Clinic
Fenway Community Health Center, INC
Fenway Community Health Center, INC was paid $22.49M by Medicaid between Jan 2018 and Dec 2024, across 122 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 44% of everything it billed.
33Billing provider infoFENWAY COMMUNITY HEALTH CENTER, INC
BOSTON, MA 02215
BOSTON, MA 02215
33aNPI1003804725assigned 10/06/2005
28Total paid$22.49M
24GClaims350,574
24DCodes billed122
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Mental Health Clinic/Center (Including Community Mental Health Center) providers in Massachusetts
Rank by total paid#13 of 72
Median peer was paid$1.85M
This provider vs. median12×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 60,773 | $2.62M | |
| 2019 | 61,303 | $2.96M | |
| 2020 | 44,580 | $3.31M | |
| 2021 | 53,020 | $3.83M | |
| 2022 | 48,481 | $4.69M | |
| 2023 | 44,490 | $2.98M | |
| 2024incomplete | 37,927 | $2.10M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 44% | 70,069 | 55,887 | $9.91M |
| G0470 | Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit | 9.9% | 15,092 | 12,595 | $2.23M |
| T1040 | Medicaid certified community behavioral health clinic services, per diem | 8.9% | 15,726 | 9,189 | $2.00M |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 8.9% | 27,005 | 13,607 | $1.99M |
| D9450 | 6.2% | 43,993 | 25,051 | $1.40M | |
| D1110 | Prophylaxis - adult | 2.1% | 18,013 | 11,860 | $483K |
| D2740 | Crown - porcelain/ceramic | 2.1% | 946 | 659 | $464K |
| G0467 | Community health center visit, returning patientFederally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | 1.8% | 11,566 | 9,106 | $400K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 1.7% | 2,710 | 2,696 | $386K |
| D0210 | Intraoral - complete series of radiographic images | <1% | 5,112 | 3,415 | $191K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | <1% | 15,066 | 10,006 | $172K |
| 90791 | Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation | <1% | 1,371 | 1,352 | $163K |
110 more codes
| D0140 | Limited oral evaluation - problem focused | <1% | 6,368 | $151K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | <1% | 4,128 | $144K |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 3,304 | $141K |
| 99214 | Doctor's office visit, returning patient (more involved) | <1% | 7,503 | $131K |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | <1% | 8,701 | $128K |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | <1% | 4,540 | $127K |
| D0274 | Bitewings - four radiographic images | <1% | 6,399 | $118K |
| 90853 | Group psychotherapy (other than of a multiple-family group) | <1% | 3,688 | $112K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | <1% | 2,637 | $105K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 3,673 | $102K |
| 90682 | <1% | 1,701 | $100K | |
| 99213 | Doctor's office visit, returning patient (routine) | <1% | 6,905 | $93K |
| 91322 | <1% | 594 | $83K | |
| 90651 | <1% | 695 | $82K | |
| D9110 | <1% | 3,828 | $75K | |
| D0220 | Intraoral - periapical first radiographic image | <1% | 7,360 | $64K |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 3,094 | $60K |
| 90750 | <1% | 426 | $60K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 751 | $57K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 9,273 | $57K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | <1% | 791 | $53K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 1,404 | $52K |
| 92015 | Determination of refractive state | <1% | 4,145 | $49K |
| D2950 | <1% | 463 | $48K | |
| 90686 | <1% | 2,530 | $46K | |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 936 | $43K |
| 90715 | <1% | 1,085 | $35K | |
| 92310 | <1% | 356 | $33K | |
| 97810 | <1% | 1,441 | $33K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 3,773 | $32K |
| 99050 | <1% | 562 | $29K | |
| 90480 | <1% | 542 | $24K | |
| D0270 | <1% | 3,195 | $22K | |
| 92250 | <1% | 1,161 | $18K | |
| 90677 | <1% | 78 | $18K | |
| D2751 | Crown - porcelain fused to predominantly base metal | <1% | 59 | $17K |
| D4341 | <1% | 1,131 | $16K | |
| 92341 | <1% | 458 | $16K | |
| D2331 | <1% | 288 | $15K | |
| 90732 | <1% | 156 | $11K | |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 1,201 | $9K |
| 0011A | <1% | 222 | $9K | |
| 0134A | <1% | 198 | $9K | |
| D0180 | <1% | 231 | $7K | |
| 0012A | <1% | 138 | $6K | |
| 90739 | <1% | 52 | $6K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 1,728 | $6K |
| D2332 | <1% | 101 | $5K | |
| D2330 | <1% | 87 | $5K | |
| 97811 | <1% | 153 | $5K | |
| D2335 | <1% | 84 | $4K | |
| 71046 | Radiologic examination, chest; 2 views | <1% | 204 | $3K |
| 99385 | <1% | 29 | $3K | |
| 90673 | <1% | 53 | $3K | |
| 93000 | <1% | 185 | $3K | |
| 81025 | <1% | 392 | $2K | |
| D0330 | Panoramic radiographic image | <1% | 50 | $2K |
| 90746 | <1% | 37 | $2K | |
| 90734 | <1% | 26 | $2K | |
| 81003 | <1% | 1,050 | $2K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 98 | $2K |
| 77067 | Screening mammography, bilateral, including computer-aided detection | <1% | 26 | $2K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 77 | $1K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 116 | $1K |
| D2394 | <1% | 25 | $1K | |
| 90649 | <1% | 14 | $1K | |
| 90630 | <1% | 61 | $996.66 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 47 | $990.84 |
| 0064A | <1% | 20 | $825.66 | |
| 90632 | <1% | 13 | $778.83 | |
| D1206 | Topical application of fluoride varnish | <1% | 29 | $696.00 |
| 97026 | <1% | 65 | $674.35 | |
| 0124A | <1% | 14 | $642.18 | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 64 | $534.09 |
| 0004A | <1% | 12 | $504.57 | |
| 90656 | <1% | 16 | $265.80 | |
| 99443 | <1% | 78 | $212.73 | |
| D1354 | <1% | 19 | $210.00 | |
| 92370 | <1% | 23 | $201.42 | |
| 99442 | <1% | 40 | $166.48 | |
| G0511 | Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month | <1% | 14 | $113.96 |
| 81002 | <1% | 29 | $85.96 | |
| 86580 | <1% | 12 | $72.48 | |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 16 | $41.38 |
| J1380 | Injection, estradiol valerate, up to 10 mg | <1% | 378 | $14.53 |
| J1071 | Injection, testosterone cypionate, 1 mg | <1% | 1,114 | $7.83 |
| D9995 | 0% | 390 | $0.00 | |
| Q9992 | Injection, buprenorphine extended-release (sublocade), greater than 100 mg | 0% | 116 | $0.00 |
| D1330 | 0% | 863 | $0.00 | |
| 11980 | 0% | 68 | $0.00 | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 0% | 571 | $0.00 |
| 36415 | Collection of venous blood by venipuncture | 0% | 45 | $0.00 |
| 91306 | 0% | 401 | $0.00 | |
| 91301 | 0% | 1,440 | $0.00 | |
| S0302 | Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) | 0% | 42 | $0.00 |
| G0008 | Administration of influenza virus vaccine | 0% | 75 | $0.00 |
| 91303 | 0% | 13 | $0.00 | |
| J0561 | Injection, penicillin g benzathine, 100,000 units | 0% | 12 | $0.00 |
| Q0144 | Azithromycin dihydrate, oral, capsules/powder, 1 gram | 0% | 183 | $0.00 |
| 91313 | 0% | 85 | $0.00 | |
| 90679 | 0% | 13 | $0.00 | |
| 91300 | 0% | 194 | $0.00 | |
| 90611 | 0% | 454 | $0.00 | |
| 90749 | 0% | 87 | $0.00 | |
| D9944 | 0% | 14 | $0.00 | |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | 0% | 15 | $0.00 |
| 46607 | 0% | 12 | $0.00 | |
| 99051 | 0% | 13 | $0.00 | |
| D9996 | 0% | 24 | $0.00 | |
| 46601 | 0% | 12 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialLIEBERMAN, JEFF (VP FINANCE & ADMINISTRATION)