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 District of Columbia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to District of Columbia 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. District of Columbia (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.

Abundant Grace Health Services LLC (NPI 1982182150)

Field	Value
Entity Type	Organization
Organization	Abundant Grace Health Services LLC
Address	4645 Nannie Helen Burroughs Ave Ne
City	Washington
State	DC
ZIP	20019
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	July 31, 2018

Payer Source	Total Paid
Medicaid	$21.9M
Medicare	$0

Key Findings

This provider is effectively single‑payer in the Medicare/Medicaid landscape: Medicare billing on file is none, while the provider reports $21.9M in lifetime Medicaid revenue. The NPI was enumerated 2018-07-31 (~8 years ago), indicating roughly eight years of active billing history concentrated in Medicaid programs.

Revenue is highly concentrated in a very small set of service codes: the precomputed top three Medicaid codes account for 93.7% of the provider’s total Medicaid revenue, with H0036 alone representing $18.1M (82.5% of Medicaid revenue). This level of concentration suggests the organization’s financial performance is heavily dependent on continued volume and reimbursement stability for those top codes.

The code mix indicates a community behavioral health operational model rather than a medical specialty practice: H0036 (community psychiatric supportive treatment) and H0034 (medication training and support) together drive the bulk of revenue, and the presence of 99214 ($690K, 3.1%) shows the organization also provides moderate-complexity outpatient medical evaluation and management visits. Taken together, these codes point to an emphasis on community-based psychiatric supports and medication-focused services with some clinic-based physician or advanced-practice encounters.

Competitive standing on the dominant code H0036 is solid but not dominant statewide: H0036 ranks #14 of 56 providers in-state (76th percentile; typical, unremarkable volume for this code). That rank places the provider above many peers on this specific community psychiatric support service, but it remains one of a number of similar-sized programs rather than an outlier market leader.

H0034 and 99214 also show relatively strong positioning within their peer groups: H0034 ranks #12 of 51 providers in-state (78th percentile; typical, unremarkable volume) and 99214 ranks #52 of 305 providers in-state (83th percentile; typical, unremarkable volume). These percentiles indicate the provider is a meaningful regional participant for medication training/support and established outpatient evaluation visits, again without exceptional outlier status.

Secondary service lines are present but represent a small share of revenue: psychotherapy and psychiatric evaluation codes such as 90837 ($454K, 2.1%), 90791 ($254.9K, 1.2%), and 90834 ($28.3K, 0.1%) appear in the mix, indicating available psychotherapy and diagnostic services but at much lower revenue levels than the community support and medication training codes. This suggests operational focus and capacity are weighted toward brief, frequent community-support encounters rather than extended psychotherapy as a primary revenue driver.

Several mid- and lower-revenue codes show above-average percentile ranks that could signal secondary strengths worth monitoring: for example, 99211 is $26.7K and ranks #8 of 64 (89th percentile; typical, unremarkable volume), and 90791 ranks #14 of 80 (84th percentile; typical, unremarkable volume). While these codes do not drive large amounts of revenue individually, their higher percentiles relative to peers suggest pockets of competitive advantage in certain ancillary or intake services.

From a payer contracting and network-management perspective, the provider’s reliance on high-volume, per-15-minute community psychiatric support (H0036) and medication support (H0034) implies that reimbursement policy changes or utilization-management limits on those services would disproportionately affect their revenue. Given the concentrated Medicaid exposure ($21.9M Medicaid, none Medicare) and the NPI tenure (2018-07-31 (~8 years ago)), analysts should treat this entity as a Medicaid-focused community behavioral health agency with modest state-level market share in its top services rather than a diversified multi-payer provider.

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
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	192,510	$90	$18.1M
H0034	Medication training and support, per 15 minutes	16,120	$110	$1.8M
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…	4,730	$150	$690K
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…	3,340	$140	$454K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	1,700	$150	$254.8K
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…	2,200	$100	$228.4K
99204	The provider sees a new 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 provider…	550	$230	$128K
H0004	Behavioral health counseling and therapy, per 15 minutes	1,030	$100	$106.6K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	350	$160	$55.7K
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…	250	$150	$36.1K

Showing 1–10 of 14

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. District of Columbia Distribution

Abundant Grace Health Services LLC — 0 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — District of Columbia

Full comparison — all codes billed, vs. District of Columbia median

14 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	14	60	82,090	$90	$13.9M
H0034	Medication training and support, per 15 minutes	12	50	5,030	$90	$1M
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…	36	120	1,050	$110	$409.5K
H0004	Behavioral health counseling and therapy, per 15 minutes	51	80	2,570	$60	$403K
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…	52	310	750	$70	$321.6K
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…	93	320	620	$50	$313.6K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	57	120	300	$120	$287.3K
99204	The provider sees a new 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 provider…	18	80	100	$120	$131.8K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	14	80	370	$130	$124.7K
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…	66	100	520	$60	$118.3K

Showing 1–10 of 14

Nearby Providers

Other providers in the same ZIP code as Abundant Grace Health Services LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mbi Health Services LLC	DC	Community/Behavioral Health Agency	$0	$270.4M
Psi Services Iii, Inc	DC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$24.8M
Unity Health Care, Inc	DC	Federally Qualified Health Center (FQHC)	$0	$16.8M
Family Preservation Services Of Dc	DC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$16.7M
Lifeline, Inc	DC	Home Health Agency	$0	$12.2M
Mbi Health Services LLC	DC	Case Management Agency	$0	$10.9M
New Living Health Care Services LLC	DC	Community/Behavioral Health Agency	$0	$9M
Unity Health Care, Inc	DC	Federally Qualified Health Center (FQHC)	$0	$8.9M
Dental Dreams PLLC	DC	General Practice Dentistry	$0	$8.1M
Kenilworth Avenue North Services	DC	Assisted Living Facility	$0	$6.7M

Abundant Grace Health Services LLC — Billing Profile & Reimbursement Data

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Abundant Grace Health Services 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

Nearby Providers

Frequently Asked Questions

References