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.

Philadelphia Mental Health Clinic (NPI 1780746917)

Field	Value
Entity Type	Organization
Organization	Philadelphia Mental Health Clinic
Address	1235 Pine Street
City	Philadelphia
State	PA
ZIP	19107
Taxonomy	Clinic/Center
NPI Enumerated	December 14, 2006

Payer Source	Total Paid
Medicaid	$18.3M
Medicare	$0

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
H0032	Mental health service plan development by non-physician	70,990	$120	$8.5M
H2021	Community-based wrap-around services, per 15 minutes	36,600	$130	$4.6M
H2019	Therapeutic behavioral services, per 15 minutes	22,200	$170	$3.8M
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…	5,550	$120	$649.4K
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…	5,880	$80	$470.3K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	930	$120	$111.4K
H0034	Medication training and support, per 15 minutes	860	$50	$41.3K
H0031	Mental health assessment, by non-physician	100	$250	$25.5K
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.	540	$20	$11.8K
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…	100	$90	$8.9K

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

Philadelphia Mental Health Clinic — 1 of 11 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
H2021	Community-based wrap-around services, per 15 minutes	25	220	3,810	$100	$1.5M
H0032	Mental health service plan development by non-physician	4	210	3,020	$130	$1.3M
H0046	Mental health services, not otherwise specified	100	170	1,200	$130	$909.6K
H2019	Therapeutic behavioral services, per 15 minutes	17	180	3,510	$80	$685K
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…	103	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…	134	540	1,490	$50	$316.4K
H0034	Medication training and support, per 15 minutes	164	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…	333	420	650	$180	$270.2K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	35	240	130	$300	$139.8K
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.	414	980	310	$50	$136.6K

Showing 1–10 of 12

Nearby Providers

Other providers in the same ZIP code as Philadelphia Mental Health Clinic, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Quality Progressions	PA	Case Management Agency	$0	$50.8M
Bright Beginnings Therapeutic Services, LLC	PA	Community/Behavioral Health Agency	$0	$46.8M
Thomas Jefferson University Hospitals Inc	PA	General Acute Care Hospital	$0	$40.3M
Jefferson University Physicians	PA	General Practice Physician	$0	$30.8M
The Pennsylvania Hospital Of The University Of Pennsylvania Health Sys	PA	General Acute Care Hospital	$0	$25.7M
Philadelphia Fight	PA	Federally Qualified Health Center (FQHC)	$0	$18.1M
Public Health Mangement Corporation	PA	Federally Qualified Health Center (FQHC)	$0	$9.3M
Addiction Medicine And Health Advocates, Incorporated	PA	Methadone Clinic	$56.9K	$9.2M
Assessment & Treatment Alternatives	PA	Community/Behavioral Health Agency	$0	$9.1M
Nadia Darbouze	PA	Social Worker	$0	$9.1M

Philadelphia Mental Health Clinic — Billing Profile & Reimbursement Data

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Philadelphia Mental Health Clinic — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References