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

Why is the Medicaid comparison limited to Alabama 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. Alabama (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 Children's Hospital Of Alabama (NPI 1114025103)

Key Findings

Field	Value
Entity Type	Organization
Organization	The Children's Hospital Of Alabama
Address	1600 7th Ave S
City	Birmingham
State	AL
ZIP	35233
Taxonomy	Psychologist
NPI Enumerated	September 21, 2006

Payer Source	Total Paid
Medicaid	$12M
Medicare	$0

This provider effectively operates on a single-payer basis for the claims on file: there is no Medicare revenue (no Medicare billing on file) while total Medicaid revenue is $12M, indicating Medicaid is the material revenue source for THE CHILDREN'S HOSPITAL OF ALABAMA's psychologist taxonomy. The absence of Medicare billing makes the provider functionally a Medicaid-focused operation in the available datasets.

Revenue is highly concentrated in a very small set of procedures: the precomputed top-3 Medicaid codes account for 64.5% of this provider's total Medicaid revenue. Those three codes are 99233 ($4.9M, 47.2K claims, 41.2% of this provider's total Medicaid revenue), 90834 ($1.5M, 18.1K claims, 12.6% of this provider's total Medicaid revenue), and 99245 ($1.3M, 6.2K claims, 10.6% of this provider's total Medicaid revenue).

The code mix points to a hybrid inpatient/outpatient pediatric behavioral-health operation rather than a small outpatient psychotherapy clinic. Large volumes and dollars for inpatient E/M codes such as 99233 (47.2K claims, $4.9M) and 99232 (11.2K claims, $938.4K), together with high-revenue outpatient consultation and E/M codes like 99245 ($1.3M) and 99214 ($1M), plus psychotherapy codes such as 90834 ($1.5M), indicate integrated inpatient consultation services plus substantial outpatient psychotherapy capacity.

THE CHILDREN'S HOSPITAL OF ALABAMA is a statewide leader on specific high-acuity codes: 99233 ranks #2 of 245 providers in-state (100th percentile; extreme outlier) and 99245 ranks #1 of 30 providers in-state (100th percentile; extreme outlier). These rankings and labels identify the provider as a dominant, high-volume performer for complex inpatient and outpatient consultation E/M services within Alabama.

Not all high-volume codes are labeled outliers; 90834 (psychotherapy) is sizable at 18.1K claims and $1.5M in revenue but is characterized as typical/unremarkable volume for the code in-state (ranks #2 of 105 providers, 99th percentile; typical, unremarkable volume for this code). Other commonly billed E/Ms such as 99214 ($1M, 8.6% of Medicaid revenue) and 99232 ($938.4K, 7.9%) appear as routine high-volume services relative to large statewide provider counts (99214 ranks #185 of 1990 providers, 91th percentile; 99232 ranks #29 of 396 providers, 93th percentile).

Specialized assessment and testing services are present but not primary revenue drivers: psychiatric evaluation codes 90791 ($140.3K) and 90792 ($104K) plus neuropsychological/testing codes such as 96132 ($35.4K) and 96130 ($19.2K) are billed, indicating availability of diagnostic and testing capacity, yet these together represent a small share of the $12M Medicaid total. This pattern suggests the hospital offers multidisciplinary evaluations but derives the bulk of revenue from E/M and psychotherapy encounters.

The provider has an established operational history in the NPI registry (enumerated/registered 2006-09-21, ~20 years ago), which, combined with concentrated high-volume Medicaid activity, suggests an entrenched role in pediatric behavioral-health services in Alabama. Payers and analysts should treat the entity as a long-tenured, high-capacity state provider for inpatient and consultative pediatric psych services.

Implication for payer strategy: given the high concentration (top 3 codes = 64.5% of Medicaid revenue) in high-acuity E/M and consultation codes (notably 99233 and 99245 as extreme outliers), payers should consider this provider a key inpatient/outpatient pediatric psychiatry resource and prioritize contract, utilization, and capacity analyses around those specific services and volumes rather than a broad-based distribution across many modest codes.

Medicaid: Complete Services Breakdown

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

36 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	47,210	$100	$4.9M
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…	18,140	$80	$1.5M
99245	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a high level of medical decision making or the provider spends…	6,160	$210	$1.3M
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…	8,290	$120	$1M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	11,170	$80	$938.4K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	2,760	$210	$565.6K
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…	2,470	$110	$271.4K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	2,080	$110	$224.6K
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…	2,290	$90	$199.2K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	1,080	$180	$188.8K

Showing 1–10 of 36

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Alabama Distribution

The Children's Hospital Of Alabama — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. Alabama median

36 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	7	20	880	$20	$618.6K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	20	180	100	$120	$381.8K
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…	198	380	440	$90	$362K
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…	86	120	500	$50	$317.7K
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…	32	120	730	$60	$212.5K
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…	185	1,990	680	$60	$201.7K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	27	120	170	$160	$200.7K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	33	330	140	$240	$197.4K
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…	591	1,990	560	$40	$185.6K
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…	2	110	240	$60	$175.6K

Showing 1–10 of 36

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratory Corporation Of America Holdings	AL	Clinical Medical Laboratory	$60.5M	$289.1M
University Of Alabama Health Services Foundation, PC	AL	Pediatrics Physician	$0	$79.6M
University Of Alabama Health Services Foundation, PC.	AL	Multi-Specialty Clinic/Center	$0	$77.1M
M&o Enterprises LLC	AL	Home Infusion Therapy Pharmacy	$0	$31.2M
Medical Resources, Inc	AL	Oxygen Equipment & Supplies (DME)	$0	$23.6M
Southern Lab Partners, LLC	AL	Clinical Medical Laboratory	$5.4M	$14.4M
University Of Alabama Health Services Foundation PC	AL	Clinic/Center	$0	$18.6M
Jefferson County Board Of Health	AL	Public Health or Welfare Agency	$0	$12.2M
Pediatric Anesthesia Associates PC	AL	Anesthesiology Physician	$0	$7.2M
University Of Alabama Ophthalmology Services Foundation	AL	Ophthalmology Physician	$0	$6.9M

The Children's Hospital Of Alabama — Billing Profile & Reimbursement Data

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The Children's Hospital Of Alabama — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Children's Hospital Of Alabama	AL	Children's Hospital	$0	$59M
The Children's Hospital Of Alabama	AL	Pediatrics Physician	$0	$22.2M
The Children's Hospital Of Alabama	AL	Pediatrics Physician	$0	$18.4M
The Children's Hospital Of Alabama	AL	Pediatrics Physician	$0	$17.7M
The Children's Hospital Of Alabama	AL	Pediatric Otolaryngology Physician	$0	$15.8M
The Children's Hospital Of Alabama	AL	Pediatrics Physician	$0	$7.5M
The Children's Hospital Of Alabama	AL	Pediatrics Physician	$0	$5.7M
The Children's Hospital Of Alabama	AL	Pediatric Pulmonology Physician	$0	$5.6M
The Children's Hospital Of Alabama	AL	Pediatrics Physician	$0	$5.3M
The Children's Hospital Of Alabama	AL	Pediatrics Physician	$0	$4.6M