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.

Childrens Behavioral Health, LLC (NPI 1619949948)

Field	Value
Entity Type	Organization
Organization	Childrens Behavioral Health, LLC
Address	321 Main St Ste 3c&3g
City	Johnstown
State	PA
ZIP	15901
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	February 2, 2006

Payer Source	Total Paid
Medicaid	$57.3M
Medicare	$0

Key Findings

CHILDRENS BEHAVIORAL HEALTH, LLC is effectively a single‑payer Medicaid provider: there is no Medicare billing on file while lifetime Medicaid revenue totals $57.3M. This concentration means the organization’s financial footprint is driven wholly by state Medicaid contracting and reimbursement policies rather than any Medicare business.

Revenue is highly concentrated in a small set of Medicaid service lines: the top three codes (97153, H2021, 97155) account for 73.6% of the provider’s total Medicaid revenue. Individually, 97153 represents $25.9M (45.2% of Medicaid revenue), H2021 $8.7M (15.2%), and 97155 $7.6M (13.2%), indicating a narrow set of revenue drivers.

The code mix points to a core operation built around intensive applied behavior analysis (ABA) and wrap‑around community services: 97153 and 97155 are adaptive behavior treatment codes for technicians and qualified professionals, while H2021 denotes community‑based wrap‑around services. The presence of 97151 (comprehensive assessment and plan development) and H0032 (mental health service plan development) further signals that the provider manages assessment-to-treatment workflows and care coordination for pediatric behavioral health.

CHILDRENS BEHAVIORAL HEALTH is a dominant statewide participant in several ABA‑related lines. For 97153 it ranks #4 of 145 providers (98th percentile, extreme outlier), for 97155 it ranks #5 of 151 providers (97th percentile, extreme outlier), for 97151 it ranks #2 of 122 providers (99th percentile, extreme outlier), and for 97156 it ranks #2 of 101 providers (99th percentile, extreme outlier), indicating volumes far above typical state peers for these services.

Beyond the top three codes, the provider shows notable strength in service planning: H0032 generated $6.1M (10.6% of Medicaid revenue) across 45.8K claims and ranks #7 of 209 providers (97th percentile, notably above typical state volume). There is also a measurable partial hospitalization footprint via H0035 ($1.6M, 13.6K claims) and a range of lower‑volume mental health assessment codes, suggesting a mixed service model that includes both intensive ABA and broader mental health program components.

Operational scale is reflected in high claim volumes and per‑claim reimbursement levels for key services: 97153 appears on 130.8K claims at $198 avg paid/claim, H2021 on 66.6K claims at $131 avg paid/claim, and 97155 on 41.6K claims at $182 avg paid/claim. These large, frequent per‑15‑minute billed encounters imply a labor‑ and time‑intensive delivery model relying on technician‑delivered sessions supervised by qualified professionals.

The provider’s heavy reliance on a small set of Medicaid codes creates concentration risk: because the top three codes represent 73.6% of Medicaid revenue, any state policy change, rate adjustment, or utilization review focused on ABA or wrap‑around services could materially affect overall revenue. The absence of Medicare exposure means there is limited reimbursement diversification to blunt such Medicaid‑specific shocks.

CHILDRENS BEHAVIORAL HEALTH has an established operational history, with NPI enumeration on 2006-02-02 (~20 years ago), indicating long tenure in the market. Coupled with the strong statewide rankings on multiple ABA and assessment codes, this tenure supports the view that the organization has scaled and sustained a specialized pediatric behavioral health/ABA offering over many years.

Medicaid: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	130,830	$200	$25.9M
H2021	Community-based wrap-around services, per 15 minutes	66,620	$130	$8.7M
97155	The provider, a physician or other qualified healthcare professional, administers adaptive behavior treatment face–to–face with one patient and makes modifications in the protocol targets and…	41,640	$180	$7.6M
H0032	Mental health service plan development by non-physician	45,830	$130	$6.1M
97151	The provider, a physician or other qualified healthcare professional, identifies the adaptive or maladaptive behavior of the patient by administering several different types of tests in person; he…	23,270	$180	$4.1M
97156	The provider discusses a patient’s adaptive behavior treatment face–to–face with the guardian(s) or caregiver(s), with or without the patient present. Report this code for each 15 minutes that the…	16,400	$130	$2.1M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	13,550	$120	$1.6M
H2019	Therapeutic behavioral services, per 15 minutes	7,220	$130	$924K
H0046	Mental health services, not otherwise specified	5,160	$60	$320K
H2014	Skills training and development, per 15 minutes	370	$40	$13.4K

Showing 1–10 of 12

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

Childrens Behavioral Health, LLC — 5 of 12 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

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	4	150	8,280	$220	$4.1M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	38	110	8,460	$150	$2.1M
H2021	Community-based wrap-around services, per 15 minutes	12	220	3,810	$100	$1.5M
97155	The provider, a physician or other qualified healthcare professional, administers adaptive behavior treatment face–to–face with one patient and makes modifications in the protocol targets and…	5	150	2,770	$200	$1.4M
H0032	Mental health service plan development by non-physician	7	210	3,020	$130	$1.3M
H2014	Skills training and development, per 15 minutes	8	20	370	$140	$1M
H0046	Mental health services, not otherwise specified	41	170	1,200	$130	$909.6K
H2019	Therapeutic behavioral services, per 15 minutes	63	180	3,510	$80	$685K
97151	The provider, a physician or other qualified healthcare professional, identifies the adaptive or maladaptive behavior of the patient by administering several different types of tests in person; he…	2	120	1,330	$180	$557.5K
97156	The provider discusses a patient’s adaptive behavior treatment face–to–face with the guardian(s) or caregiver(s), with or without the patient present. Report this code for each 15 minutes that the…	2	100	530	$120	$196.1K

Showing 1–10 of 12

Nearby Providers

Other providers in the same ZIP code as Childrens Behavioral Health, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Alternative Community Resource Program, Inc.	PA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$20.1M
Ibrahim Sbeitan	PA	Hematology & Oncology Physician	$236.6K	$200.4K
Subarna Eisaman	PA	Radiation Oncology Physician	$392.1K	$0
Jude Mugerwa	PA	Cardiovascular Disease Physician	$99.1K	$42.1K
Boutros Zeidan	PA	Specialist	$25.8K	$17.5K
Diane May	PA	Psychiatric/Mental Health Nurse Practitioner	$5.3K	$0

Childrens Behavioral Health, LLC — Billing Profile & Reimbursement Data

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Childrens Behavioral Health, 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

Nearby Providers

Frequently Asked Questions

References