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

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

Michael Sefton (NPI 1275748758)

Field	Value
Entity Type	Individual
Organization	Michael Sefton
Address	150 Flanders Rd
City	Westborough
State	MA
ZIP	01581
Taxonomy	Health Service Psychologist
NPI Enumerated	May 10, 2007

Payer Source	Total Paid
Medicare	$85.6K
Medicaid	$0

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
96133	The provider, a physician or other qualified healthcare professional, administers neuropsychological tests, face–to–face with the patient. Report this code in addition to the primary code (96132) for…	780	$60	$45.2K
96121	A physician or other qualified healthcare professional performs a face–to–face assessment of a patient’s thinking, reasoning, and judgment. Report this code for each additional hour of face–to–face…	210	$50	$11.1K
96132	The provider, a physician or other qualified healthcare professional, spends up to one hour administering neuropsychological tests, which includes time spent face–to–face with the patient in…	130	$90	$10.8K
96131	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	120	$60	$7K
96116	A physician or other qualified healthcare professional performs a face–to–face assessment of a patient’s thinking, reasoning, and judgment. Report this code for the first hour of face–to–face…	90	$70	$5.7K
96130	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	40	$90	$3.3K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	20	$120	$2.5K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Massachusetts Distribution

Michael Sefton — 1 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. state median

7 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
96133	3	90	130	$80	$14.7K
96131	3	10	90	$70	$8.6K
96130	7	10	40	$90	$6.7K
96132	10	110	40	$100	$5.6K
96121	2	10	70	$50	$5.3K
90791	257	470	20	$110	$4.3K
96116	7	50	40	$70	$3.4K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Michael Sefton, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pierre Mayer	MA	Psychiatry Physician	$56.2K	$71.9K
Michael Rater	MA	Forensic Psychiatry Physician	$87.3K	$0
Buck Woo	MA	Clinical Neuropsychologist	$43K	$0
Sandeep Sobti	NH	Geriatric Psychiatry Physician	$28.9K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Shriver Nursing Services, Inc	MA	Nursing Care Agency	$0	$62.7M
Esoterix Genetic Laboratories, LLC	MA	Clinical Medical Laboratory	$37.6K	$56.9M
Bsd Home Care Management LLC	MA	Adult Care Home Facility	$0	$13.2M
Bsd Home Care Management LLC	MA	Home Health Agency	$0	$9.4M
Commonwealth Of Massachusetts-dmh	MA	Case Management Agency	$0	$7.8M
Town Of Westborough	MA	Land Ambulance	$412.3K	$1.4M
Gregory Malloy	MA	Physical Medicine & Rehabilitation Physician	$149.3K	$403.9K
Sotiraq Terova	MA	Internal Medicine Physician	$290.9K	$0
James Karadimos	MA	Podiatrist	$160.3K	$0
Eriola Terova	MA	Internal Medicine Physician	$153.9K	$0

Michael Sefton — Billing Profile & Reimbursement Data

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Michael Sefton — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References