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

Why is the Medicaid comparison limited to New Jersey 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. New Jersey (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.

Advanced Behavioral Care Services, LLC (NPI 1043354442)

Field	Value
Entity Type	Organization
Organization	Advanced Behavioral Care Services, LLC
Address	1 S Main St Suite A1
City	South Toms River
State	NJ
ZIP	08757
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	February 18, 2007

Payer Source	Total Paid
Medicaid	$13.5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0035	Mental health partial hospitalization, treatment, less than 24 hours	145,140	$90	$12.5M
A0090	Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest	64,640	$10	$581.8K
A0425	Ground mileage, per statute mile	64,450	$10	$322.2K
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…	230	$370	$86.4K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	20	$40	$980
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	10	$60	$780
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.	10	$20	$220

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Jersey Distribution

Advanced Behavioral Care Services, LLC — 2 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Jersey

Full comparison — all codes billed, vs. New Jersey median

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0035	Mental health partial hospitalization, treatment, less than 24 hours	6	170	21,080	$100	$4.2M
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…	233	480	220	$260	$260.3K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	4,080	4,450	740	$40	$229.8K
A0090	Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest	15	230	7,800	$10	$218.8K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	3,647	3,790	580	$60	$204K
A0425	Ground mileage, per statute mile	22	430	3,700	$10	$106.9K
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.	603	660	190	$30	$42.6K

Nearby Providers

Other providers in the same ZIP code as Advanced Behavioral Care Services, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Open Door Of New Jersey	NJ	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$26.8M
Robert Lee	NJ	Dermatology Physician	$941.5K	$0
Chi Wu	NJ	Physical Medicine & Rehabilitation Physician	$402.2K	$0
Dhiren Shah	NJ	Pulmonary Disease Physician	$388.3K	$0
Patrick Alcasid	NJ	Pulmonary Disease Physician	$353.6K	$0
Physicians Surgicenter LLC	NJ	Ambulatory Surgical Clinic/Center	$349.9K	$0
Emad Kamel	NJ	Pulmonary Disease Physician	$308.1K	$0
Walter Wynkoop	NJ	Pulmonary Disease Physician	$293.5K	$0
Muhammad Khan	NJ	Pulmonary Disease Physician	$284.5K	$0
Ramesh Kumar	NJ	Rheumatology Physician	$274.1K	$20

Advanced Behavioral Care Services, LLC — Billing Profile & Reimbursement Data

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Advanced Behavioral Care Services, LLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References