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.

Corecare Behavioral Health Management, Inc. (NPI 1558520841)

Field	Value
Entity Type	Organization
Organization	Corecare Behavioral Health Management, Inc.
Address	111 N 49th St
City	Philadelphia
State	PA
ZIP	19139
Taxonomy	Substance Abuse Rehabilitation Facility
NPI Enumerated	June 3, 2008

Payer Source	Total Paid
Medicaid	$73.2M
Medicare	$0

Key Findings

CORECARE BEHAVIORAL HEALTH MANAGEMENT, INC. is effectively a single‑payer Medicaid provider: there is no Medicare revenue on file and the provider reports $73.2M in total Medicaid revenue, indicating Medicaid drives the entirety of recorded public-payer billing for this entity. This concentration in a single primary payer materially shapes both revenue risk and contracting leverage.

Revenue is heavily concentrated in a very small set of service lines: the precomputed top three Medicaid codes (H2036, H0018, H0013) account for 98.3% of the provider's total Medicaid revenue. Those three codes are H2036 $57.5M (78.5%), H0018 $10.4M (14.2%), and H0013 $4.1M (5.6%), showing the business depends on a narrow set of per‑diem and detox services for nearly all Medicaid receipts.

The code mix identifies CORECARE as a primarily residential and detox-focused substance abuse rehabilitation operation: H2036 is an alcohol and/or other drug treatment program, per diem, H0018 is short‑term residential (non‑hospital) per diem without room and board, and H0013 is acute detoxification (residential addiction program outpatient). The dominance of per‑diem residential codes plus a substantial detox component suggests the organization operates sizable bed‑based treatment and short‑term residential programs.

For its highest‑revenue code H2036, CORECARE ranks as a major in-state provider—#3 of 117 (98th percentile; notably above typical state volume)—which signals strong scale in per‑diem substance‑use programming relative to peers. H0018 also shows outsized state presence at #4 of 95 (97th percentile; notably above typical state volume), while H0013 sits at #6 of 61 (92th percentile; described as typical, unremarkable volume for this code), indicating market leadership in residential per‑diem services but more ordinary standing in acute detoxification.

Several ancillary or lower-revenue codes appear in the billing mix but contribute minimally to overall Medicaid revenue, indicating limited diversification beyond residential and detox services. Examples include T1015 (776 claims, $850 avg paid/claim, $659.6K revenue; 0.9% of Medicaid revenue; ranks #838 of 1691, 50th percentile) and T2048 (19.4K claims, $28 avg paid/claim, $543.6K revenue; 0.7% of Medicaid revenue; ranks #6 of 58, 91th percentile; notably above typical state volume), showing presence in clinic/long‑term residential billing but at much lower revenue impact.

The provider bills a substantial volume of certain services that generate minimal or no Medicaid payments on file, which may reflect payer coverage rules or billing practices rather than core revenue generation. Notably, H0020 appears with 19.9K claims but $0 avg paid/claim and $0 revenue (0.0% of Medicaid revenue), and 90853 shows 1.7K claims at $1 avg paid/claim totaling $1.7K; these items are activity indicators without material revenue contribution.

CORECARE has a long tenure in the dataset with NPI enumerated 2008-06-03 (~18 years ago), consistent with an established operator in the state Medicaid behavioral‑health market. Given the long history and current dependence on a few high‑volume per‑diem codes, the provider faces concentrated exposure to Medicaid reimbursement and policy changes affecting residential substance‑use treatment rates and utilization.

Medicaid: Complete Services Breakdown

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
H2036	Alcohol and/or other drug treatment program, per diem	150,430	$380	$57.5M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	75,430	$140	$10.4M
H0013	Alcohol and/or drug services: acute detox (residential addiction program outpatient)	14,000	$290	$4.1M
T1015	Clinic visit/encounter, all-inclusive	780	$850	$659.6K
T2048	Behavioral health; long-term care residential (non-acute care in a residential treatment program where stay is typically longer than 30 days), with room and board, per diem	19,410	$30	$543.6K
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…	1,220	$20	$24.4K
G9012	Other specified case management service not elsewhere classified	80	$280	$23.3K
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…	1,650	$1	$1.7K
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	19,910	$0	$0

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

Corecare Behavioral Health Management, Inc. — 2 of 8 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

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2036	Alcohol and/or other drug treatment program, per diem	3	120	7,190	$420	$8.7M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	4	100	5,130	$370	$4.5M
H0013	Alcohol and/or drug services: acute detox (residential addiction program outpatient)	6	60	2,400	$450	$2.6M
T2048	Behavioral health; long-term care residential (non-acute care in a residential treatment program where stay is typically longer than 30 days), with room and board, per diem	6	60	1,280	$360	$1.8M
T1015	Clinic visit/encounter, all-inclusive	838	1,690	760	$170	$1.2M
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	54	80	74,580	$10	$1.2M
G9012	Other specified case management service not elsewhere classified	266	320	770	$260	$758K
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…	300	540	1,490	$50	$316.4K
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…	187	340	2,010	$50	$269.8K

Nearby Providers

Other providers in the same ZIP code as Corecare Behavioral Health Management, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
West Philadelphia Community Mh Consortium, Inc.	PA	Case Management Agency	$0	$22M
Spectrum Health Services, Inc.	PA	Federally Qualified Health Center (FQHC)	$0	$12M
The Children's Hospital Of Philadelphia	PA	Pediatrics Physician	$0	$11.9M
West Phila Community Mental Health Consortium, Inc.	PA	Adult Mental Health Clinic/Center	$0	$5.8M
Children's Hospital Of Philadelphia	PA	Pediatrics Physician	$0	$5.7M
Haytham Albizem	PA	Cardiovascular Disease Physician	$1.2M	$5.7K
Jeannine Weimar-fitzpatrick	PA	Family Medicine Physician	$64.7K	$0
Rachel Bennov	PA	Gerontology Nurse Practitioner	$18.9K	$0

Corecare Behavioral Health Management, Inc. — Billing Profile & Reimbursement Data

Sign up for Corecare Behavioral Health Management, Inc. — Billing Profile & Reimbursement Data policy alerts

Corecare Behavioral Health Management, Inc. — Billing Profile & Reimbursement Data

Sign up for Corecare Behavioral Health Management, Inc. — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References