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.

Pennsylvania Counseling Services Inc. (NPI 1669474979)

Field	Value
Entity Type	Organization
Organization	Pennsylvania Counseling Services Inc.
Address	200 N 7th St
City	Lebanon
State	PA
ZIP	17046
Taxonomy	Counselor
NPI Enumerated	June 1, 2005

Payer Source	Total Paid
Medicaid	$80.2M
Medicare	$0

Key Findings

This provider is effectively a single‑payer Medicaid billing entity: there is no Medicare revenue on file while Medicaid revenue totals $80.2M. The absence of Medicare activity makes Medicaid the primary and near‑exclusive source of reported public payer revenue for this NPI.

Revenue is highly concentrated in a small set of services: the top three Medicaid codes (90834, H0004, 97153) account for 72.1% of total Medicaid revenue. Individually those codes generate $30.2M (90834, 37.7%), $18.4M (H0004, 23.0%), and $9.2M (97153, 11.5%), indicating the bulk of dollars flow through psychotherapy, behavioral counseling, and adaptive behavior treatment.

The code mix points to a behavioral‑health and applied behavior analysis (ABA)–oriented operation: 90834 and 90837 reflect long individual psychotherapy sessions, H0004 denotes behavioral health counseling per 15 minutes, and 97153/97155 represent technician‑delivered and clinician‑supervised adaptive behavior treatments. Additional codes such as T1016 (case management) and H2021 (wrap‑around services) indicate the organization provides care coordination and community-based behavioral supports in addition to direct therapy.

The provider is a dominant statewide player for several high‑value codes: 90834 ranks #1 of 692 providers in Pennsylvania and is flagged an "extreme outlier," and H0004 ranks #2 of 1405 providers and is also an "extreme outlier," pointing to volumes far above typical state peers for core psychotherapy and counseling services. By contrast, 97153 ranks #12 of 145 (92nd percentile) and is characterized as typical for that code, showing market leadership is strongest in psychotherapy and counseling rather than uniformly across ABA services.

Claim volumes reinforce a high‑throughput outpatient model: 90834 accounts for 420.1K claims, H0004 for 68.9K claims, and 97153 for 56.8K claims, with average paid/claim figures of $72, $267, and $162 respectively. These counts suggest sustained, large‑scale delivery of recurring therapy sessions and technician time rather than one‑off evaluations.

Several secondary codes further underscore a broad behavioral health footprint and notable outlier behavior in specific service areas: 90846 ranks #1 of 93 providers in‑state (100th percentile; "extreme outlier") for family psychotherapy without the patient present, 96127 ranks #6 of 944 (99th percentile; "extreme outlier") for brief standardized assessments, and 99211 ranks #16 of 978 (98th percentile; "notably above typical") for low‑intensity outpatient visits. Together these suggest the provider captures high volume across therapy formats, assessments, and ancillary E/M touchpoints.

The heavy concentration of revenue in a small set of behavioral health codes (72.1% in the top three) implies business exposure to shifts in Medicaid policy, reimbursement, or network contracting for those specific services. Because a majority of dollars are tied to psychotherapy and counseling codes, payers should monitor utilization trends and service definitions for 90834 and H0004 when evaluating network dependence or rate negotiations.

This NPI has been active for a long period, enumerated on 2005‑06‑01 (~21 years ago), which aligns with the sustained Medicaid volume reported. The combination of long tenure and outsized code‑level market positions suggests an established provider organization with entrenched delivery of psychotherapy, counseling, and related behavioral services in Pennsylvania.

Medicaid: Complete Services Breakdown

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

25 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…	420,130	$70	$30.2M
H0004	Behavioral health counseling and therapy, per 15 minutes	68,940	$270	$18.4M
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…	56,770	$160	$9.2M
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…	21,690	$210	$4.4M
H2021	Community-based wrap-around services, per 15 minutes	27,390	$100	$2.8M
T1016	Case management, each 15 minutes	11,600	$200	$2.3M
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…	17,450	$120	$2.1M
H0032	Mental health service plan development by non-physician	11,370	$150	$1.7M
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.	26,370	$60	$1.5M
H2033	Multisystemic therapy for juveniles, per 15 minutes	7,010	$210	$1.4M

Showing 1–10 of 25

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

Pennsylvania Counseling Services Inc. — 8 of 25 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

25 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…	12	150	8,280	$220	$4.1M
H2033	Multisystemic therapy for juveniles, per 15 minutes	6	20	3,890	$290	$3.3M
H2021	Community-based wrap-around services, per 15 minutes	34	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…	12	150	2,770	$200	$1.4M
H0032	Mental health service plan development by non-physician	51	210	3,020	$130	$1.3M
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…	1	690	2,240	$80	$1M
T1016	Case management, each 15 minutes	35	160	2,180	$80	$965.8K
H0046	Mental health services, not otherwise specified	90	170	1,200	$130	$909.6K
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…	127	150	2,970	$100	$699.4K
H2019	Therapeutic behavioral services, per 15 minutes	108	180	3,510	$80	$685K

Showing 1–10 of 25

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pennsylvania Counseling Services Inc	PA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$24.3M
Martin Desantis	FL	Psychiatry Physician	$126.4K	$0

Nearby Providers

Other providers in the same ZIP code as Pennsylvania Counseling Services Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Advanced Treatment Systems, LLC	PA	Methadone Clinic	$122.1K	$11.7M
Gsh Home Med Care LLC	PA	Oxygen Equipment & Supplies (DME)	$0	$6.5M
Milan Patel	PA	Physical Medicine & Rehabilitation Physician	$96.3K	$0

Pennsylvania Counseling Services Inc. — Billing Profile & Reimbursement Data

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Pennsylvania Counseling Services 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

Related Providers

Nearby Providers

Frequently Asked Questions

References