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.

Pyramid Healthcare Inc. (NPI 1629352927)

Field	Value
Entity Type	Organization
Organization	Pyramid Healthcare Inc.
Address	1605 North Cedar Crest Boulevard, Suite 105
City	Allentown
State	PA
ZIP	18104
Taxonomy	Substance Use Disorder Rehabilitation Clinic/Center
NPI Enumerated	October 5, 2011

Payer Source	Total Paid
Medicaid	$11M
Medicare	$0

Medicaid: Complete Services Breakdown

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	62,930	$110	$6.8M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	6,410	$180	$1.2M
H2035	Alcohol and/or other drug treatment program, per hour	4,950	$160	$767.7K
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…	11,550	$60	$635K
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…	3,730	$120	$451.7K
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…	7,390	$50	$376.7K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	9,180	$40	$339.6K
H0047	Alcohol and/or other drug abuse services, not otherwise specified	4,830	$50	$246.2K
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…	1,460	$100	$143.3K
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…	670	$70	$43.7K

Showing 1–10 of 16

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

Pyramid Healthcare Inc. — 1 of 16 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

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0035	Mental health partial hospitalization, treatment, less than 24 hours	63	110	8,460	$150	$2.1M
H2035	Alcohol and/or other drug treatment program, per hour	9	20	1,150	$180	$1.2M
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…	158	690	2,240	$80	$1M
H0038	Self‑help/peer services, per 15 minutes	153	160	2,290	$150	$865.4K
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	3	150	2,970	$100	$699.4K
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…	271	560	1,400	$90	$485.7K
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…	334	540	1,490	$50	$316.4K
H0047	Alcohol and/or other drug abuse services, not otherwise specified	21	90	1,610	$80	$297.9K
H0034	Medication training and support, per 15 minutes	249	260	1,710	$80	$279.8K
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…	49	420	650	$180	$270.2K

Showing 1–10 of 16

Related Providers

Other providers that share a Tax Identification Number (TIN) with Pyramid Healthcare Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pyramid Health Care Inc.	PA	Substance Abuse Rehabilitation Facility	$0	$128.8M
Pyramid Healthcare	PA	Substance Abuse Rehabilitation Facility	$0	$87.4M
Pyramid Healthcare, Inc.	VA	Community/Behavioral Health Agency	$0	$40.6M
Pyramid Health Care Inc.	PA	Substance Abuse Rehabilitation Facility	$0	$23.9M
Pyramid Healthcare Inc.	PA	Substance Use Disorder Rehabilitation Clinic/Center	$0	$14.3M
Pyramid Healthcare Inc.	PA	Methadone Clinic	$125.2K	$13.3M
Pyramid Healthcare Inc.	PA	Substance Abuse Rehabilitation Facility	$0	$10.4M
Pyramid Healthcare Inc.	PA	Substance Abuse Rehabilitation Facility	$0	$8.6M
Pyrmaid Healthcare Inc.	PA	Methadone Clinic	$96.6K	$8.1M
Pyramid Healthcare Inc	PA	Children's Substance Abuse Rehabilitation Facility	$0	$8.2M

Nearby Providers

Other providers in the same ZIP code as Pyramid Healthcare Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. Luke's Hospital	PA	General Acute Care Hospital	$0	$23.4M
Loving Care Agency, Inc.	PA	Home Health Agency	$0	$21.2M
The Salvation Army	PA	Nursing Care Agency	$0	$17.9M
Maxim Healthcare Services, Inc.	PA	Home Health Agency	$0	$16M
Valley Health Partners Community Health Center	PA	Federally Qualified Health Center (FQHC)	$0	$11.9M
Horizon House, Inc.	PA	Community/Behavioral Health Agency	$0	$8.2M
Lehigh Valley Physician Group	PA	Pediatrics Physician	$0	$7.6M
Cetronia Ambulance Corps, Inc	PA	Land Ambulance	$1.7M	$4.3M
Alan Listhaus	PA	Ophthalmology Physician	$2.6M	$0
Surgery Center Of Allentown LLC	PA	Ambulatory Surgical Clinic/Center	$2M	$0

Pyramid Healthcare Inc. — Billing Profile & Reimbursement Data

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Pyramid Healthcare 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

Related Providers

Nearby Providers

Frequently Asked Questions

References