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

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

Rushford Center Inc (NPI 1982813713)

Field	Value
Entity Type	Organization
Organization	Rushford Center Inc
Address	1250 Silver St
City	Middletown
State	CT
ZIP	06457
Taxonomy	Substance Abuse Rehabilitation Facility
NPI Enumerated	May 21, 2007

Payer Source	Total Paid
Medicaid	$23M
Medicare	$0

Key Findings

RUSHFORD CENTER INC is effectively a single-payer provider in our file: there is no Medicare billing on file and the organization reports $23M in total Medicaid revenue, indicating Medicaid is the dominant (and in-practice sole) public payer for this entity. The NPI was enumerated on 2007-05-21 (~19 years ago), confirming a long-tenured presence in-state.

Revenue is highly concentrated in three service lines: H2036, H0011, and H0015 together account for 90.8% of this provider's total Medicaid revenue. Those top three codes alone ($13.1M for H2036, $5.9M for H0011, and $1.9M for H0015) drive the bulk of financial volume, so changes in reimbursement or utilization for these codes would materially affect overall revenue.

The code mix shows a service model focused on substance use treatment across residential and intensive outpatient settings: H2036 (per diem AOD treatment program) has 66.7K claims with a $197 avg paid/claim and $13.1M revenue, H0011 (acute detoxification/residential inpatient) has 13.1K claims with a $449 avg paid/claim and $5.9M revenue, and H0015 (intensive outpatient) has 16.1K claims with a $118 avg paid/claim and $1.9M revenue. This mix indicates a substantial operation providing both higher-acuity inpatient detox services and high-volume per-diem program care plus intensive outpatient programming.

Competitive standing varies by code: for H2036 the provider ranks #3 of 20 in-state and sits in the 89th percentile (notably above typical state volume), signaling the organization is a major statewide participant for per-diem AOD program services. In contrast, H0011 ranks #5 of 7 and is in the 33th percentile (typical, unremarkable volume), indicating a more modest role among inpatient detox providers, while H0015 ranks #13 of 74 and is in the 84th percentile (typical, unremarkable volume) which suggests above-average activity for intensive outpatient services but not market dominance.

Per-claim payment patterns align with care intensity: H0011 carries the highest avg paid/claim at $449 consistent with inpatient/acute detox services, H2036 averages $197 per claim for per-diem program care, and H0015 averages $118 per claim for intensive outpatient services. These differences imply that while H2036 dominates total revenue by dollars, H0011 generates higher revenue per event and H0015 drives volume at lower per-claim rates.

There are notable reporting anomalies in ancillary codes: H0047 shows 17.1K claims but $0 avg paid/claim and $0 revenue while ranking #1 of 17 providers in-state (100th percentile, notably above typical state volume), and several SARS-CoV-2 lab/test codes (U0005, U0003, U0004, C9803, 87811) appear with claims but $0 reported revenue. These patterns suggest substantial claim activity that did not translate into paid Medicaid revenue for those codes and should be reviewed if adjudication or reporting completeness is a concern.

Service breadth is further evidenced by activity in partial hospitalization and psychotherapy codes: H0035 contributes $724K (3.1% of Medicaid revenue) and 90853 contributes $314.9K (1.4% of Medicaid revenue), while evaluation and E/M codes such as 90791 and 99213 appear as smaller contributors. This indicates the provider offers a continuum that includes partial hospitalization and outpatient group/individual behavioral health services in addition to core substance-use treatment programs.

Given the concentration in a few Medicaid codes and the provider's long tenure (~19 years), strategic or operational changes affecting per-diem AOD programs (H2036) or inpatient detox (H0011) would have outsized impacts on the provider's financial profile; payers or analysts monitoring contract performance should prioritize these codes for utilization reviews and rate negotiations.

Medicaid: Complete Services Breakdown

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

21 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2036	Alcohol and/or other drug treatment program, per diem	66,680	$200	$13.1M
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	13,080	$450	$5.9M
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…	16,080	$120	$1.9M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	3,460	$210	$724K
S9480	Intensive outpatient psychiatric services, per diem	7,130	$90	$662.7K
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…	15,740	$20	$314.9K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	1,790	$110	$193.3K
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…	2,290	$60	$142.2K
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…	380	$90	$34.5K
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…	420	$70	$28.2K

Showing 1–10 of 21

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Connecticut Distribution

Rushford Center Inc — 0 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Connecticut

Full comparison — all codes billed, vs. Connecticut median

21 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2036	Alcohol and/or other drug treatment program, per diem	3	20	13,690	$300	$6.9M
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	5	10	15,610	$490	$6.9M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	5	10	2,820	$160	$1.6M
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…	13	70	3,710	$120	$1.6M
S9480	Intensive outpatient psychiatric services, per diem	25	60	5,640	$110	$1.3M
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	26	50	3,340	$60	$1M
U0004	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by…	18	30	5,480	$60	$581.1K
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…	932	1,590	740	$50	$331.8K
U0005	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc,…	26	50	4,960	$20	$273.9K
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…	524	1,710	750	$30	$243.3K

Showing 1–10 of 21

Related Providers

Other providers that share a Tax Identification Number (TIN) with Rushford Center Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rushford Center, Inc.	CT	Psychologist	$0	$12.6M
John Moore	CT	Psychiatry Physician	$17.7K	$0
Karen Robinson	CT	Clinical Social Worker	$13.6K	$0
Amber Johnson	CT	Psychiatric/Mental Health Nurse Practitioner	$2.7K	$0

Nearby Providers

Other providers in the same ZIP code as Rushford Center Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Health Center Inc	CT	Federally Qualified Health Center (FQHC)	$0	$533.4M
Middlesex Hospital	CT	General Acute Care Hospital	$0	$116.1M
Pursuecare, LLC	CT	Addiction Medicine (Preventive Medicine) Physician	$0	$9.8M
Gilead Community Services, Inc.	CT	Adult Mental Health Clinic/Center	$0	$8.9M
Middlesex Hospital	CT	Family Nurse Practitioner	$0	$7.5M
Mhs Primary Care, Inc	CT	Family Medicine Physician	$0	$5.4M
City Of Middletown	CT	Local Education Agency (LEA)	$0	$4.2M
Surgi-care, Inc	CT	Prosthetic/Orthotic Supplier	$0	$4.2M
Unison Health Services, Inc.	CT	Home Health Agency	$0	$3.8M
Middlesex Hospital	CT	Land Ambulance	$1.4M	$2M

Rushford Center Inc — Billing Profile & Reimbursement Data

Sign up for Rushford Center Inc — Billing Profile & Reimbursement Data policy alerts

Rushford Center Inc — Billing Profile & Reimbursement Data

Sign up for Rushford Center Inc — Billing Profile & Reimbursement Data policy alerts

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