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

Why is the Medicaid comparison limited to Rhode Island 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. Rhode Island (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.

Plaza Psychology & Psychiatry, Inc. (NPI 1306890546)

Plaza Psychology & Psychiatry, Inc. is a clinical psychologist provider located in Woonsocket, Rhode Island. This profile covers 0 Medicare and 9 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	Plaza Psychology & Psychiatry, Inc.
Address	191 Social St Ste 180
City	Woonsocket
State	RI
ZIP	02895
Taxonomy	Clinical Psychologist
NPI Enumerated	May 20, 2006

Payer Source	Total Paid
Medicaid	$1.1M
Medicare	$0

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

9 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…	4,260	$120	$494.5K
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…	2,610	$80	$203.2K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	3,770	$40	$150.6K
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…	2,090	$60	$125.2K
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…	2,590	$40	$101K
90836	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient in addition to an evaluation and management service in the…	260	$60	$15.8K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	40	$140	$5.3K
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…	10	$110	$1.4K
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…	20	$50	$980

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Rhode Island Distribution

Plaza Psychology & Psychiatry, Inc. — 2 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Rhode Island

Full comparison — all codes billed, vs. Rhode Island median

9 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…	84	750	330	$70	$92.5K
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…	18	360	280	$90	$86.4K
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…	165	1,730	220	$70	$75.2K
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…	229	2,050	300	$50	$72.3K
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…	135	160	50	$150	$59.2K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	10	200	340	$40	$35.5K
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…	53	60	140	$70	$35.3K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	184	290	60	$110	$33.5K
90836	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient in addition to an evaluation and management service in the…	9	30	140	$60	$15.4K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Care Alliance	RI	Community/Behavioral Health Agency	$0	$46.4M
Prime Healthcare Services Landmark LLC	RI	General Acute Care Hospital	$0	$26.2M
R.i.s.a.t., LLC	RI	Methadone Clinic	$306K	$21.6M
Thundermist Health Center	RI	Dental Clinic/Center	$0	$18.6M
Thundermist Health Center	RI	Federally Qualified Health Center (FQHC)	$0	$15.8M
Action Based Enterprises	RI	Developmentally Disabled Services Day Training Agency	$0	$15.2M
Woonsocket Education Department	RI	Local Education Agency (LEA)	$0	$9.5M
Woonsocket Housing Authority	RI	Assisted Living Facility	$0	$7M
Beata Nelken	RI	Pediatrics Physician	$0	$4.2M
Tmed Holdings, Inc.	RI	Durable Medical Equipment & Medical Supplies	$0	$3.8M

Plaza Psychology & Psychiatry, Inc. — Billing Profile & Reimbursement Data

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Plaza Psychology & Psychiatry, Inc. — 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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Frequently Asked Questions

References