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.

Wesley Family Services (NPI 1316450638)

Field	Value
Entity Type	Organization
Organization	Wesley Family Services
Address	221 Penn Ave
City	Wilkinsburg
State	PA
ZIP	15221
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	November 8, 2017

Payer Source	Total Paid
Medicaid	$123.4M
Medicare	$0

Key Findings

WESLEY FAMILY SERVICES shows an effectively single-payer footprint: there is no Medicare billing on file and all recorded lifetime revenue is Medicaid, totaling $123.4M. This indicates the provider’s clinical and billing operations are focused on Medicaid-covered populations rather than Medicare fee-for-service patients.

Revenue is highly concentrated in a small set of Medicaid codes: the top three revenue drivers (W9045, W9047, H0004) together account for 48.7% of the provider’s total Medicaid revenue. Specifically, W9045 generated $22.3M (44.5K claims, $501 avg paid/claim, 18.3%), W9047 generated $20.5M (57.7K claims, $355 avg paid/claim, 16.8%), and H0004 generated $16.5M (51.2K claims, $322 avg paid/claim, 13.6%).

The mix of billed services points to a community-based behavioral health operation with high volumes of counseling and outreach: H0004 (behavioral health counseling and therapy, per 15 minutes) appears as a major clinical driver with 51.2K claims, and H0039 (assertive community treatment, per 15 minutes) had 46.6K claims and $9.2M in revenue. Additional codes such as H0035 (partial hospitalization) with 42K claims and H2021 (community-based wrap-around services) with 62.7K claims further suggest the provider delivers frequent, time-based community and partial hospitalization services rather than predominantly brief office visits.

Competitive standing in-state is uneven by service line: the provider is a statewide volume leader for several proprietary or unlabeled codes, ranking #1 for W9045 (1 of 4 providers, 100th percentile) and W9047 (1 of 3 providers, 100th percentile) and is an extreme outlier on H0004 (rank #3 of 1405 providers, 100th percentile), signaling dominant scale on counseling/therapy within Pennsylvania. For other common behavioral-health codes the provider ranges from notably above typical (e.g., H0035 rank #10 of 111, 92th percentile) to more modest positions (e.g., 90834 rank #62 of 692, 91th percentile), indicating strength in certain program areas rather than uniform dominance across all Medicaid mental-health services.

Operational intensity is reflected in very large claim counts for multiple short-interval, per-15-minute codes: W7226 shows 67.6K claims ($7.2M revenue, $106 avg paid/claim) and H2021 shows 62.7K claims ($4.5M revenue, $71 avg paid/claim). These volumes are consistent with a delivery model that bills many short-duration units of service (case management, wrap-around, or community visits) rather than a low-frequency, high-duration outpatient model.

The provider’s portfolio includes a mix of high-unit-value and high-frequency low-unit-value services: W9029 has a high avg paid/claim ($673) and contributed $4.9M in revenue (7.2K claims), while group and brief psychotherapy codes such as 90853 ($42 avg, $929K revenue, 22.1K claims) and H2021 ($71 avg, $4.5M revenue) show lower per-claim reimbursement but heavy utilization. This combination drives sizable Medicaid revenue without Medicare participation, amplifying the financial importance of both expensive service units and high-volume low-cost units.

Since its NPI enumeration on 2017-11-08 (~9 years ago) WESLEY FAMILY SERVICES has built a substantial Medicaid revenue base ($123.4M) in a relatively short tenure, suggesting rapid scale-up of community mental health services and program enrollment focused on Medicaid populations. The absence of Medicare billing further implies strategic or operational alignment with Medicaid-funded programs and populations (e.g., children, disabled, or low-income adults) rather than Medicare beneficiaries.

Medicaid: Complete Services Breakdown

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

43 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
W9045	N/A	44,510	$500	$22.3M
W9047	N/A	57,670	$360	$20.5M
H0004	Behavioral health counseling and therapy, per 15 minutes	51,200	$320	$16.5M
H0039	Assertive community treatment, face-to-face, per 15 minutes	46,590	$200	$9.2M
W7226	N/A	67,600	$110	$7.2M
H0046	Mental health services, not otherwise specified	27,880	$230	$6.3M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	41,970	$140	$5.8M
W9029	N/A	7,250	$670	$4.9M
H2021	Community-based wrap-around services, per 15 minutes	62,750	$70	$4.5M
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…	40,390	$90	$3.8M

Showing 1–10 of 43

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

Wesley Family Services — 6 of 25 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

43 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
W9045	N/A	1	10	8,320	$720	$11.1M
W9029	N/A	1	10	6,870	$1,460	$10M
W9047	N/A	1	10	10,140	$350	$8M
H0039	Assertive community treatment, face-to-face, per 15 minutes	14	40	27,890	$150	$6.2M
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	93	150	8,280	$220	$4.1M
W7226	N/A	1	10	35,530	$110	$3.8M
W7224	N/A	1	10	20,450	$150	$3.1M
T1017	Targeted case management, each 15 minutes	88	210	18,200	$100	$2.9M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	10	110	8,460	$150	$2.1M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	36	100	9,680	$110	$1.5M

Showing 1–10 of 43

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Human Services Center	PA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$7.1M

Nearby Providers

Other providers in the same ZIP code as Wesley Family Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pyramid Health Care Inc.	PA	Substance Abuse Rehabilitation Facility	$0	$128.8M
Bayada Home Health Care, Inc.	PA	Home Health Agency	$0	$21.7M
Therapeutic Early Intervention Services, LP.	PA	Home Health Agency	$0	$12.6M
Milestone Centers Inc.	PA	Community/Behavioral Health Agency	$0	$5.7M
Brian Carlin	PA	Pulmonary Disease Physician	$183K	$29K
Vasantha Madhavan	PA	Cardiovascular Disease Physician	$47.9K	$44.6K
Rong-chung Lin	PA	Urology Physician	$29.3K	$33.1K
Isaac Levari	PA	Family Medicine Physician	$47.1K	$2.1K

Wesley Family Services — Billing Profile & Reimbursement Data

Sign up for Wesley Family Services — Billing Profile & Reimbursement Data policy alerts

Wesley Family Services — Billing Profile & Reimbursement Data

Sign up for Wesley Family Services — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References