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.

Keystone Service Systems, Inc. (NPI 1568525640)

Field	Value
Entity Type	Organization
Organization	Keystone Service Systems, Inc.
Address	4391 Sturbridge Dr
City	Harrisburg
State	PA
ZIP	17110
Taxonomy	Intellectual & Developmental Disabilities Psychologist
NPI Enumerated	December 19, 2006

Payer Source	Total Paid
Medicaid	$85.6M
Medicare	$0

Key Findings

This entity reports no Medicare billing on file and $85.6M in lifetime Medicaid revenue, making it effectively a single-payer (Medicaid-focused) operation at scale rather than a mixed Medicare/Medicaid provider. The absence of Medicare activity is explicit in the source data and shapes any comparative analysis toward in-state Medicaid peers rather than national Medicare peers.

Revenue is highly concentrated: the precomputed top 3 Medicaid codes by revenue account for 99.9% of this provider's total Medicaid revenue, with T2025 alone contributing $77.8M revenue (90.9% of this provider's total Medicaid revenue). That extreme concentration means a single code drives the overwhelming share of the reported $85.6M Medicaid lifetime revenue.

The code mix indicates a waiver-centric residential habilitation service model: T2025 (Waiver services; nos) with 127.4K claims and $611 avg paid/claim and T2016 (Habilitation, residential, waiver; per diem) with 15.1K claims and $466 avg paid/claim together suggest primary operations delivering Medicaid waiver and residential habilitation supports for individuals with intellectual and developmental disabilities. The presence of G0175 (15.7K claims, $42 avg paid/claim) — scheduled interdisciplinary team conferences with the patient present — further supports a model that emphasizes coordinated, team-based care and regular interdisciplinary oversight.

Competitive standing within the state is pronounced for key Medicaid services: T2025 ranks #1 of 24 providers in-state (100th percentile; extreme outlier, far above typical state volume for this code), and T1001 ranks #1 of 66 providers in-state (100th percentile; extreme outlier). By contrast, T2016 and G0175 also rank #1 among their smaller peer groups (#1 of 5 and #1 of 2 respectively) but are described as typical, unremarkable volumes in the available notes, indicating dominance specifically around the large waiver service line rather than uniformly across all service types.

High-volume metrics underline operational scale on a per-service basis: T2025 shows 127.4K claims at $611 avg paid/claim generating $77.8M, T2016 shows 15.1K claims at $466 avg paid/claim generating $7M, G0175 shows 15.7K claims at $42 avg paid/claim generating $658.2K, and T1001 shows 5K claims at $25 avg paid/claim generating $125.7K. These figures demonstrate that the majority of dollars are tied to high average paid/claim activity under T2025, while the other codes contribute materially less revenue despite significant claim counts for some services.

From an operational and policy perspective, the provider’s heavy dependence on T2025 (90.9% of Medicaid revenue) means reimbursement changes, waiver eligibility rules, or program reconfigurations affecting that code would materially affect overall revenue; similarly, T1001’s status as an extreme outlier suggests unusually large nursing assessment volume relative to peers, which could be sensitive to scope-of-service or documentation changes. Analysts should treat the provider as highly exposed to policy and reimbursement shifts concentrated in a small set of waiver and assessment codes.

The provider has an established tenure in the dataset, with an NPI enumeration date of 2006-12-19 (~20 years ago), indicating long-running participation in the state Medicaid system. That longevity, combined with the very large T2025 volumes, suggests the organization has built sustained scale in waiver service delivery over many years.

Data gaps and interpretation notes: because there is no Medicare billing on file, any cross-payer comparisons must rely solely on Medicaid activity and in-state peer ranks; national Medicare benchmarks are not applicable for this provider. For Medicaid-based competitive analysis, the available rank/percentile and the explicit "extreme outlier" labels should guide conclusions about dominance in specific waiver and assessment services rather than implying uniform market leadership across all IDD-related codes.

Medicaid: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2025	Waiver services; not otherwise specified (nos)	127,380	$610	$77.8M
T2016	Habilitation, residential, waiver; per diem	15,060	$470	$7M
G0175	Scheduled interdisciplinary team conference (minimum of three exclusive of patient care nursing staff) with patient present	15,670	$40	$658.2K
T1001	Nursing assessment / evaluation	5,030	$30	$125.7K

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

Keystone Service Systems, Inc. — 4 of 4 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

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2025	Waiver services; not otherwise specified (nos)	1	20	10,570	$680	$14M
T2016	Habilitation, residential, waiver; per diem	1	10	2,730	$800	$4.9M
G0175	Scheduled interdisciplinary team conference (minimum of three exclusive of patient care nursing staff) with patient present	1	10	7,870	$40	$332.1K
T1001	Nursing assessment / evaluation	1	70	90	$120	$46.5K

Nearby Providers

Other providers in the same ZIP code as Keystone Service Systems, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Youth Advocate Programs, Inc.	PA	Community/Behavioral Health Agency	$0	$101M
Pediatric Services Of America, LLC	PA	Home Health Agency	$0	$31.5M
Maxim Healthcare Services Inc	PA	Home Health Agency	$0	$20.9M
Tri Valley Care, Inc	PA	Case Management Agency	$0	$19.4M
Center For Behavioral Health Ha, LLC	PA	Methadone Clinic	$169.3K	$14.3M
Global Healthcare Group, LLC	PA	Home Health Agency	$0	$11.9M
Adrian Harewood	PA	General Practice Physician	$967.8K	$3.3K
Capital Surgery And Laser Center, LLC	PA	Ambulatory Surgical Clinic/Center	$785.8K	$0
Elena Farrell	PA	Ophthalmology Physician	$277.2K	$0
Maciej Charczuk	PA	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$44.8K	$226.3K

Keystone Service Systems, Inc. — Billing Profile & Reimbursement Data

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Keystone Service Systems, Inc. — 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

Nearby Providers

Frequently Asked Questions

References