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

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

Erlanger Behavioral Health, LLC (NPI 1306354790)

Erlanger Behavioral Health, LLC is a psychiatric hospital provider located in Chattanooga, Tennessee. This profile covers 0 Medicare and 11 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	Erlanger Behavioral Health, LLC
Address	804 North Holtzclaw Avenue
City	Chattanooga
State	TN
ZIP	37404
Taxonomy	Psychiatric Hospital
NPI Enumerated	January 19, 2018

Payer Source	Total Paid
Medicaid	$2.2M
Medicare	$0

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	24,410	$20	$585.9K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	29,810	$20	$506.7K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	10,510	$40	$441.2K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	4,760	$30	$157K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	2,440	$60	$153.9K
90870	The provider applies an electric current to the patient's brain for the purpose of producing a seizure or series of seizures to alleviate symptoms of various mental disorders.	2,120	$60	$124.9K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	3,310	$30	$89.3K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	2,550	$30	$68.9K
99221	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	890	$40	$36.5K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	240	$40	$8.9K

Showing 1–10 of 11

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Erlanger Behavioral Health, LLC — 5 of 11 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	114	310	110	$70	$142.8K
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…	187	200	130	$60	$86.5K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	64	550	290	$30	$77K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	39	840	440	$20	$73K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	42	480	160	$50	$46.3K
90870	The provider applies an electric current to the patient's brain for the purpose of producing a seizure or series of seizures to alleviate symptoms of various mental disorders.	1	10	300	$80	$38.5K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	16	310	160	$40	$37.9K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	4	260	280	$20	$35.4K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	28	280	110	$30	$29K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	1	350	110	$40	$25.4K

Showing 1–10 of 11

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Chattanooga Hamilton County Hospital Authority	TN	General Acute Care Hospital	$0	$52.4M
Chattanooga Hamilton County Hospital Authority	TN	Internal Medicine Physician	$0	$27.9M
Chattanooga Hamilton County Hospital Authority	TN	Critical Access Hospital	$0	$5.6M
Erlanger Health	TN	General Acute Care Hospital	$0	$3.3M
Erlanger Health	TN	Internal Medicine Physician	$0	$2.3M
Medical Foundation, Inc.	MS	Geriatric Medicine (Family Medicine) Physician	$0	$1.8M
Clint Kingsley	AL	Hematology & Oncology Physician	$1.6M	$22K
Robert Graham	TN	Hematology & Oncology Physician	$1.2M	$19.8K
Harsha Vardhana	TN	Medical Oncology Physician	$941.1K	$66.6K
Sreejit Nair	NC	Vascular Surgery Physician	$658K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Parkridge Medical Center, Inc.	TN	General Acute Care Hospital	$0	$26.8M
County Of Hamilton	TN	Land Ambulance	$3.2M	$10.4M
Orange Grove Center, Inc.	TN	Developmentally Disabled Services Day Training Agency	$0	$7.8M
Memorial Health Care System Inc.	TN	General Acute Care Hospital	$0	$4.1M
Mark Womack	TN	Hematology & Oncology Physician	$2.4M	$0
Bertrand Anz	TN	Hematology & Oncology Physician	$2.4M	$0
Derek Holland	TN	Hematology & Oncology Physician	$2M	$0
Gregory Sutton	TN	Hematology & Oncology Physician	$1.6M	$0
Edward Arrowsmith	TN	Hematology & Oncology Physician	$1.4M	$0
Benjamin Nadeau	TN	Hematology & Oncology Physician	$1.3M	$0

Erlanger Behavioral Health, LLC — Billing Profile & Reimbursement Data

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Erlanger Behavioral Health, LLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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