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

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

Prestige Healthcare Resources Inc. (NPI 1144516824)

Field	Value
Entity Type	Organization
Organization	Prestige Healthcare Resources Inc.
Address	6011 Emerson St
City	Bladensburg
State	MD
ZIP	20710
Taxonomy	Adult Mental Health Clinic/Center
NPI Enumerated	June 22, 2011

Payer Source	Total Paid
Medicaid	$55.6M
Medicare	$0

Key Findings

This provider is effectively single-payer in scope: there is no Medicare billing on file and all recorded lifetime revenue is Medicaid-based ($55.6M). The NPI was enumerated on 2011-06-22 (approximately 15 years ago), indicating an established operational history concentrated on Medicaid populations.

Revenue is highly concentrated in a very small set of time-based community mental health codes: H0036 (541.6K claims, $64 avg paid/claim, $34.7M revenue, 62.3% of this provider's total Medicaid revenue), T1023 (21.9K claims, $255 avg paid/claim, $5.6M revenue, 10.0%), and H0039 (36.6K claims, $122 avg paid/claim, $4.5M revenue, 8.0%) together account for 80.4% of the provider’s Medicaid revenue. This concentration implies the business is heavily dependent on a few programmatic service lines.

The code mix points to a community-based, intensive mental health operations model: the dominance of H0036 (community psychiatric supportive treatment), H0039 (assertive community treatment), and H0034 (medication training and support — 61.5K claims, $68 avg paid/claim, $4.2M revenue, 7.5%) indicates the provider delivers frequent, short-interval, face-to-face community services and medication support rather than relying on high-revenue, low-frequency procedures. The presence of H0018 (short-term residential per diem: 23.4K claims, $113 avg paid/claim, $2.6M revenue, 4.7%) further signals a mix of community outreach and non-hospital residential programming.

Operationally, the provider’s billing profile shows extremely high claim volumes in 15-minute unit codes, most notably 541.6K claims for H0036 and 61.5K claims for H0034, which suggests a workflow optimized for high-frequency, short-duration encounters and substantial field- or community-based staff time. These unit-based services can drive administrative complexity for payers (large volumes of small-unit claims) and may affect utilization management and payment models.

On competitive standing within Maryland, the provider is a dominant reporter for several key Medicaid services: H0036 ranks #1 of 5 providers in-state (100th percentile; notably above typical state volume), and H0039 ranks #1 of 1 providers in-state (no state peer volume comparison available), indicating this entity is either the primary or sole provider reporting these services at scale in the state. Other codes show strong relative activity too — for example, 90791 (psychiatric evaluation) ranks #55 of 1093 providers in-state (95th percentile; notably above typical state volume) — reinforcing a specialty position in public behavioral health.

There are clear statistical outliers in the state benchmarking: H0002 (behavioral health screening) is listed as an extreme outlier (4K claims, $42 avg paid/claim, $167.5K revenue, 0.3%) and ranks #1 of 344 providers in-state (100th percentile), which suggests materially higher screening activity relative to most peers. Similarly, several high-volume, high-percentile ranks (for example, H0036 at the 100th percentile and 90791 at the 95th percentile) indicate the provider performs substantially more of these services than typical in-state peers.

Although community and ACT services dominate revenue, the provider also bills conventional outpatient E/M and psychotherapy codes at modest levels — for example 99214 (10.5K claims, $99 avg paid/claim, $1M revenue, 1.9%) and 90837 (3.4K claims, $102 avg paid/claim, $348.5K revenue, 0.6%). These figures show the organization maintains some clinic-based evaluation and psychotherapy capacity, but these are a small share of overall Medicaid revenue compared with the time-based community treatment codes.

For payers and network planners, the provider’s heavy reliance on a handful of high-volume, time-based community codes (top three account for 80.4% of Medicaid revenue) represents both an operational dependency and a leverage point in contracting or program design. Given the provider’s ~15-year tenure and dominant in-state reporting for specific codes, payers should treat this entity as an established, specialized Medicaid behavioral health vendor whose performance and capacity will materially affect state-level access to community psychiatric supportive treatment and assertive community treatment.

Medicaid: Complete Services Breakdown

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

28 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	541,630	$60	$34.7M
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	21,900	$260	$5.6M
H0039	Assertive community treatment, face-to-face, per 15 minutes	36,570	$120	$4.5M
H0034	Medication training and support, per 15 minutes	61,510	$70	$4.2M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	23,380	$110	$2.6M
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…	10,500	$100	$1M
H0004	Behavioral health counseling and therapy, per 15 minutes	16,260	$50	$813K
T1017	Targeted case management, each 15 minutes	9,640	$70	$694K
H2014	Skills training and development, per 15 minutes	17,810	$20	$391.9K
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…	3,420	$100	$348.5K

Showing 1–10 of 28

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Maryland Distribution

Prestige Healthcare Resources Inc. — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maryland

Full comparison — all codes billed, vs. Maryland median

28 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	1	10	19,590	$70	$11.2M
H0040	Assertive community treatment program, per diem	49	50	3,460	$1,240	$5.2M
H0039	Assertive community treatment, face-to-face, per 15 minutes	1	10	36,570	$120	$4.4M
T1017	Targeted case management, each 15 minutes	11	20	6,750	$150	$2.8M
H2014	Skills training and development, per 15 minutes	2	10	1,820	$290	$2.7M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	1	10	23,380	$110	$2.6M
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	9	60	3,550	$250	$2.6M
H0034	Medication training and support, per 15 minutes	1	10	2,040	$70	$1.1M
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…	1,847	2,200	890	$110	$596.1K
H0004	Behavioral health counseling and therapy, per 15 minutes	60	380	1,450	$60	$459K

Showing 1–10 of 28

Nearby Providers

Other providers in the same ZIP code as Prestige Healthcare Resources Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lifeline, Inc	MD	Home Health Agency	$0	$103.5M
Healthtech Institute	MD	Developmentally Disabled Services Day Training Agency	$0	$4.5M
Parmjit Aujla	MD	Internal Medicine Physician	$193.7K	$175.4K
Asghar Shaigany	MD	Gastroenterology Physician	$133.7K	$0
Muyiwa Elesho	MD	Clinical Social Worker	$10.4K	$0

Prestige Healthcare Resources Inc. — Billing Profile & Reimbursement Data

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Prestige Healthcare Resources Inc. — 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

Nearby Providers

Frequently Asked Questions

References