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

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

Thresholds, Inc. (NPI 1811970668)

Field	Value
Entity Type	Organization
Organization	Thresholds, Inc.
Address	6 N Railroad Ave
City	Georgetown
State	DE
ZIP	19947
Taxonomy	Addiction (Substance Use Disorder) Counselor
NPI Enumerated	November 25, 2005

Payer Source	Total Paid
Medicaid	$126.7K
Medicare	$0

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	1,900	$20	$37.9K
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…	870	$30	$26.9K
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…	490	$40	$20.9K
98968	A nonphysician qualified healthcare professional discusses, via telephone, a health issue and possible treatment or management with an established patient, parent, or guardian. This service includes…	470	$30	$12.7K
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…	2,010	$10	$12.1K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	200	$40	$8.9K
H0048	Alcohol and/or other drug testing: collection and handling only, specimens other than blood	2,630	$1	$5.3K
98967	A nonphysician qualified healthcare professional discusses, via telephone, a health issue and possible treatment or management with an established patient, parent, or guardian. This service includes…	100	$20	$1.9K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Delaware Distribution

Thresholds, Inc. — 2 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. Delaware median

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	138	240	700	$60	$205.6K
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…	40	80	790	$40	$180.4K
H0048	Alcohol and/or other drug testing: collection and handling only, specimens other than blood	7	10	4,340	$1	$92.2K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	32	80	120	$60	$60.5K
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…	20	50	1,240	$20	$57.8K
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…	14	30	2,010	$10	$38.5K
98968	A nonphysician qualified healthcare professional discusses, via telephone, a health issue and possible treatment or management with an established patient, parent, or guardian. This service includes…	1	10	40	$30	$3.8K
98967	A nonphysician qualified healthcare professional discusses, via telephone, a health issue and possible treatment or management with an established patient, parent, or guardian. This service includes…	1	10	60	$20	$1.3K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Packd LLC	DE	In Home Supportive Care Agency	$0	$31M
Sea Care LLC	DE	Intellectual & Developmental Disabilities Psychologist	$0	$10.1M
La Red Health Center Inc	DE	Federally Qualified Health Center (FQHC)	$0	$7.3M
Cheer, Inc.	DE	Home Health Agency	$0	$7.3M
Rainbow Pediatrics	DE	Pediatrics Physician	$0	$5.6M
Wilmington Orthodontic Center	DE	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$3.8M
Horizon House Delaware Inc.	DE	Case Management Agency	$0	$3.3M
La Red Health Center Inc	DE	Federally Qualified Health Center (FQHC)	$0	$3.1M
Fellowship Health Resources, Inc	DE	Community/Behavioral Health Agency	$0	$2.8M
Nutrihealth LLC	DE	Internal Medicine Physician	$0	$994.6K

Thresholds, Inc. — Billing Profile & Reimbursement Data

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Thresholds, Inc. — 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