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.

Prospect Ccmc, LLC (NPI 1366897241)

Prospect Ccmc, LLC is a clinic/center provider located in Chester, Pennsylvania. This profile covers 0 Medicare and 15 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	Prospect Ccmc, LLC
Address	301 W 15th St
City	Chester
State	PA
ZIP	19013
Taxonomy	Clinic/Center
NPI Enumerated	April 28, 2016

Payer Source	Total Paid
Medicaid	$5.5M
Medicare	$0

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

15 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…	48,170	$50	$2.4M
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…	7,100	$150	$1.1M
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…	10,030	$70	$681.9K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	6,710	$60	$409.1K
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.	16,820	$20	$302.7K
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…	8,820	$20	$149.9K
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…	1,050	$130	$131.7K
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…	6,540	$20	$130.8K
H2012	Behavioral health day treatment, per hour	2,470	$50	$118.6K
H2010	Comprehensive medication services, per 15 minutes	1,050	$20	$25.1K

Showing 1–10 of 15

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

Prospect Ccmc, LLC — 4 of 13 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

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1017	Targeted case management, each 15 minutes	91	210	18,200	$100	$2.9M
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…	51	690	2,240	$80	$1M
H2019	Therapeutic behavioral services, per 15 minutes	164	180	3,510	$80	$685K
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…	313	560	1,400	$90	$485.7K
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…	115	540	1,490	$50	$316.4K
H0034	Medication training and support, per 15 minutes	204	260	1,710	$80	$279.8K
H2012	Behavioral health day treatment, per hour	2	10	430	$160	$278.3K
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…	20	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…	65	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…	115	180	860	$70	$195.9K

Showing 1–10 of 15

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Uhs Recovery Foundation Inc	PA	Community/Behavioral Health Agency	$0	$51.6M
Chespenn Health Services	PA	Federally Qualified Health Center (FQHC)	$0	$9.8M
Community Surgical Supply Of Toms River LLC	PA	Durable Medical Equipment & Medical Supplies	$0	$7.1M
Mylene Go	PA	Hematology & Oncology Physician	$792.9K	$0
Sherry Jose	PA	Pain Medicine (Anesthesiology) Physician	$304.3K	$45.3K
Heather Hahn	PA	Diagnostic Radiology Physician	$320.4K	$0
John Witherell	PA	Ophthalmology Physician	$309K	$0
Kenneth Lander	PA	Pulmonary Disease Physician	$295.4K	$4.4K
John Feehery	PA	Otolaryngology Physician	$276.7K	$0
Raymond Wolfe	PA	Orthopaedic Surgery Physician	$254.6K	$0

Prospect Ccmc, LLC — Billing Profile & Reimbursement Data

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Prospect Ccmc, 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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