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

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

Smpsychotherapy & Counseling Services, LLC (NPI 1245708189)

Smpsychotherapy & Counseling Services, LLC is a clinical social worker provider located in Danbury, Connecticut. This profile covers 0 Medicare and 10 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Smpsychotherapy & Counseling Services, LLC
Address	100 Mill Plain Rd Fl 3
City	Danbury
State	CT
ZIP	06811
Taxonomy	Clinical Social Worker
NPI Enumerated	November 8, 2018

Payer Source	Total Paid
Medicaid	$1.7M
Medicare	$0

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	14,280	$90	$1.3M
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…	4,160	$70	$282.9K
99204	The provider sees a new 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 provider…	650	$90	$61.2K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	300	$70	$21K
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…	320	$60	$19.3K
99205	The provider sees a new 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 provider…	130	$140	$18.5K
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…	90	$100	$9.1K
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…	140	$40	$5.9K
90785	This add–on code represents increased work intensity of psychotherapy services that adds difficulty to delivery of service.	1,390	$1	$1.4K
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…	30	$20	$500

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Connecticut Distribution

Smpsychotherapy & Counseling Services, LLC — 1 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Connecticut

Full comparison — all codes billed, vs. Connecticut median

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	325	1,590	740	$50	$331.8K
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…	1,569	1,710	750	$30	$243.3K
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…	48	2,180	850	$90	$202.1K
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…	307	420	1,230	$20	$199.3K
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…	307	570	410	$50	$197.6K
99204	The provider sees a new 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 provider…	119	480	150	$90	$100.9K
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…	247	380	220	$70	$99.8K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	172	560	80	$80	$90.3K
99205	The provider sees a new 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 provider…	61	170	70	$110	$34K
90785	This add–on code represents increased work intensity of psychotherapy services that adds difficulty to delivery of service.	18	80	440	$10	$7.4K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sebrina Henderson	NY	Family Nurse Practitioner	$112.5K	$0
Kary Krochko	CT	Family Nurse Practitioner	$65.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dental Associates Of Ct PC	CT	Periodontics	$0	$3.8M
Kato Counseling	CT	Professional Counselor	$0	$1.6M
Fabian Dunn	CT	General Practice Dentistry	$0	$1.3M
Raven Roberts Henderson	CT	Pediatric Dentistry	$0	$1.3M
D&s Vision Care	CT	Optician	$0	$1M
William Drew	CT	Physical Therapist	$192K	$694.3K
Jonathan Zirn	CT	Dermatology Physician	$311.3K	$0
Graeme Lipper	CT	Dermatology Physician	$239.8K	$0
Grace Federman	CT	Dermatology Physician	$184.7K	$0
Mona Gohara	CT	Dermatology Physician	$108.6K	$0

Smpsychotherapy & Counseling Services, LLC — Billing Profile & Reimbursement Data

Sign up for Smpsychotherapy & Counseling Services, LLC — Billing Profile & Reimbursement Data policy alerts

Smpsychotherapy & Counseling Services, LLC — Billing Profile & Reimbursement Data

Sign up for Smpsychotherapy & Counseling Services, LLC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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