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

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

Merakey Pennsylvania (NPI 1033484019)

Field	Value
Entity Type	Organization
Organization	Merakey Pennsylvania
Address	106 Heymann Blvd
City	Lafayette
State	LA
ZIP	70503
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	March 9, 2012

Payer Source	Total Paid
Medicaid	$37.7M
Medicare	$0

Key Findings

MER AKEY PENNSYLVANIA is a community/behavioral health agency based in LAFAYETTE, LA with its NPI enumerated on 2012-03-09 (~14 years ago). The provider reports $37.7M in lifetime Medicaid revenue and has no Medicare billing on file, making its public revenue footprint effectively single-payer (Medicaid) in scale and exposure.

Revenue for this provider is extremely concentrated: the precomputed top 3 Medicaid codes account for 100.0% of its total Medicaid revenue, with H0039 alone representing $37.6M (99.8% of Medicaid revenue). This concentration indicates that a single service line drives virtually all of the provider’s billed Medicaid dollars.

The code mix and volumes identify MERAKEY PENNSYLVANIA operationally as an intensive community-based behavioral health provider: H0039 (Assertive community treatment, face-to-face, per 15 minutes) tallied 44.2K claims at an $851 avg paid/claim, consistent with a high-frequency, unit-based ACT model that bills multiple 15-minute encounters per member.

On competitive standing for its principal service, the provider ranks #1 of 25 providers in-state for H0039 (100th percentile; notably above typical state volume for this code), marking it as a dominant statewide ACT service provider by volume and reimbursement among peers captured in the dataset.

Secondary codes contribute negligible revenue despite nontrivial claim counts: 90791 shows 2.8K claims and $87K revenue (0.2% of Medicaid revenue) and ranks #48 of 764 providers in-state (94th percentile; typical, unremarkable volume), indicating that psychiatric evaluation encounters are reported but are not the organization’s primary revenue driver.

Ancillary billed services are present but immaterial to revenue and uneven in peer context: A0160 (non-emergency transportation per mile) has 644 claims, $5.2K revenue and ranks #1 of 1 providers in-state (0th percentile; no state peer volume comparison available), while 99487 (care coordination) and 98960 (patient education) show small claim counts and $0–$800 in revenue and are characterized as typical, unremarkable volume in their peer sets.

Notably, 98960 appears as 1.3K claims with a $0 avg paid/claim and $0 revenue (0.0% of Medicaid revenue), which suggests recorded billings without an associated paid amount in this dataset; this pattern is a reporting detail analysts should track rather than an arithmetic anomaly in the provider’s revenue totals.

Given the single-payer profile and the outsized role of H0039 in the provider’s $37.7M Medicaid revenue, the organization is highly exposed to changes in Medicaid policy, reimbursement for ACT services, or utilization management practices tied to H0039; analysts should treat H0039 utilization and state-level ACT policy as the primary levers affecting this provider’s financial and service footprint.

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0039	Assertive community treatment, face-to-face, per 15 minutes	44,190	$850	$37.6M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	2,810	$30	$87K
A0160	Non-emergency transportation: per mile - case worker or social worker	640	$10	$5.2K
99487	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	30	$30	$800
98960	A nonphysician qualified healthcare professional uses a standard curriculum to educate a patient about their disease or disorder and how to manage it more effectively. This code represents each 30…	1,310	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Louisiana Distribution

Merakey Pennsylvania — 1 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Louisiana

Full comparison — all codes billed, vs. Louisiana median

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0039	Assertive community treatment, face-to-face, per 15 minutes	1	30	6,840	$900	$11.5M
98960	A nonphysician qualified healthcare professional uses a standard curriculum to educate a patient about their disease or disorder and how to manage it more effectively. This code represents each 30…	16	80	440	$20	$29K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	48	760	170	$40	$25.6K
99487	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	12	20	40	$20	$6K
A0160	Non-emergency transportation: per mile - case worker or social worker	1	10	640	$10	$5.3K

Nearby Providers

Other providers in the same ZIP code as Merakey Pennsylvania, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lafayette General Medical Center Inc	LA	General Acute Care Hospital	$0	$31.1M
New Day Personal Care Services	LA	In Home Supportive Care Agency	$0	$28.5M
Gulf Coast Teaching Family Services, Inc.	LA	Community/Behavioral Health Agency	$0	$13.1M
Coolidge Emergency Group LLC	LA	Emergency Medicine Physician	$0	$11.1M
Pediatrust Acadiana, LLC	LA	Medically Fragile Infants and Children Day Care	$0	$8.6M
Critical Care Newborn Services	LA	Neonatal-Perinatal Medicine Physician	$0	$7.6M
New Day Personal Care Services	LA	In Home Supportive Care Agency	$0	$6.9M
A Blessing Personal Home Care	LA	In Home Supportive Care Agency	$0	$6.4M
Priority Medical Care Inc.	LA	Home Health Agency	$0	$6.2M
Bryan G Sibley Md Apmc	LA	Pediatrics Physician	$0	$6M

Merakey Pennsylvania — Billing Profile & Reimbursement Data

Sign up for Merakey Pennsylvania — Billing Profile & Reimbursement Data policy alerts

Merakey Pennsylvania — Billing Profile & Reimbursement Data

Sign up for Merakey Pennsylvania — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References