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

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

Apex Family Healthcare Services, LLC (NPI 1447670518)

Field	Value
Entity Type	Organization
Organization	Apex Family Healthcare Services, LLC
Address	159 Burke St Ste 201
City	Stockbridge
State	GA
ZIP	30281
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	April 16, 2014

Payer Source	Total Paid
Medicaid	$19M
Medicare	$0

Key Findings

APEX FAMILY HEALTHCARE SERVICES, LLC is effectively a Medicaid-first provider: no Medicare billing is on file and all reported program revenue is from Medicaid ($19M). This makes the organization functionally single-payer in the available claims data, with scale and operations centered on Medicaid reimbursement rather than Medicare-facing services.

Revenue is highly concentrated in a few behavioral-health codes: the top three Medicaid codes (90837, H2017, H2015) together account for 55.3% of the provider's total Medicaid revenue. The single largest line is 90837 ($6.3M revenue, 33.1% of Medicaid revenue), followed by H2017 ($2.4M, 12.6%) and H2015 ($1.8M, 9.7%), indicating that a small set of services drives the majority of cash flow.

The code mix shows a service model focused on psychotherapy and community-based behavioral supports: 90837 (long psychotherapy sessions) is the top revenue driver, while H2017 (psychosocial rehabilitation), H2015 (comprehensive community support), and H2014 (skills training and development) together reflect high-volume, community-oriented treatment. High counts for 15-minute unit codes (H2017: 26.6K claims; H2015: 22.2K claims; H2014: 20.1K claims) suggest operational reliance on frequent, short-interval encounters and programs delivered by multi-disciplinary staff.

APEX occupies a dominant competitive position in several state-level code lines: 90837 ranks #2 of 884 providers in-state (100th percentile; labeled an "extreme outlier"), H2014 ranks #1 of 28 (100th percentile; "extreme outlier"), 90847 ranks #1 of 140 (100th percentile; "extreme outlier"), and 90791 ranks #2 of 236 (100th percentile; "extreme outlier"). These standings indicate the provider is a major Medicaid behavioral-health supplier in Georgia for multiple core services.

Other codes show materially above-typical volumes but are more mixed in competitiveness: H0032 (mental health service plan development) is ranked #3 of 65 (97th percentile; "notably above typical"), and H0004 (behavioral health counseling per 15 minutes) is #3 of 23 (91th percentile; "notably above typical"). In contrast, H2017 and H2015 are in the mid-to-high percentiles (80th and 87th respectively) and are described as typical or unremarkable compared with in-state peers, indicating pockets of both exceptional dominance and routine participation across service lines.

Payment-per-encounter patterns highlight higher-dollar assessment and nursing services that supplement high-volume psychotherapy: H0031 (mental health assessment) pays $165 avg/claim and generated $1.4M (7.1% of Medicaid revenue), while T1001 (nursing assessment) pays $197 avg/claim and generated $499K (2.6% of Medicaid revenue). These higher avg-paid encounters likely improve revenue per patient encounter and reflect a blend of assessment and treatment billing streams.

Operational implications from the claims profile point to a staffing and scheduling model built around many short-unit services and frequent psychotherapy sessions. The combination of very large counts for 15-minute codes (e.g., H2017 26.6K claims, H2015 22.2K claims, H2014 20.1K claims) together with high volumes of long psychotherapy sessions (90837 78.7K claims) suggests mixed-intensity programming delivered by non-physician clinicians and structured community supports.

The provider has an established presence in the market, with its NPI enumerated 2014-04-16 (~12 years ago). Given its $19M Medicaid footprint and repeated top-state rankings on multiple core behavioral-health codes, the organization appears to be a mature, Medicaid-focused behavioral health agency with concentrated revenue drivers and demonstrated in-state market leadership.

Medicaid: Complete Services Breakdown

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

28 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…	78,690	$80	$6.3M
H2017	Psychosocial rehabilitation services, per 15 minutes	26,600	$90	$2.4M
H2015	Comprehensive community support services, per 15 minutes	22,180	$80	$1.8M
H2014	Skills training and development, per 15 minutes	20,110	$90	$1.7M
H0031	Mental health assessment, by non-physician	8,220	$170	$1.4M
H0032	Mental health service plan development by non-physician	7,380	$150	$1.1M
H0004	Behavioral health counseling and therapy, per 15 minutes	11,920	$80	$941.6K
T1016	Case management, each 15 minutes	10,210	$90	$908.9K
T1001	Nursing assessment / evaluation	2,530	$200	$499K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	3,640	$110	$385.3K

Showing 1–10 of 28

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Georgia Distribution

Apex Family Healthcare Services, LLC — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Georgia

Full comparison — all codes billed, vs. Georgia median

28 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1003	Lpn/lvn services, up to 15 minutes	9	20	470	$150	$1.1M
T1016	Case management, each 15 minutes	6	10	4,850	$70	$923.5K
H2017	Psychosocial rehabilitation services, per 15 minutes	5	20	3,800	$70	$896.7K
H2015	Comprehensive community support services, per 15 minutes	6	40	2,260	$70	$518.1K
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…	203	920	370	$60	$360.6K
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…	136	820	390	$70	$245K
H0031	Mental health assessment, by non-physician	10	80	80	$110	$233.6K
H0004	Behavioral health counseling and therapy, per 15 minutes	3	20	270	$60	$173.9K
H2014	Skills training and development, per 15 minutes	1	30	620	$50	$166.3K
T1002	Rn services, up to 15 minutes	15	30	640	$50	$162.7K

Showing 1–10 of 28

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Aaron Roquemore	GA	Professional Counselor	$0	$291K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pacific Health Systems LLC	GA	Home Health Agency	$0	$9.9M
Southern Crescent Pediatrics PC	GA	Pediatrics Physician	$0	$9.6M
Healthsource Agency Inc	GA	Home Health Agency	$0	$5.8M
Piedmont Hospitalist Physicians LLC	GA	Family Medicine Physician	$0	$3.6M
National Premier Laboratories Inc	GA	Clinical Medical Laboratory	$0	$3.4M
Covenant Care Pediatrics PC	GA	Pediatrics Physician	$0	$3M
Stockbridge Pediatrics	GA	Pediatrics Physician	$0	$2.6M
Surgical Center For Urology LLC	GA	Ambulatory Surgical Clinic/Center	$805.2K	$0
Regenerative Orthopaedics Surgery Center, LLC	GA	Ambulatory Surgical Clinic/Center	$622K	$0
Tambrea Ellison	GA	Physical Medicine & Rehabilitation Physician	$509.4K	$0

Apex Family Healthcare Services, LLC — Billing Profile & Reimbursement Data

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Apex Family Healthcare Services, LLC — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References