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

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

Optimum Health Systems Inc (NPI 1598094997)

Optimum Health Systems Inc is a mental health clinic/center (including community mental health center) provider located in Baltimore, Maryland. This profile covers 0 Medicare and 11 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	Optimum Health Systems Inc
Address	2300 Garrison Blvd
City	Baltimore
State	MD
ZIP	21216
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	December 14, 2009

Payer Source	Total Paid
Medicaid	$9.8M
Medicare	$0

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

11 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…	52,290	$110	$5.9M
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…	17,850	$120	$2.1M
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…	8,210	$110	$928.1K
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…	3,910	$60	$230.6K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	1,000	$200	$198.4K
H0032	Mental health service plan development by non-physician	1,960	$100	$190.4K
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…	690	$190	$126.9K
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…	1,410	$70	$92.9K
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…	140	$100	$13.4K
90846	A provider meets with the patient’s family without the patient present to counsel the family on the psychological issues affecting the patient and the family.	40	$110	$4K

Showing 1–10 of 11

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Maryland Distribution

Optimum Health Systems Inc — 2 of 11 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maryland

Full comparison — all codes billed, vs. Maryland median

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	49	2,200	890	$110	$596.1K
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…	46	450	510	$120	$393.2K
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…	105	3,670	680	$90	$310K
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…	344	450	730	$110	$298.2K
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…	661	3,280	610	$80	$296.1K
H0032	Mental health service plan development by non-physician	82	330	520	$100	$183K
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…	205	610	520	$50	$178.2K
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…	417	440	510	$40	$128.6K
90846	A provider meets with the patient’s family without the patient present to counsel the family on the psychological issues affecting the patient and the family.	118	160	150	$130	$113.3K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	149	1,090	90	$200	$101.4K

Showing 1–10 of 11

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tuerk House, Inc	MD	Substance Abuse Rehabilitation Facility	$0	$30.9M
Winchester Health LLC	MD	Methadone Clinic	$398.1K	$10.7M
Aaa Management, LLC	MD	Adult Day Care Clinic/Center	$0	$9.5M
New Insights Behavioral Health	MD	Community/Behavioral Health Agency	$0	$7.1M
Misha House, LLC	MD	Substance Use Disorder Rehabilitation Clinic/Center	$0	$6.4M
Life Worth Living	MD	Substance Use Disorder Rehabilitation Clinic/Center	$0	$6.1M
Hebron House, Inc.	MD	Community/Behavioral Health Agency	$0	$5.3M
New Insights Behavioral Health	MD	Clinical Social Worker	$0	$4.8M
Larry Gaston	MD	Dermatology Physician	$84.5K	$2.1M

Optimum Health Systems Inc — Billing Profile & Reimbursement Data

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Optimum Health Systems Inc — 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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References