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

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

The Center For Autism (NPI 1003808106)

The Center For Autism is a mental health counselor provider located in Philadelphia, Pennsylvania. This profile covers 0 Medicare and 11 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	The Center For Autism
Address	3905 Ford Rd
City	Philadelphia
State	PA
ZIP	19131
Taxonomy	Mental Health Counselor
NPI Enumerated	August 16, 2005

Payer Source	Total Paid
Medicaid	$10.5M
Medicare	$0

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	38,110	$130	$4.9M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	11,660	$320	$3.7M
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…	10,370	$70	$767.2K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	8,700	$70	$591.9K
90846	A provider meets with the patient’s family without the patient present to counsel the family on the psychological issues affecting the patient and the family.	3,250	$60	$204.6K
H0034	Medication training and support, per 15 minutes	1,350	$70	$98.2K
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…	220	$370	$81K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	1,030	$50	$52.5K
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…	1,520	$30	$45.5K
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…	460	$80	$36K

Showing 1–10 of 11

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Pennsylvania Distribution

The Center For Autism — 2 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2021	Community-based wrap-around services, per 15 minutes	101	220	3,810	$100	$1.5M
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…	492	690	2,240	$80	$1M
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…	64	560	1,400	$90	$485.7K
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…	270	540	1,490	$50	$316.4K
H0034	Medication training and support, per 15 minutes	137	260	1,710	$80	$279.8K
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…	282	420	650	$180	$270.2K
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…	9	340	2,010	$50	$269.8K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	12	180	860	$70	$195.9K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	1	240	130	$300	$139.8K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	320	980	310	$50	$136.6K

Showing 1–10 of 11

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Yapa Apartment Living Program, Inc	PA	Community/Behavioral Health Agency	$0	$18.5M
Merakey Parkside Recovery	PA	Community/Behavioral Health Agency	$130.8K	$11.8M
Community Council	PA	Community/Behavioral Health Agency	$0	$7.8M
Easter Seals Of Southeastern Pennsylvania	PA	Speech-Language Pathologist	$0	$6M
Community Council For Mental Health And Mental Retardation I	PA	Community/Behavioral Health Agency	$0	$5.7M
Belmont Behavioral Hospital, LLC	PA	Psychiatric Hospital	$0	$5.5M
John Costello	PA	Clinical Cardiac Electrophysiology Physician	$313.1K	$0
Daniela Marinaro	PA	Orthopaedic Surgery Physician	$221.5K	$0
Bradley Bacik	PA	Clinical Cardiac Electrophysiology Physician	$188.5K	$600
Jeffrey Freeman	PA	Endocrinology, Diabetes & Metabolism Physician	$120.3K	$25K

The Center For Autism — Billing Profile & Reimbursement Data

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The Center For Autism — 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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