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.

Advanced Behavioral Health, Inc (NPI 1154799559)

Key Findings

Field	Value
Entity Type	Organization
Organization	Advanced Behavioral Health, Inc
Address	1003 W 7th St Ste 500. 205
City	Frederick
State	MD
ZIP	21701
Taxonomy	Clinic/Center
NPI Enumerated	September 2, 2015

Payer Source	Total Paid
Medicaid	$30.7M
Medicare	$0

ADVANCED BEHAVIORAL HEALTH, INC is effectively a Medicaid-centric outpatient behavioral health provider: it reports $30.7M in lifetime Medicaid revenue and has no Medicare billing on file, so its commercial exposure to Medicare beneficiaries is nil. The provider’s NPI was enumerated on 2015-09-02 (~11 years ago), indicating roughly a decade of operations under this enrollment.

Revenue is highly concentrated in a small set of psychotherapy and E/M services: the top three Medicaid codes (90834, 90847, 99214) together account for 86.8% of this provider’s total Medicaid revenue. Specifically, 90834 alone represents $20.2M (65.7%) on 160.3K claims at $126 avg paid/claim, 90847 contributes $4.3M (14.1%) on 37.6K claims at $115 avg paid/claim, and 99214 contributes $2.2M (7.1%) on 19.1K claims at $114 avg paid/claim.

The code mix points to an operation organized around high-volume psychotherapy and family therapy with supporting psychiatric evaluation and care planning: substantial volumes of 90834 (individual psychotherapy), 90847 (family with patient present), 90832 (shorter individual psychotherapy), and 90791/90792 (psychiatric evaluations) indicate outpatient talk-therapy as the core service line. The presence of H0032 (10.9K claims, $1.1M revenue) further shows systematic provision of mental health service plan development by non-physicians, consistent with clinic/center staffing that likely relies heavily on non-physician therapists.

By statewide competitive measures this provider is a major volume outlier on its core psychotherapy codes: 90834 ranks #7 of 2204 providers in-state (100th percentile; extreme outlier) and 90847 ranks #9 of 451 providers in-state (98th percentile; extreme outlier), signaling dominant market share for those services in Maryland. Other high-volume behavioral codes such as H0032 (rank #8 of 332, 98th percentile; extreme outlier) and 90791 (rank #24 of 1093, 98th percentile; extreme outlier) reinforce the pattern of above-typical statewide scale for core behavioral-health operations.

Operational behavior shows very large claim counts for time-based psychotherapy: 90834 has 160.3K claims and 90847 has 37.6K claims, which implies high visit throughput and an operational model built around frequent, relatively low-dollar-per-claim services (90834 $126 avg paid/claim; 90847 $115 avg paid/claim). H0032’s 10.9K claims at $105 avg paid/claim and the presence of multiple evaluation codes (90791, 90792) suggest ongoing intake, care planning, and follow-up workflows that would require consistent scheduling capacity and non-physician clinical resources.

There are items on file with claims but no recorded Medicaid revenue that warrant attention in contract and utilization reviews: 90889 shows 555 claims at $0 avg paid/claim ($0 revenue) and H0044 shows 12 claims at $0 avg paid/claim ($0 revenue). These zero-paid entries may reflect administrative reporting, bundled or non-reimbursed services, or state-specific payment rules and should be reviewed for coding, billing, or reconciliation implications rather than interpreted as revenue drivers.

From a payer-mix and strategic-risk perspective, the practice’s lack of Medicare billing combined with $30.7M of Medicaid revenue makes it effectively single-payer reliant on Medicaid populations and reimbursement policies. That concentration increases sensitivity to Medicaid rate changes, program policy shifts, or contract negotiations; analysts should treat Medicaid utilization trends for 90834/90847 as the most material levers affecting this provider’s revenue base.

Medicaid: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	160,260	$130	$20.2M
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…	37,570	$120	$4.3M
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…	19,080	$110	$2.2M
H0032	Mental health service plan development by non-physician	10,950	$110	$1.1M
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…	15,510	$70	$1.1M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	4,290	$230	$969.8K
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…	1,550	$220	$334.8K
90846	A provider meets with the patient’s family without the patient present to counsel the family on the psychological issues affecting the patient and the family.	2,300	$130	$296.6K
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…	900	$170	$155.7K
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…	300	$80	$22.7K

Showing 1–10 of 13

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

Advanced Behavioral Health, Inc — 6 of 11 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

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0044	Supported housing, per month	754	760	1,170	$760	$2.2M
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…	7	2,200	890	$110	$596.1K
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	450	510	$120	$393.2K
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…	90	3,670	680	$90	$310K
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…	2,018	3,280	610	$80	$296.1K
H0032	Mental health service plan development by non-physician	8	330	520	$100	$183K
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…	28	610	520	$50	$178.2K
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…	253	440	510	$40	$128.6K
90846	A provider meets with the patient’s family without the patient present to counsel the family on the psychological issues affecting the patient and the family.	19	160	150	$130	$113.3K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	24	1,090	90	$200	$101.4K

Showing 1–10 of 13

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Way Station, Inc.	MD	Rehabilitation Clinic/Center	$0	$42.8M
Wells House, Inc	MD	Substance Use Disorder Rehabilitation Clinic/Center	$0	$12.3M
Frederick Health Hospital Inc	MD	Community Based Hospice Care Agency	$0	$9.7M
The Orenda Center For Wellness LLC	MD	Substance Abuse Rehabilitation Facility	$0	$7.2M
Associated Catholic Charities, Inc	MD	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$6.2M
Frederick County Maryland	MD	Land Ambulance	$3M	$3.2M
Hospitalist Medicine Physicians Of Maryland-frederick PC	MD	Internal Medicine Physician	$0	$6M
Chesapeake Toxicology Resources, LLC	MD	Clinical Medical Laboratory	$153.8K	$5.8M
Way Station Inc	MD	Community/Behavioral Health Agency	$0	$4.5M
Mental Health Assoc Of Frederick Cty	MD	Clinical Social Worker	$0	$4.4M

Advanced Behavioral Health, Inc — Billing Profile & Reimbursement Data

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Advanced Behavioral Health, 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