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

Why is the Medicaid comparison limited to North Carolina 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. North Carolina (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.

Access Family Services (NPI 1063571131)

Field	Value
Entity Type	Organization
Organization	Access Family Services
Address	725 Wellington Ave
City	Wilmington
State	NC
ZIP	28401
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	December 6, 2006

Payer Source	Total Paid
Medicaid	$15.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

23 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5145	Foster care, therapeutic, child; per diem	67,000	$140	$9.4M
H2022	Community-based wrap-around services, per diem	15,560	$270	$4.1M
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	2,720	$160	$424.2K
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…	4,210	$70	$311.7K
97155	The provider, a physician or other qualified healthcare professional, administers adaptive behavior treatment face–to–face with one patient and makes modifications in the protocol targets and…	1,070	$230	$241.8K
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…	3,140	$70	$226.2K
0365T	Adaptive behavior tx addl	1,870	$90	$158.5K
T1017	Targeted case management, each 15 minutes	1,510	$90	$136.2K
0369T	Duodenal mucosal resurfacing, endoscopic	690	$110	$76.4K
0364T	Behavior treatment	2,020	$20	$48.4K

Showing 1–10 of 23

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Carolina Distribution

Access Family Services — 0 of 23 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. North Carolina median

23 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5145	Foster care, therapeutic, child; per diem	15	60	27,280	$160	$7.2M
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	63	90	5,820	$310	$6.4M
H2022	Community-based wrap-around services, per diem	47	220	3,330	$290	$3.3M
97155	The provider, a physician or other qualified healthcare professional, administers adaptive behavior treatment face–to–face with one patient and makes modifications in the protocol targets and…	58	80	2,260	$190	$1.4M
T1017	Targeted case management, each 15 minutes	114	220	1,700	$150	$1.3M
0365T	Adaptive behavior tx addl	10	10	3,990	$140	$567.1K
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…	334	1,710	810	$80	$274.5K
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…	1,233	4,400	960	$60	$271.3K
97156	The provider discusses a patient’s adaptive behavior treatment face–to–face with the guardian(s) or caregiver(s), with or without the patient present. Report this code for each 15 minutes that the…	36	70	1,020	$70	$152.1K
0369T	Duodenal mucosal resurfacing, endoscopic	4	10	550	$170	$142.8K

Showing 1–10 of 23

Related Providers

Other providers that share a Tax Identification Number (TIN) with Access Family Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pathways Human Services Of North Carolina, LLC	NC	Community/Behavioral Health Agency	$0	$10.3M
Pathways Human Services Of North Carolina, LLC	NC	Community/Behavioral Health Agency	$0	$10.3M

Nearby Providers

Other providers in the same ZIP code as Access Family Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Novant Health New Hanover Regional Medical Center LLC	NC	General Acute Care Hospital	$0	$57.5M
New Hanover Regional Medical Center	NC	General Acute Care Hospital	$0	$23.7M
Care Providers Of Wilmington	NC	Home Health Agency	$0	$10M
Wilmington Health PLLC	NC	Pediatrics Physician	$0	$10M
Ecep Ii PA	NC	Emergency Medicine Physician	$0	$9.7M
Novant Health New Hanover Regional Medical Center LLC	NC	Ambulance	$6.1M	$2.7M
Coastal Horizons Center Inc.	NC	Community/Behavioral Health Agency	$0	$8.7M
New Hanover Community Health Center Incorporated	NC	Federally Qualified Health Center (FQHC)	$0	$8.5M
Kidzcare Pediatrics, PC	NC	Pediatrics Physician	$0	$8.2M
Rha Health Services, Inc	NC	Community/Behavioral Health Agency	$0	$7.5M

Access Family Services — Billing Profile & Reimbursement Data

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Access Family Services — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References