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    OpenPayerNPI Medicare & MedicaidUmass Memorial Health-harrington Hospital Inc
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    Umass Memorial Health-harrington Hospital Inc — Billing Profile & Reimbursement Data

    NPI 1790780047 · Southbridge, MA · General Acute Care Hospital

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    Umass Memorial Health-harrington Hospital Inc is a general acute care hospital provider located in Southbridge, Massachusetts. This profile covers 0 Medicare and 425 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationUmass Memorial Health-harrington Hospital Inc
    Address100 South Street
    CitySouthbridge
    StateMA
    ZIP01550
    TaxonomyGeneral Acute Care Hospital
    NPI EnumeratedJune 14, 2005

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$71.3M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    425 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99285The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.49,190$160$7.7M
    96361The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.18,010$350$6.3M
    90834In 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…98,250$60$5.6M
    99284The 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.40,550$130$5.1M
    99283The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.34,280$140$4.9M
    99282The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.22,890$130$3M
    97110Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…49,850$50$2.7M
    99214The 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…29,930$70$2.1M
    74177The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.9,910$150$1.4M
    43239The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.1,910$700$1.3M

    Showing 1–10 of 425

    • More pages

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other Massachusetts providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. Massachusetts median

    425 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    H0020Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)194026,400$10$9.7M
    G2067Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed…20308,280$140$8M
    41899Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.1110470$2,670$6.3M
    96361The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.22907,560$350$4.2M
    S9485Crisis intervention mental health services, per diem421101,250$540$3.2M
    96413Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…40501,870$210$1.4M
    G0378Hospital observation service, per hour38707,250$100$1.3M
    96365The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.23804,380$140$1.1M
    G0463Hospital outpatient clinic visit for assessment and management of a patient251105,660$30$1.1M
    99285The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.25520120$130$1M

    Showing 1–10 of 425

    • More pages

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Umass Memorial Health-harrington Hospital Inc, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Harrington Physician Services IncMAFamily Medicine Physician$0$9.1M
    Edward ArousMAVascular Surgery Physician$387.7K$0
    Waqas QureshiMAInterventional Cardiology Physician$130.9K$490
    Andres SchanzerMAVascular Surgery Physician$118.6K$450
    David MorinMAPsychiatry Physician$84.6K$0
    Georgios PonirosMAPodiatrist$65.6K$10.1K
    Douglas JonesMAVascular Surgery Physician$69.2K$0
    Laura BoitanoMAVascular Surgery Physician$53.3K$0
    Erika ClarkMAClinical Neuropsychologist$44.9K$0
    Stephen FerberOHPsychiatry Physician$15.3K$80

    Nearby Providers

    Other providers in the same ZIP code as Umass Memorial Health-harrington Hospital Inc, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Commonwealth Of MassachusettsMACase Management Agency$0$1.3B
    Rmg Home Care, IncMAHome Health Agency$0$12.8M
    Rmg Adult Day Health Centers, LLCMAAdult Day Care Clinic/Center$0$12.2M
    Southern Worcester County Arc IncMADevelopmentally Disabled Services Day Training Agency$0$11.3M
    Renaissance Primary Care, LLCMAInternal Medicine Physician$0$11.3M
    People First Gafc LLCMAAdult Care Home Facility$0$8.8M
    Hugh CooperMAOphthalmology Physician$286K$204K
    Craig GoldbergMAFamily Medicine Physician$68.1K$104.1K
    Young-ho OhMAOrthopaedic Surgery Physician$117.8K$13.8K
    John StagiasMAGastroenterology Physician$111.2K$3.6K

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Massachusetts Providers
    7 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Massachusetts Distribution
    Umass Memorial Health-harrington Hospital Inc — 9 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Massachusetts