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

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

Starfish Family Services Inc. (NPI 1184865776)

Field	Value
Entity Type	Organization
Organization	Starfish Family Services Inc.
Address	30000 Hiveley St
City	Inkster
State	MI
ZIP	48141
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	March 12, 2009

Payer Source	Total Paid
Medicaid	$79M
Medicare	$0

Key Findings

STARFISH FAMILY SERVICES INC. is effectively a Medicaid-focused provider: it has no Medicare billing on file and reports $79M in lifetime Medicaid revenue, with an NPI enumerated on 2009-03-12 (≈17 years ago), indicating long-term operation in the state Medicaid market. This payer concentration means analyses and contract negotiations should treat it as a Medicaid-centric vendor rather than a dual-payer outpatient practice.

Revenue is highly concentrated in a small set of service lines: the precomputed top three Medicaid codes account for 69.4% of this provider’s total Medicaid revenue, driven by H0036 ($35.2M, 44.6% of total), T1017 ($12.8M, 16.2% of total), and H2021 ($6.8M, 8.6% of total). That concentration signals that a few ambulatory/community-treatment activities dominate financial performance.

The top-paying activities reflect a community behavioral health operating model: H0036 (Community psychiatric supportive treatment, per 15 minutes) and H2021 (Community-based wrap-around services, per 15 minutes) plus T1017 (Targeted case management, each 15 minutes) indicate intensive, time-based community interventions and care coordination as the organization’s core services. Together these codes imply the provider delivers sustained, face-to-face community psychiatric and wrap-around supports rather than brief office-based medical visits.

STARFISH is a dominant statewide provider for several community-treatment codes: H0036 ranks #3 of 93 providers in-state (98th percentile; labeled an “extreme outlier”) and H2021 ranks #2 of 49 providers in-state (98th percentile; “extreme outlier”), which positions the organization as a major destination for those specific service types within Michigan. Payers should interpret those ranks as evidence of unusually high volume and market share in intensive community psychiatric services.

Not all high-revenue codes reflect dominance: T1017 (Targeted case management) generated $12.8M and ranks #48 of 175 providers in-state (73th percentile; described as typical), showing that while case management is a material revenue source, STARFISH’s market position for that code is more middle-of-the-market compared with its leadership in wrap-around and community psychiatric supports. This mixed competitive standing suggests pockets of specialty strength rather than uniform dominance across all care-coordination codes.

Psychotherapy and family therapy services also contribute meaningful revenue and high volume: 90834 produced $4.7M from 33.6K claims (6.0% of total) and ranks #21 of 950 providers (98th percentile; notably above typical), while 90832 produced $2.4M from 25.9K claims (3.0% of total) and ranks #9 of 672 providers (99th percentile; extreme outlier). The counts and ranks indicate large-scale outpatient psychotherapy capacity, including extended and brief individual sessions, plus notable family therapy volumes (90847 $2.1M, rank #7 of 174, 97th percentile).

The provider’s service breadth is broad across assessment, planning, in-home training and behavioral therapies: notable volumes in H0032 (plan development, $3.8M), H0031 (mental health assessment, $2.8M), S5111 (home care training, $787.6K), and adaptive behavior codes like 97153 ($470.6K) reflect an integrated mix of assessment, care planning, home-based supports, and habilitation-focused treatments. This mix aligns with its Community/Behavioral Health Agency taxonomy and suggests capacity to serve both serious mental illness and developmental-disability populations.

From a payer oversight and contracting perspective, the combination of (a) extreme outlier volume in H0036 and H2021, (b) high per-claim paid levels for these codes (H0036 avg paid/claim $382; H2021 avg paid/claim $479), and (c) heavy revenue concentration (69.4% in the top three codes) warrants attention to network capacity, unit-rate adequacy, and utilization management for intensive community psychiatric services; these are the clear drivers of STARFISH’s Medicaid footprint and should be prioritized in negotiations and audits.

Medicaid: Complete Services Breakdown

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

30 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	92,270	$380	$35.2M
T1017	Targeted case management, each 15 minutes	42,960	$300	$12.8M
H2021	Community-based wrap-around services, per 15 minutes	14,160	$480	$6.8M
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…	33,610	$140	$4.7M
H0032	Mental health service plan development by non-physician	19,520	$190	$3.8M
H0031	Mental health assessment, by non-physician	14,320	$200	$2.8M
T1016	Case management, each 15 minutes	11,230	$250	$2.8M
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…	25,860	$90	$2.4M
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…	15,870	$130	$2.1M
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…	6,750	$140	$911.3K

Showing 1–10 of 30

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Michigan Distribution

Starfish Family Services Inc. — 6 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

30 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1017	Targeted case management, each 15 minutes	48	180	10,890	$210	$8.1M
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…	81	130	11,590	$190	$7.6M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	3	90	8,750	$300	$4.7M
T1016	Case management, each 15 minutes	48	120	8,060	$210	$3.4M
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…	90	130	3,170	$180	$2.2M
0365T	Adaptive behavior tx addl	50	70	3,180	$170	$1.5M
H2021	Community-based wrap-around services, per 15 minutes	2	50	1,690	$460	$1.4M
H0032	Mental health service plan development by non-physician	21	180	2,030	$170	$1.2M
H0031	Mental health assessment, by non-physician	19	180	1,290	$250	$1.1M
S5111	Home care training, family; per session	26	80	1,460	$160	$664.5K

Showing 1–10 of 30

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Divined Company	MI	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$18.8M
Kennedy's Care Enterprise, Inc.	MI	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$18.5M
Hill's Support Services, Inc.	MI	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$15.2M
Western Wayne Family Health Centers	MI	Federally Qualified Health Center (FQHC)	$0	$9.1M

Starfish Family Services Inc. — Billing Profile & Reimbursement Data

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Starfish Family Services 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