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NPI 1043271539 · Feasterville, PA · Clinical Medical Laboratory
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Sma Medical, Inc. is a clinical medical laboratory provider located in Feasterville, Pennsylvania. This profile covers 250 Medicare and 262 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Sma Medical, Inc. |
| Address | 940 Pennsylvania Blvd |
| City | Feasterville |
| State | PA |
| ZIP | 19053 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | April 1, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $20.4M |
| Medicare | $13.4M |
SMA MEDICAL, INC. is a high-volume clinical diagnostic laboratory that reports a heavy molecular and toxicology testing mix: its Medicare top codes are 87798, 87150, and 87481, and the provider’s top 3 Medicare codes account for 58.7% of this provider's total Medicare revenue. On Medicaid the top-revenue drivers are G0481, U0004, and 87798, and the top 3 Medicaid codes account for 47.5% of this provider's total Medicaid revenue, indicating concentrated revenue streams around targeted test modalities.
Payer mix shows Medicaid scale exceeds Medicare scale: the provider reports Total Medicare revenue: $13.4M versus Total Medicaid revenue: $20.4M, so Medicaid is the larger single payer relationship on file. Both payers are material to the business, but Medicaid represents the larger revenue pool for the lab’s operations and volume of claims.
The code-level mix implies a dual operating focus on high-throughput infectious disease and confirmatory drug testing alongside routine clinical chemistry. High-revenue COVID and respiratory-related codes appear on Medicaid (U0004, U0005, 87633) while large volumes of confirmatory drug testing (G0481, G0480) and presumptive screens (80307) show up on both Medicaid and Medicare, consistent with a centralized lab performing both pandemic-era molecular diagnostics and routine/toxicology testing.
SMA MEDICAL is a national-level outlier on multiple molecular codes in Medicare: 87798 ranks #17 of 1319 providers nationally (99th percentile; notably above typical national volume for this code) and 87150 ranks #7 of 190 providers nationally (97th percentile; notably above typical national volume for this code), which indicates the lab is a major national player for several amplified-probe molecular assays. Additionally, 83018 is listed as rank #1 of 68 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code), highlighting unusually large volume in a specific heavy-metal testing code.
In the state Medicaid market SMA MEDICAL shows dominant positions on several tests: G0481 (rank #4 of 23 in-state, 86th percentile) and U0004 (rank #5 of 73 in-state, 94th percentile) provide substantial Medicaid revenue, while 87150 ranks #2 of 44 providers in-state (98th percentile; extreme outlier, far above typical state volume for this code), signaling particularly strong in-state market share for that amplified-probe organism-typing service. The provider also ranks #1 in-state for several high-claim, low-unit-price chemistry codes (for example 84311 and 82570), indicating both breadth and depth across test types in the local Medicaid market.
Revenue concentration creates operational implications: because the top 3 Medicare codes drive 58.7% of Medicare dollars and the top 3 Medicaid codes drive 47.5% of Medicaid dollars, a meaningful portion of the lab’s revenue is tied to a small set of assay types (molecular amplification assays and definitive drug testing). This concentration suggests sensitivity to reimbursement or demand shifts on those specific assays and underscores the strategic importance of maintaining capacity, supply chains, and payer contracts for amplified-probe and confirmatory toxicology workflows.
Several individual codes are flagged as statistical outliers or notably above typical volumes, which frames competitive standing rather than clinical implication: Medicare-level extreme outliers include 87500 and 87640 (99th percentile; extreme outlier) and 83018 (100th percentile; extreme outlier), while Medicaid-level extremes include 87150 (98th percentile; extreme outlier) and high-ranking items like 84311 and 82570 (both top-ranked in-state or extreme outliers). These labels indicate the provider operates at volumes far above most peers on multiple specific tests, consistent with specialized capacity or large referral volumes for those assays.
The practice has an established tenure in the dataset, with NPI enumerated 2006-04-01 (~20 years ago), which combined with the observed high-volume, concentrated test mix suggests an experienced laboratory operation that has scaled specific service lines (molecular infectious disease testing and definitive toxicology) over time rather than a recently launched testing center.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
250 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 87798 | The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified… | 91,870 | $30 | $3.1M |
| 87150 | The lab analyst performs an analysis using amplified DNA or RNA probe technique on a previously isolated and identified organism to categorize the organism more specifically, such as to the taxonomic… | 65,590 | $30 | $2.2M |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 20,780 | $30 | $706.5K |
| 82306 | The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced… | 13,590 | $30 | $394K |
| 84443 | The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the… | 19,470 | $20 | $311.6K |
| 87799 | The lab analyst performs a test to quantify infection with an infectious agent, not otherwise specified in another code, using a nucleic acid probe technique. Use this code if you know the laboratory… | 6,220 | $40 | $261.2K |
| 87653 | The lab analyst performs a test for Streptococcus, group B, using amplified nucleic acid probe technique. The amplified probe provides a rapid means to assess colonization by Streptococcus, group B,… | 7,580 | $30 | $257.6K |
| 87500 | The lab analyst performs a test for vancomycin resistance in an infectious organism’s nucleic acid using amplified probe technique. VRE, vancomycin resistant enterococcus, is the most common organism… | 7,570 | $30 | $257.5K |
| 87640 | The lab analyst performs the technical lab test to look for Staphylococcus aureus nucleic acid using an amplified probe technique. | 7,450 | $30 | $253.2K |
| 81226 | The lab analyst performs the technical lab test to detect the presence of common changes in the gene for cytochrome P450, family 2, subfamily D, polypeptide 6, also known as CYP2D6. | 570 | $440 | $251.1K |
Showing 1–10 of 250
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 250 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
250 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 87798 | 3 | 40 | 1,250 | $30 | $1.1M |
| 87150 | 2 | 10 | 7,730 | $30 | $1M |
| 87481 | 4 | 20 | 940 | $30 | $574.2K |
| 87653 | 3 | 20 | 360 | $30 | $175.8K |
| 87799 | 2 | 10 | 790 | $40 | $128.8K |
| 81514 | 2 | 10 | 130 | $260 | $119.1K |
| 81226 | 1 | 10 | 220 | $440 | $117.7K |
| U0004 | 4 | 10 | 190 | $70 | $105.8K |
| 87529 | 3 | 10 | 80 | $30 | $96.6K |
| G0480 | 8 | 40 | 270 | $110 | $94.5K |
Showing 1–10 of 250
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
262 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| G0481 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 56,850 | $60 | $3.2M |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by… | 36,380 | $70 | $2.4M |
| 87798 | The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified… | 15,570 | $90 | $1.4M |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 53,950 | $20 | $1.2M |
| 87633 | The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for… | 3,390 | $310 | $1.1M |
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 23,220 | $40 | $998.5K |
| 87150 | The lab analyst performs an analysis using amplified DNA or RNA probe technique on a previously isolated and identified organism to categorize the organism more specifically, such as to the taxonomic… | 9,740 | $70 | $701.6K |
| 82306 | The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced… | 44,690 | $10 | $491.6K |
| U0005 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc,… | 23,340 | $20 | $396.7K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 11,020 | $30 | $286.5K |
Showing 1–10 of 262
How this provider's Medicaid billing volume and revenue compare to other Pennsylvania providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Pennsylvania median
262 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| G0481 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 4 | 20 | 710 | $80 | $1.7M |
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 8 | 130 | 310 | $60 | $769.3K |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 8 | 210 | 730 | $40 | $689.7K |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by… | 5 | 70 | 620 | $60 | $464.8K |
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 14 | 20 | 540 | $50 | $367.6K |
| 0202U | This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the… | 51 | 60 | 430 | $200 | $354.2K |
| 87633 | The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for… | 5 | 60 | 110 | $220 | $151.2K |
| 81226 | The lab analyst performs the technical lab test to detect the presence of common changes in the gene for cytochrome P450, family 2, subfamily D, polypeptide 6, also known as CYP2D6. | 2 | 10 | 110 | $40 | $149.3K |
| 81225 | The lab analyst performs the technical lab test to detect the presence of common changes in the gene for cytochrome P450, family 2, subfamily C, polypeptide 19, also known as CYP2C19. | 2 | 10 | 110 | $30 | $135.4K |
| 80348 | The lab analyst measures the amount of or detects the presence of buprenorphine in a patient specimen. Buprenorphine is a drug used to treat opioid addiction, to control acute pain in individuals who… | 6 | 10 | 4,750 | $1 | $133.9K |
Showing 1–10 of 262
Other providers in the same ZIP code as Sma Medical, Inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Aurora Home Care, Inc | PA | Home Health Agency | $0 | $51.7M |
| Partnership For Community Supports | PA | Case Management Agency | $0 | $34.6M |
| Better Home Care Agency, LLC | PA | Home Health Agency | $0 | $20.7M |
| Loving Care Agency, Inc. | PA | Home Health Agency | $0 | $18.4M |
| Fidelity Home Health LLC | PA | Home Health Agency | $0 | $13.8M |
| Vitacare Home Health Inc | PA | Home Health Agency | $0 | $12.9M |
| Partnership For Community Supports | PA | Early Intervention Provider Agency | $0 | $9.9M |
| A-team Home Care, Inc. | PA | Home Health Agency | $0 | $8.3M |
| Altruistic Home Care Agency, LLC | PA | In Home Supportive Care Agency | $0 | $6.7M |
| Acsr, Inc. | PA | Adult Day Care Clinic/Center | $0 | $6.2M |
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