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

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

Michael Hayes (NPI 1528106606)

Field	Value
Entity Type	Individual
Organization	Michael Hayes
Address	512 S Union St
City	Traverse City
State	MI
ZIP	49684
Taxonomy	Clinical Psychologist
NPI Enumerated	February 2, 2007

Payer Source	Total Paid
Medicare	$22.8K
Medicaid	$0

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

6 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…	160	$70	$11.3K
96131	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	60	$70	$4K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	20	$120	$2.9K
96130	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	20	$90	$2.1K
96137	Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; each additional 30 minutes (List…	60	$30	$1.8K
96136	The provider, a physician or other qualified healthcare professional, administers two or more psychological or neuropsychological tests and scores them. Report this code for the first 30 minutes of…	20	$30	$710

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Michigan Distribution

Michael Hayes — 0 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90834	118	410	100	$60	$9.3K
96130	26	40	30	$90	$5.4K
90791	175	420	20	$110	$4.6K
96131	7	20	40	$60	$4.3K
96137	29	40	90	$20	$2.5K
96136	38	60	30	$30	$1.3K

Michael Hayes — Billing Profile & Reimbursement Data

Sign up for Michael Hayes — Billing Profile & Reimbursement Data policy alerts

Michael Hayes — Billing Profile & Reimbursement Data

Sign up for Michael Hayes — Billing Profile & Reimbursement Data policy alerts

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References