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

Why is the Medicaid comparison limited to Rhode Island 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. Rhode Island (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.

Phoenix Houses Of New England, Inc. (NPI 1992884787)

Phoenix Houses Of New England, Inc. is a substance abuse rehabilitation facility provider located in Providence, Rhode Island. This profile covers 0 Medicare and 14 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Phoenix Houses Of New England, Inc.
Address	99 Wayland Ave
City	Providence
State	RI
ZIP	02906
Taxonomy	Substance Abuse Rehabilitation Facility
NPI Enumerated	November 3, 2006

Payer Source	Total Paid
Medicaid	$7.3M
Medicare	$0

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
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	43,070	$150	$6.2M
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…	6,790	$70	$475K
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	1,270	$200	$251.9K
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…	1,210	$90	$102.8K
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…	1,130	$50	$56.6K
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…	410	$110	$42.8K
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…	200	$150	$30K
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…	250	$100	$24.4K
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…	130	$100	$13.4K
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…	290	$40	$11.4K

Showing 1–10 of 14

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Rhode Island Distribution

Phoenix Houses Of New England, Inc. — 1 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Rhode Island

Full comparison — all codes billed, vs. Rhode Island median

14 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	4	30	1,530	$360	$9.7M
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	10	540	$160	$333.3K
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	1	10	1,270	$200	$251.5K
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…	178	750	330	$70	$92.5K
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…	239	360	280	$90	$86.4K
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…	46	1,730	220	$70	$75.2K
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…	487	2,050	300	$50	$72.3K
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…	25	160	50	$150	$59.2K
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…	41	160	90	$110	$54.6K
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…	87	190	270	$40	$51K

Showing 1–10 of 14

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Peter Kassis	RI	Addiction Medicine (Family Medicine) Physician	$0	$12.2M
Sylvester Sviokla	RI	Addiction Medicine (Family Medicine) Physician	$0	$4.2M
Thomas Defanti	CT	Addiction Medicine (Psychiatry & Neurology) Physician	$0	$3.6M
Jennifer Porschitz	NH	Clinical Social Worker	$0	$530.5K
Joyce Martin	RI	Nurse Practitioner	$159.1K	$29.2K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Miriam Hospital	RI	General Acute Care Hospital	$0	$138.6M
Family Service Of Rhode Island Inc.	RI	Taxi	$0	$12M
Butler Hospital	RI	Psychiatric Hospital	$0	$9.6M
Thomas Mulvey	RI	Pediatric Dentistry	$0	$6.3M
Silver Fern Practice, LLC	RI	Physical Therapist	$0	$5M
Providence Interventional Associates Ii LLC	RI	Ambulatory Surgical Clinic/Center	$1.9M	$8.3K
Gaurav Gupta	RI	Ophthalmology Physician	$1.8M	$5.8K
Robert Eden	RI	Pediatrics Physician	$0	$1.7M
Brian Ackerman	RI	Psychiatry Physician	$24.8K	$1.5M
Steven Hirsch	RI	Clinical Neuropsychologist	$0	$1.2M

Phoenix Houses Of New England, Inc. — Billing Profile & Reimbursement Data

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Phoenix Houses Of New England, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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