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

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

The Children's Guild, Inc. (NPI 1306023817)

Key Findings

Field	Value
Entity Type	Organization
Organization	The Children's Guild, Inc.
Address	6802 Mcclean Blvd
City	Baltimore
State	MD
ZIP	21234
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	January 28, 2008

Payer Source	Total Paid
Medicaid	$34.6M
Medicare	$0

THE CHILDREN'S GUILD, INC. is effectively a Medicaid-focused provider: there is no Medicare billing on file and all reported lifetime revenue is from Medicaid at $34.6M. This makes its payer mix functionally single‑payer (Medicaid) at scale, so changes in state Medicaid policy or rates will disproportionately affect its overall revenue base.

Revenue is highly concentrated in a small number of psychotherapy codes: the top three Medicaid codes (90834, 90847, 90832) account for 88.1% of the provider's total Medicaid revenue. Specifically, 90834 is reported at $24.7M (71.5% of Medicaid revenue), 90847 at $2.9M (8.4%), and 90832 at $2.8M (8.2%), indicating that most billing and reimbursement flow from a narrow set of outpatient behavioral health services.

The code mix shows an operation centered on outpatient psychotherapy and family therapy: the dominant codes are 90834 (individual psychotherapy, 38–52 minutes), 90832 (shorter individual psychotherapy, 16–37 minutes), and 90847 (family psychotherapy with patient present). The presence of related family codes (90846, 90849), group therapy (90853), and evaluation codes (90791, 90792) points to a multi‑modal behavioral health practice that prioritizes psychotherapy modalities over medical/somatic services.

Competitive standing in-state is exceptionally strong for core psychotherapy services: 90834 ranks #3 of 2204 providers in Maryland (100th percentile; extreme outlier), 90832 ranks #6 of 610 (99th percentile; extreme outlier), and 90847 ranks #15 of 451 (97th percentile; notably above typical state volume). These ranks indicate the organization is a major, high-volume provider of psychotherapy within Maryland rather than a modest participant.

Operational scale is reflected in claim volumes for leading codes: 90834 shows 217.1K claims and 90832 shows 45K claims, demonstrating sustained high throughput for individual psychotherapy sessions. Such claim-level volume implies substantial clinical capacity and staffing oriented to frequent, time-based psychotherapy encounters rather than low-frequency specialty procedures.

While psychotherapy dominates revenue, the provider also bills evaluation and E/M codes at smaller but meaningful levels: 90791 is $848.4K (2.5% of Medicaid revenue) and 99214 is $1.1M (3.3% of Medicaid revenue), suggesting routine psychiatric evaluation and some medical management co-exist with psychotherapy services. This blend indicates the organization provides both diagnostic/evaluation services and ongoing psychotherapy within its care model.

Telehealth and some ancillary services are comparatively minor in the billing mix: Q3014 (telehealth originating site facility fee) accounts for $5.5K and 90889 (report preparation) shows $0 paid; group psychotherapy 90853 totals $327.3K (0.9% of Medicaid revenue). The low telehealth facility fee revenue suggests either limited use of telehealth originating site billing or that telehealth encounters are not a primary revenue driver for this provider.

The provider has an established presence based on NPI tenure — NPI enumerated on 2008-01-28 (~18 years ago) — and the combination of long tenure with concentrated, high-volume psychotherapy billing makes it an entrenched regional behavioral health provider. Analysts should note the business risk that accompanies heavy reliance on a narrow set of psychotherapy codes, as any reimbursement or utilization shifts for those codes would materially affect the organization's Medicaid revenue profile.

Medicaid: Complete Services Breakdown

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

16 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…	217,070	$110	$24.7M
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…	26,760	$110	$2.9M
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…	45,000	$60	$2.8M
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…	9,700	$120	$1.1M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	4,040	$210	$848.4K
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.	7,370	$110	$817.7K
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…	4,670	$110	$527.8K
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…	7,980	$40	$327.3K
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…	1,820	$180	$318.1K
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…	410	$220	$87.1K

Showing 1–10 of 16

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Maryland Distribution

The Children's Guild, Inc. — 5 of 15 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maryland

Full comparison — all codes billed, vs. Maryland median

16 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…	3	2,200	890	$110	$596.1K
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	450	510	$120	$393.2K
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…	264	3,670	680	$90	$310K
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…	66	450	730	$110	$298.2K
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…	2,056	3,280	610	$80	$296.1K
H0032	Mental health service plan development by non-physician	241	330	520	$100	$183K
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…	6	610	520	$50	$178.2K
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…	38	440	510	$40	$128.6K
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.	2	160	150	$130	$113.3K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	28	1,090	90	$200	$101.4K

Showing 1–10 of 16

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Care Nursing Services, Inc.	MD	Nursing Care Agency	$0	$48.6M
Maryland Medical First P.A.	MD	Internal Medicine Physician	$0	$14.6M
Northern Pharmacy And Medical Equipment, Inc	MD	Community/Retail Pharmacy	$168.6K	$14.2M
Hope Haven Holistic Treatment Services LLC	MD	Addiction (Substance Use Disorder) Counselor	$0	$12.7M
Kts Mental Health Group, Inc	MD	Professional Counselor	$0	$9.3M
More Than Just Friends Adult Medical Day Center	MD	Adult Day Care Clinic/Center	$0	$6.5M
D&t Health Services	MD	Community/Behavioral Health Agency	$0	$6.5M
Kts Mental Health Group, Inc	MD	Community/Behavioral Health Agency	$0	$6.1M
Deerfield Healthcare Corp.	MD	Adult Day Care Clinic/Center	$0	$6M
The Children's Guild, Inc	MD	Adolescent and Children Mental Health Clinic/Center	$0	$5.9M

The Children's Guild, Inc. — Billing Profile & Reimbursement Data

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The Children's Guild, 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