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

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

Philhaven (NPI 1275758393)

Philhaven is a clinic/center provider located in Lebanon, Pennsylvania. This profile covers 0 Medicare and 19 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	Philhaven
Address	283 S Butler Rd
City	Lebanon
State	PA
ZIP	17042
Taxonomy	Clinic/Center
NPI Enumerated	April 16, 2007

Payer Source	Total Paid
Medicaid	$10.9M
Medicare	$0

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

19 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…	75,300	$40	$3.2M
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…	42,850	$60	$2.5M
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…	23,000	$80	$1.9M
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…	16,880	$30	$556.9K
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…	3,730	$130	$496.1K
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…	18,880	$20	$434.3K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	49,340	$10	$345.4K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	36,280	$10	$326.5K
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…	5,070	$60	$309.3K
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.	4,900	$40	$190.9K

Showing 1–10 of 19

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Pennsylvania Distribution

Philhaven — 7 of 18 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

19 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	28	690	2,240	$80	$1M
T1016	Case management, each 15 minutes	151	160	2,180	$80	$965.8K
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…	9	560	1,400	$90	$485.7K
H0004	Behavioral health counseling and therapy, per 15 minutes	349	1,410	820	$160	$353.5K
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…	44	540	1,490	$50	$316.4K
H0034	Medication training and support, per 15 minutes	112	260	1,710	$80	$279.8K
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…	50	420	650	$180	$270.2K
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…	30	340	2,010	$50	$269.8K
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…	68	180	860	$70	$195.9K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	155	240	130	$300	$139.8K

Showing 1–10 of 19

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Good Samaritan Hospital Of Lebanon, Pennsylvania	PA	General Acute Care Hospital	$0	$18.2M
Wicare Home Care Agency, LLC.	PA	Home Health Agency	$0	$5.5M
Lebanon Fire Department First Aid And Safety Patrol	PA	Ambulance	$1M	$3.8M
Surgery Center Of Lebanon, LP	PA	Ambulatory Surgical Clinic/Center	$945.9K	$0
Mark Maria	PA	Ophthalmology Physician	$581K	$0
Lebanon Internal Medicine Associates PC	PA	Clinical Medical Laboratory	$529.8K	$7.5K
Thomas Kantor	PA	Rheumatology Physician	$448.3K	$0
Francis Gallagher	PA	Rheumatology Physician	$399.9K	$0
Ernesto Gutierrez	PA	Rheumatology Physician	$382.6K	$310
Raymond Demaio	PA	Ophthalmology Physician	$314.5K	$0

Philhaven — Billing Profile & Reimbursement Data

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Philhaven — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wellspan Medical Group	PA	Psychiatry Physician	$0	$22.3M
Philhaven	PA	Clinic/Center	$0	$19.8M
Philhaven	PA	Clinic/Center	$0	$7.1M
Philhaven	PA	Psychiatric Hospital	$0	$5.9M
Alfred Sylvester	PA	Psychiatry Physician	$41.1K	$0
Thomas Fenstermacher	PA	Psychiatry Physician	$30.2K	$0
April Mandeville-palm	PA	Clinical Social Worker	$17K	$0