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.

Quality Progressions (NPI 1790864312)

Field	Value
Entity Type	Organization
Organization	Quality Progressions
Address	125 S 9th St
City	Philadelphia
State	PA
ZIP	19107
Taxonomy	Case Management Agency
NPI Enumerated	November 3, 2006

Payer Source	Total Paid
Medicaid	$50.8M
Medicare	$0

Key Findings

This entity has no Medicare billing on file and is effectively a single-payer Medicaid operation: lifetime Medicare revenue is none below while lifetime Medicaid revenue is $50.8M. Analysts should treat this provider as concentrated in Medicaid exposure rather than a mixed Medicare/Medicaid business model.

Medicaid revenue is extremely concentrated at the code level: the precomputed top 3 Medicaid codes account for 100.0% of this provider's total Medicaid revenue, with two listed codes alone comprising the overwhelming share of payments. This concentration means a small set of services defines the provider’s financial footprint in Medicaid.

W7210 is the dominant revenue driver with 485.8K claims, $91 avg paid/claim, and $44.2M in revenue representing 87.0% of this provider's Medicaid revenue. Although no description is available for W7210 in the file, its volume and dollar share indicate this single code underpins the provider’s core operational throughput and financial performance.

T1017 (T1017 – Targeted case management, each 15 minutes) is the secondary driver with 78.9K claims, $84 avg paid/claim, and $6.6M in revenue representing 13.0% of Medicaid revenue. The presence of T1017 aligns with the provider taxonomy of Case Management Agency and indicates routine, time-based case management encounters are a material part of delivery.

Competitive standing varies by code: for W7210 the provider ranks #2 of 69 in-state and sits at the 99th percentile, characterized in the file as notably above typical state volume; this signals near-top dominance for that particular code within the state. For T1017 the provider ranks #13 of 205 and is at the 94th percentile with a label of typical, unremarkable volume, indicating strong but not market-leading participation for standard targeted case management.

Operational profile implied by the code mix is high-volume, low-to-moderate unit-payment services: both listed codes show large claim counts (485.8K and 78.9K) with modest avg paid/claim amounts ($91 and $84), consistent with recurring, time-based case management rather than infrequent high-cost procedures. This suggests staffing and scheduling models optimized for many short encounters rather than episodic procedural care.

The provider has long tenure in the NPI registry (enumerated 2006-11-03, ~20 years ago), indicating an established presence in the state Medicaid market. Combined with $50.8M in Medicaid revenue, tenure and scale point to a substantial, sustained operating role in Medicaid case management services.

Because the top 3 codes make up 100.0% of Medicaid revenue and W7210 alone accounts for 87.0%, the provider is highly exposed to any state-level payment, policy, or utilization changes tied to that code. Analysts should note the concentrated dependence on code-specific reimbursement rules and monitor state policy or program shifts affecting W7210 and T1017.

Medicaid: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
W7210	N/A	485,770	$90	$44.2M
T1017	Targeted case management, each 15 minutes	78,910	$80	$6.6M

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

Quality Progressions — 1 of 2 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

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
W7210	N/A	2	70	83,330	$80	$10M
T1017	Targeted case management, each 15 minutes	13	210	18,200	$100	$2.9M

Nearby Providers

Other providers in the same ZIP code as Quality Progressions, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
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 Mental Health Clinic	PA	Clinic/Center	$0	$18.3M
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

Quality Progressions — Billing Profile & Reimbursement Data

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Quality Progressions — 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

Nearby Providers

Frequently Asked Questions

References