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.

Wellspan Medical Group (NPI 1740249325)

Wellspan Medical Group is a psychiatry physician provider located in York, Pennsylvania. This profile covers 0 Medicare and 30 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	Wellspan Medical Group
Address	1407 Williams Rd
City	York
State	PA
ZIP	17402
Taxonomy	Psychiatry Physician
NPI Enumerated	March 21, 2006

Payer Source	Total Paid
Medicaid	$22.3M
Medicare	$0

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

30 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…	81,110	$70	$6M
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.	70,680	$70	$4.8M
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…	43,310	$90	$4M
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…	12,290	$200	$2.4M
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…	14,780	$100	$1.4M
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…	8,540	$70	$563.6K
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…	12,690	$40	$507.7K
96131	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	2,730	$180	$479.8K
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…	12,160	$40	$474.2K
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…	7,570	$60	$454K

Showing 1–10 of 30

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

Wellspan Medical Group — 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

30 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	335	1,690	760	$170	$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…	23	690	2,240	$80	$1M
H0038	Self‑help/peer services, per 15 minutes	104	160	2,290	$150	$865.4K
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…	47	560	1,400	$90	$485.7K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	1,469	1,600	270	$120	$409.7K
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…	69	540	1,490	$50	$316.4K
H0047	Alcohol and/or other drug abuse services, not otherwise specified	49	90	1,610	$80	$297.9K
H0034	Medication training and support, per 15 minutes	46	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…	3	420	650	$180	$270.2K
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…	41	340	2,010	$50	$269.8K

Showing 1–10 of 30

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
York Hospital	PA	General Acute Care Hospital	$0	$40.7M
Philhaven	PA	Clinic/Center	$0	$19.8M
The Good Samaritan Hospital Of Lebanon, Pennsylvania	PA	General Acute Care Hospital	$0	$18.2M
Philhaven	PA	Clinic/Center	$0	$10.9M
The Chambersburg Hospital	PA	General Acute Care Hospital	$0	$10.3M
Wellspan Medical Group	PA	Pediatrics Physician	$0	$9.9M
Philhaven	PA	Clinic/Center	$0	$7.1M
Gsh Home Med Care LLC	PA	Oxygen Equipment & Supplies (DME)	$0	$6.5M
York Hospital	PA	Family Medicine Physician	$0	$6.2M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Andventure, LLC	PA	Home Health Agency	$0	$21.7M
Maxim Healthcare Services, Inc.	PA	Home Health Agency	$0	$20.3M
Bayada Home Health Care, Inc.	PA	Home Health Agency	$0	$11.9M
Pyrmaid Healthcare Inc.	PA	Methadone Clinic	$96.6K	$8.1M
Ivan Marchena- Mendez	PA	Rheumatology Physician	$1M	$0
Christina Collins	PA	Internal Medicine Physician	$844.7K	$0
Luciano Iorizzo	PA	MOHS-Micrographic Surgery Physician	$539.5K	$0
Steven Heird	PA	Vascular Surgery Physician	$494.8K	$0
Stanton Lebouitz	PA	Dermatology Physician	$331.1K	$5.1K
Steven Caplan	PA	Dermatology Physician	$312.9K	$0

Wellspan Medical Group — Billing Profile & Reimbursement Data

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Wellspan Medical Group — 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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