has 16.8K claims for $1.1M (1.0%), while Q3014 (telehealth originating site) has 3.5K claims for $17.6K. These items indicate the provider delivers a full continuum of outpatient modalities (group, family, telehealth) that complement its high-volume partial hospitalization and IOP offerings.

Medicaid: Complete Services Breakdown

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

28 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0035	Mental health partial hospitalization, treatment, less than 24 hours	232,020	$300	$69.8M
S9480	Intensive outpatient psychiatric services, per diem	16,490	$690	$11.4M
T2034	Crisis intervention, waiver; per diem	6,960	$860	$6M
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…	88,080	$60	$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…	43,680	$90	$3.8M
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…	22,460	$120	$2.7M
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…	17,680	$130	$2.3M
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…	24,290	$80	$2M
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…	28,920	$40	$1.2M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	9,270	$130	$1.2M

Showing 1–10 of 28

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Jersey Distribution

Rutgers Health - University Behavioral Health Care — 10 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Jersey

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

28 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0035	Mental health partial hospitalization, treatment, less than 24 hours	2	170	21,080	$100	$4.2M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	176	260	4,240	$220	$4.1M
S9480	Intensive outpatient psychiatric services, per diem	1	30	3,840	$770	$3.3M
T2034	Crisis intervention, waiver; per diem	3	20	2,220	$860	$2.3M
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	126	150	3,680	$30	$1.5M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	90	140	1,410	$180	$1.3M
J2426	Injection, paliperidone palmitate extended release (invega sustenna), 1 mg	2	10	500	$750	$1.1M
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…	440	720	1,690	$80	$629.2K
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…	6	160	780	$110	$358.9K
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…	7	330	1,220	$50	$323.4K

Showing 1–10 of 28

Nearby Providers

Other providers in the same ZIP code as Rutgers Health - University Behavioral Health Care, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rutgers-university Behavioral Health Care	NJ	Community/Behavioral Health Agency	$0	$60.2M
Harmony Adult Medical Day Care Center, Inc.	NJ	Adult Day Care Clinic/Center	$0	$35.4M
Vcare Adult Center LLC	NJ	Adult Day Care Clinic/Center	$0	$29.7M
Star Laboratory Corporation	NJ	Clinical Medical Laboratory	$17.7M	$11.9M
Gentle Care Home Services, Inc.	NJ	Home Health Agency	$0	$24.4M
Vatsalya Adult Day Care	NJ	Adult Day Care Clinic/Center	$0	$17.5M
Rutgers-university Behavioral Health Care	NJ	Community/Behavioral Health Agency	$0	$16.3M
Sokkyun Yi	NJ	Mental Health Counselor	$0	$13M
Community Care Behavioral Health	NJ	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$12M
Infinity Biologix LLC	NJ	Clinical Medical Laboratory	$0	$9.4M

Rutgers Health - University Behavioral Health Care — Billing Profile & Reimbursement Data

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Rutgers Health - University Behavioral Health Care — 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

Nearby Providers

Frequently Asked Questions

References