Clinic
Gifford Health Care, INC.
Gifford Health Care, INC. was paid $934K by Medicaid between Jan 2018 and Nov 2023, across 10 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 99% of everything it billed.
33Billing provider infoGIFFORD HEALTH CARE, INC.
RANDOLPH, VT 05060
RANDOLPH, VT 05060
33aNPI1619427663assigned 10/13/2016
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$934K
24GClaims12,556
24DCodes billed10
24AFirst – last monthJan 2018 – Nov 2023
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in Vermont
Rank by total paid#18 of 33
Median peer was paid$1.23M
This provider vs. median0.8×
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 | 2,152 | $176K | |
| 2019 | 2,855 | $201K | |
| 2020 | 2,984 | $184K | |
| 2021 | 2,261 | $177K | |
| 2022 | 1,738 | $146K | |
| 2023 | 566 | $49K |
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 | 99% | 6,625 | 4,123 | $925K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | <1% | 3,703 | 2,574 | $4K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | <1% | 1,240 | 860 | $2K |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | <1% | 357 | 209 | $979.60 |
| 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% | 91 | 61 | $537.20 |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | <1% | 45 | 37 | $158.00 |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 49 | 39 | $126.40 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 386 | 275 | $31.60 |
| 80305 | 0% | 43 | 25 | $0.00 | |
| 96127 | 0% | 17 | 13 | $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 officialCOSTA, MICHAEL (CEO)
Parent organizationGIFFORD HEALTH CARE, INC.
| Provider | Location | Paid |
|---|---|---|
| Gifford Health Care, INC | Randolph, VT | $8.43M |
| Gifford Health Care, INC | Barre, VT | $2.05M |
| Northern Counties Health Care, INC. | St Johnsbury, VT | $1.85M |
| Gifford Health Care, INC | Bethel, VT | $1.83M |
| Gifford Health Care, INC | Chelsea, VT | $819K |
| Gifford Health Care, INC | Rochester, VT | $345K |
| Gifford Health Care, INC | Randolph, VT | $258K |
| Gifford Medical Center INC. | Randolph, VT | $218K |
| Gifford Health Care, INC | White River Junction, VT | $111K |
| Gifford Medical Center INC | Randolph, VT | $15K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.