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

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

Macomb Family Services, Inc. (NPI 1831190701)

Field	Value
Entity Type	Organization
Organization	Macomb Family Services, Inc.
Address	36975 Utica Rd
City	Clinton Township
State	MI
ZIP	48036
Taxonomy	Clinical Social Worker
NPI Enumerated	August 2, 2005

Payer Source	Total Paid
Medicaid	$20.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2016	Comprehensive community support services, per diem	7,920	$770	$6.1M
H2015	Comprehensive community support services, per 15 minutes	52,480	$90	$4.7M
T1020	Personal care services, per diem, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	7,880	$520	$4.1M
H0043	Supported housing, per diem	780	$2,430	$1.9M
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…	19,640	$80	$1.5M
H0022	Alcohol and/or drug intervention service (planned facilitation)	7,880	$90	$741K
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…	9,590	$60	$565.6K
H0001	Alcohol and/or drug assessment	1,890	$150	$289.8K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	4,150	$50	$186.5K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	1,150	$90	$103K

Showing 1–10 of 17

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Michigan Distribution

Macomb Family Services, Inc. — 2 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

17 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2016	Comprehensive community support services, per diem	141	300	6,660	$310	$8.7M
H2015	Comprehensive community support services, per 15 minutes	154	610	14,740	$90	$6M
T1020	Personal care services, per diem, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	105	220	7,030	$170	$4.6M
H0043	Supported housing, per diem	118	130	10,330	$210	$4.5M
H0032	Mental health service plan development by non-physician	161	180	2,030	$170	$1.2M
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…	75	1,960	870	$100	$376.5K
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…	206	290	300	$240	$336.5K
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…	105	950	610	$80	$328.2K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	142	170	370	$150	$317.9K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	1,224	4,770	1,060	$50	$247.8K

Showing 1–10 of 17

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Macomb County Community Mental Health	MI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$299.9M
Lifelong Advocacy,inc	MI	Voluntary or Charitable Agency	$0	$78.8M
Medstar, Inc.	MI	Ambulance	$11.5M	$50.5M
Henry Ford Health Eastwood Behavioral Health	MI	Social Worker	$0	$25.2M
Arc Services Of Macomb, Inc	MI	Developmentally Disabled Services Day Training Agency	$0	$13.8M
Developmental Essential Services Inc	MI	Developmentally Disabled Services Day Training Agency	$0	$12.7M
Asc-tcg, LLC	MI	Ambulatory Surgical Clinic/Center	$407.7K	$0
Robert Franchi	MI	Ophthalmology Physician	$222.7K	$0
Rene Peleman	MI	Gastroenterology Physician	$151.5K	$0
Adam Feinstein	MI	Neuromusculoskeletal Medicine & OMM Physician	$146.5K	$0

Macomb Family Services, Inc. — Billing Profile & Reimbursement Data

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Macomb Family Services, 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