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.

Shalom House, Inc. (NPI 1992702955)

Field	Value
Entity Type	Organization
Organization	Shalom House, Inc.
Address	106 Gilman St
City	Portland
State	ME
ZIP	04102
Taxonomy	Mental Illness Community Based Residential Treatment Facility
NPI Enumerated	July 6, 2005

Payer Source	Total Paid
Medicaid	$81.9M
Medicare	$0

Key Findings

SHALOM HOUSE, INC. is effectively a Medicaid-centric operator: there is no Medicare billing on file while total Medicaid revenue is $81.9M, indicating the provider’s entire recorded Medicare/Medicaid footprint is driven by Medicaid. This makes the organization financially dependent on Medicaid program reimbursement rather than a balanced Medicare/Medicaid payer mix.

Revenue is highly concentrated in a very small set of services: the precomputed top three Medicaid codes account for 100.0% of the provider’s Medicaid revenue, with H0019 alone representing 85.4% of that total. Such concentration means changes in reimbursement, utilization, or policy for these specific codes would disproportionately affect the provider’s overall Medicaid revenue.

H0019 (long-term residential, without room and board, per diem) dominates the billing profile with 90.6K claims, $772 avg paid/claim, and $69.9M revenue, accounting for 85.4% of Medicaid revenue. The code’s volume places the provider at rank #5 of 28 in-state (85th percentile), which the source labels as typical or unremarkable volume relative to peers despite the large absolute revenue share.

H2018 (psychosocial rehabilitation services, per diem) is the second revenue driver with 54.7K claims, $200 avg paid/claim, and $10.9M revenue, representing 13.4% of Medicaid revenue. The provider ranks #3 of 8 in-state for this code (71th percentile) and the reported descriptor is “typical, unremarkable volume,” indicating meaningful participation in psychosocial rehab services but not market dominance.

H2015 (comprehensive community support services, per 15 minutes) is a minor contributor with 10.5K claims, $101 avg paid/claim, and $1.1M revenue, or 1.3% of Medicaid revenue. The provider’s rank for this code is #32 of 71 in-state (56th percentile) and is likewise described as a typical participant, suggesting community support services are present but not a core revenue engine.

Service-line implications from the code mix point to a long-term residential treatment model supplemented by day/per-diem psychosocial rehabilitation and time-based community support. The prominence of H0019 (long-term residential, per diem without room and board) suggests the organization operates sustained residential programs where clinical per-diem billing—rather than episodic medical services—is the primary business model.

Competitive standing is mixed: for H0019 the provider sits in the upper range of in-state peers by rank (85th percentile, #5 of 28) but the data labels volumes as typical, so the provider appears to be an established regional participant rather than an outlier market dominator. For H2018 and H2015 the provider’s ranks (71th and 56th percentiles, respectively) further support characterization as a solid but not dominant statewide competitor across its secondary service lines.

The provider has a longstanding NPI enumeration date of 2005-07-06 (~21 years ago), indicating sustained presence in the market that aligns with the observed high cumulative Medicaid billing. No top codes are flagged as statistical outliers in the supplied labels; each of the top three codes is described as “typical, unremarkable volume,” which suggests stable, routine utilization patterns rather than anomalous spikes in billing.

Medicaid: Complete Services Breakdown

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

3 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	90,590	$770	$69.9M
H2018	Psychosocial rehabilitation services, per diem	54,690	$200	$10.9M
H2015	Comprehensive community support services, per 15 minutes	10,470	$100	$1.1M

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

Shalom House, Inc. — 0 of 3 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

3 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	5	30	13,990	$560	$23.9M
H2018	Psychosocial rehabilitation services, per diem	3	10	28,460	$110	$3.3M
H2015	Comprehensive community support services, per 15 minutes	32	70	7,120	$100	$1.7M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mainehealth	ME	General Acute Care Hospital	$0	$142.6M
Mercy Hospital	ME	General Acute Care Hospital	$0	$35.5M
Maxim Healthcare Services, Inc.	ME	Home Health Agency	$0	$28.1M
Quality Care Access, LLC	ME	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$17.2M
Portland Community Health Center	ME	Federally Qualified Health Center (FQHC)	$0	$12.9M
Al-shawk Home Healthcare, LLC	ME	Personal Care Attendant	$0	$7M
Maine Eye Center, PA	ME	Ophthalmology Physician	$0	$6.1M
Hand Of Mercy Health Care, LLC	ME	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$6.1M
Mainehealth	ME	General Acute Care Hospital	$0	$5.5M
Merrimack River Medical Services, Inc.	ME	Substance Use Disorder Rehabilitation Clinic/Center	$253.7K	$4.6M

Shalom House, Inc. — Billing Profile & Reimbursement Data

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Shalom House, Inc. — 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