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

Why is the Medicaid comparison limited to New Jersey 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. New Jersey (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.

Kelsch Associates (NPI 1235574617)

Field	Value
Entity Type	Organization
Organization	Kelsch Associates
Address	335 Glassboro Rd
City	Woodbury Heights
State	NJ
ZIP	08097
Taxonomy	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NPI Enumerated	April 30, 2013

Payer Source	Total Paid
Medicaid	$117.4M
Medicare	$0

Key Findings

This provider is effectively single-payer in its covered dataset: Medicare revenue is listed as none while Medicaid revenue totals $117.4M, indicating the provider’s billed activity in the available records is concentrated entirely in Medicaid. Analysts should treat Medicare comparisons as not applicable for this entity.

Revenue concentration is extreme: the precomputed top 3 Medicaid codes account for 100.0% of this provider’s Medicaid revenue, with H2016 alone representing $106.6M (90.8% of Medicaid revenue) and T2021 contributing $10.8M (9.2%). This means nearly all reported Medicaid dollars flow through two service lines.

The code mix points to an IDD-focused, community-based support operation consistent with the provider’s taxonomy: H2016 (Comprehensive community support services, per diem) is the dominant service and T2021 (Day habilitation, waiver; per 15 minutes) provides supplemental day-program services. Together these codes indicate primary revenue from per-diem residential/community supports and time-based habilitation rather than from medical or acute care procedures.

Claim counts and unit payments show service intensity differences: H2016 appears as 75K claims with an average paid/claim of $1421, while T2021 shows 22.2K claims with an average paid/claim of $488. The higher per-claim payment and much larger share of revenue for H2016 suggest per-diem residential or wraparound services drive financial scale, while T2021 supplies lower-paid, time-based day services.

Statewide competitive standing is modestly above median but not dominant: H2016 ranks #71 of 206 providers in-state (66th percentile; characterized as typical, unremarkable volume) and T2021 ranks #95 of 218 providers in-state (57th percentile; also typical, unremarkable volume). These ranks indicate the provider is a mid-tier participant for its primary Medicaid codes rather than a top statewide leader.

Tenure in the enrollment system is established: the NPI was enumerated 2013-04-30 (~13 years ago), indicating more than a decade of billing history under this identifier. That longevity supports interpretation of the observed code mix as a stable operating profile rather than a short-term anomaly.

The revenue dependence on H2016 creates concentration risk: with 90.8% of Medicaid revenue tied to a single comprehensive community support per-diem code, policy, rate, or program changes affecting H2016 would materially impact overall revenue. Analysts monitoring financial resilience should watch utilization and payment trends for H2016 closely.

From a diversification and competitive-position perspective, the provider’s Medicaid activity appears narrowly focused on residential/community support and day habilitation services with little evidence of other service lines in the dataset. That focused footprint may limit cross-service market reach but also signals specialization in IDD community-based residential treatment aligned to its taxonomy.

Medicaid: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2016	Comprehensive community support services, per diem	75,000	$1,420	$106.6M
T2021	Day habilitation, waiver; per 15 minutes	22,210	$490	$10.8M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Jersey Distribution

Kelsch Associates — 0 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Jersey

Full comparison — all codes billed, vs. New Jersey median

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2016	Comprehensive community support services, per diem	71	210	23,310	$490	$41.9M
T2021	Day habilitation, waiver; per 15 minutes	95	220	14,500	$170	$7.7M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Michael Hewitt	NJ	Diagnostic Radiology Physician	$150.9K	$0
Stephanie Yellin	NJ	Sports Medicine (Family Medicine) Physician	$89.3K	$0
Lawrence Lo	NJ	Diagnostic Radiology Physician	$46.8K	$26.5K

Kelsch Associates — Billing Profile & Reimbursement Data

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Kelsch Associates — 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