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 California for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to California 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. California (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.

California Psychcare, Inc. (NPI 1811289150)

Field	Value
Entity Type	Organization
Organization	California Psychcare, Inc.
Address	16380 Roscoe Blvd Ste 100
City	Van Nuys
State	CA
ZIP	91406
Taxonomy	Behavior Analyst
NPI Enumerated	May 4, 2011

Payer Source	Total Paid
Medicaid	$154.4M
Medicare	$0

Key Findings

CALIFORNIA PSYCHCARE, INC. in VAN NUYS, CA is effectively a single‑payer Medicare/Medicaid provider: there is no Medicare billing on file and the practice reports $154.4M in lifetime Medicaid revenue. Its NPI was enumerated on 2011-05-04 (~15 years ago), indicating a long-enough operating history to have built scale within state Medicaid programs.

Revenue for this provider is highly concentrated: the precomputed top three Medicaid codes account for 89.4% of its total Medicaid revenue. The three largest contributors are H2019 (69.0% of Medicaid revenue), H0032 (15.5%), and H0046 (5.0%), which together dominate the revenue profile.

The code mix and volumes point to an operations model focused on intensive, short-interval behavioral health encounters and care planning. H2019 (Therapeutic behavioral services, per 15 minutes) is the single largest line by far, supplemented by plan development (H0032) and broad mental health services (H0046), and additional home training and technician-delivered ABA codes such as S5111 and 97153 appear throughout the top codes list. This combination indicates a business built around high-frequency behavioral intervention and caregiver training rather than episodic, long-duration medical visits.

CALIFORNIA PSYCHCARE is a dominant statewide player for H2019: it billed 942.6K claims of H2019 for $106.5M in revenue with an average paid/claim of $113, and it ranks #2 of 657 providers in-state (100th percentile; extreme outlier). Those counts and rank place the provider far above typical state volume for this code and indicate massive scale in therapeutic behavioral services delivery.

The provider also shows unusually high volumes for related care-planning and broad mental health codes. H0032 has 215.1K claims, a $111 avg paid/claim and $23.9M revenue (rank #3 of 976 in-state; 100th percentile; notably above typical state volume), while H0046 has 71.9K claims, a $107 avg paid/claim and $7.7M revenue (rank #1 of 140 in-state; 100th percentile; extreme outlier). Together these ranks and volumes underscore that the provider is materially above peers across multiple behavioral health service categories.

Telehealth and home-based caregiver training are meaningful parts of the mix: T1014 appears with 152.5K claims, $14 avg paid/claim and $2.1M revenue (1.4% of Medicaid revenue; rank #3 of 290; 99th percentile; extreme outlier), and S5111 shows 85.7K claims, $75 avg paid/claim and $6.4M revenue (4.2% of Medicaid revenue; rank #1 of 273; 100th percentile; extreme outlier). This pattern suggests a significant operational emphasis on remote/brief encounters and family-focused training delivered in-home or via telehealth.

While technician-delivered adaptive behavior treatment codes are present, their dollar contribution is small relative to H2019. For example, 97153 shows 1.9K claims, $97 avg paid/claim and $180.7K revenue, and 97155 shows 658 claims, $147 avg paid/claim and $96.7K revenue; these lower totals relative to H2019 imply the operation relies heavily on high-volume per-15-minute behavioral units rather than proportionally on higher-paid clinician-modification sessions. This suggests a staffing model that likely scales with many short technician sessions supervised by higher-level staff.

From a competitive and risk perspective, the provider’s dominant in-state standing on a handful of Medicaid behavioral codes gives it strong market presence in California’s behavioral service space but also concentrates reimbursement exposure in Medicaid. The absence of Medicare billing means the organization’s revenue is effectively tied to Medicaid policy, reimbursement rates, and managed care contracting; its ~15-year tenure indicates established scale, which is an operational strength but also creates concentration risk if program rules or rates change.

Medicaid: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2019	Therapeutic behavioral services, per 15 minutes	942,600	$110	$106.5M
H0032	Mental health service plan development by non-physician	215,140	$110	$23.9M
H0046	Mental health services, not otherwise specified	71,920	$110	$7.7M
S5111	Home care training, family; per session	85,650	$80	$6.4M
H0031	Mental health assessment, by non-physician	44,060	$120	$5.3M
T1014	Telehealth transmission, per minute, professional services bill separately	152,490	$10	$2.1M
H2012	Behavioral health day treatment, per hour	11,570	$140	$1.6M
S5110	Home care training, family; per 15 minutes	2,740	$80	$229.7K
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…	1,860	$100	$180.7K
H2014	Skills training and development, per 15 minutes	2,450	$60	$154.1K

Showing 1–10 of 15

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. California Distribution

California Psychcare, Inc. — 6 of 15 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. California median

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0004	Behavioral health counseling and therapy, per 15 minutes	114	200	3,070	$120	$4.5M
H2019	Therapeutic behavioral services, per 15 minutes	2	660	4,750	$140	$3.1M
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…	51	90	2,960	$150	$2.6M
H0032	Mental health service plan development by non-physician	3	980	1,080	$160	$1.5M
H2012	Behavioral health day treatment, per hour	24	110	3,310	$160	$1.3M
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…	48	80	1,300	$150	$798.6K
G9012	Other specified case management service not elsewhere classified	328	720	1,110	$110	$651.3K
H0046	Mental health services, not otherwise specified	1	140	1,570	$130	$598.9K
H0031	Mental health assessment, by non-physician	2	360	330	$180	$492.6K
H2014	Skills training and development, per 15 minutes	40	140	790	$120	$395.1K

Showing 1–10 of 15

Nearby Providers

Other providers in the same ZIP code as California Psychcare, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Primex Clinical Laboratories Inc.	CA	Clinical Medical Laboratory	$5.8M	$27.3M
A Change In Trajectory, Inc.	CA	Behavior Analyst	$0	$31.7M
Pasteur Inc	CA	Clinical Medical Laboratory	$4.4M	$26.2M
All Town Transport Inc	CA	Non-emergency Medical Transport (VAN)	$0	$28.5M
American Professional Ambulance Corp	CA	Land Ambulance	$5.5M	$7.2M
K & T Portable X-ray Solutions	CA	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	$995.8K	$221.3K
K & T Diagnostic, Inc.	CA	Mobile Radiology Clinic/Center	$681.4K	$303.6K
Munaf Shamji	CA	Interventional Cardiology Physician	$930.8K	$5.5K
Leon Kupferwasser	CA	Cardiovascular Disease Physician	$828.1K	$1.7K
Valley Surgery Center, Inc.	CA	Ambulatory Surgical Clinic/Center	$453.3K	$0

California Psychcare, Inc. — Billing Profile & Reimbursement Data

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California Psychcare, 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

Nearby Providers

Frequently Asked Questions

References