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

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

Gemma Services (NPI 1144310830)

Field	Value
Entity Type	Organization
Organization	Gemma Services
Address	512 Township Line Rd
City	Plymouth Meeting
State	PA
ZIP	19462
Taxonomy	Psychiatric Residential Treatment Facility
NPI Enumerated	October 13, 2006

Payer Source	Total Paid
Medicaid	$23.8M
Medicare	$0

Medicaid: Complete Services Breakdown

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	17,650	$330	$5.8M
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…	19,760	$190	$3.7M
H0032	Mental health service plan development by non-physician	24,430	$120	$2.9M
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…	25,560	$90	$2.3M
H2019	Therapeutic behavioral services, per 15 minutes	16,030	$130	$2.1M
H0004	Behavioral health counseling and therapy, per 15 minutes	5,610	$300	$1.7M
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…	9,630	$110	$1M
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…	9,440	$110	$991.1K
H2021	Community-based wrap-around services, per 15 minutes	5,270	$170	$891.1K
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…	6,450	$90	$573.9K

Showing 1–10 of 22

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Pennsylvania Distribution

Gemma Services — 2 of 21 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

22 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	36	150	8,280	$220	$4.1M
H2021	Community-based wrap-around services, per 15 minutes	96	220	3,810	$100	$1.5M
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…	14	150	2,770	$200	$1.4M
H0032	Mental health service plan development by non-physician	28	210	3,020	$130	$1.3M
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…	218	690	2,240	$80	$1M
T1016	Case management, each 15 minutes	106	160	2,180	$80	$965.8K
H0046	Mental health services, not otherwise specified	122	170	1,200	$130	$909.6K
H2019	Therapeutic behavioral services, per 15 minutes	24	180	3,510	$80	$685K
97151	The provider, a physician or other qualified healthcare professional, identifies the adaptive or maladaptive behavior of the patient by administering several different types of tests in person; he…	73	120	1,330	$180	$557.5K
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…	22	560	1,400	$90	$485.7K

Showing 1–10 of 22

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Access Services Inc	PA	Community/Behavioral Health Agency	$0	$8.3M
Omesh Gupta	PA	Ophthalmology Physician	$7.1M	$80
Mitchell Fineman	PA	Ophthalmology Physician	$7M	$0
Michael Klufas	PA	Ophthalmology Physician	$7M	$0
Richard Kaiser	PA	Ophthalmology Physician	$6.6M	$0
Allen Chiang	PA	Ophthalmology Physician	$6.6M	$0
Carl Regillo	PA	Ophthalmology Physician	$6.5M	$0
Allen Ho	PA	Ophthalmology Physician	$6.4M	$0
Yoshihiro Yonekawa	PA	Ophthalmology Physician	$6.4M	$0
James Vander	PA	Ophthalmology Physician	$6.3M	$0

Gemma Services — Billing Profile & Reimbursement Data

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Gemma 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

Nearby Providers

Frequently Asked Questions

References