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

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

Outer Cape Health Services, Inc. (NPI 1841384013)

Outer Cape Health Services, Inc. is a federally qualified health center (fqhc) provider located in Provincetown, Massachusetts. This profile covers 0 Medicare and 84 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Outer Cape Health Services, Inc.
Address	49 Harry Kemp Way
City	Provincetown
State	MA
ZIP	02657
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	October 3, 2006

Payer Source	Total Paid
Medicaid	$6.5M
Medicare	$0

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

84 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	25,120	$150	$3.8M
G0470	Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc…	5,970	$130	$781.9K
T1040	Medicaid certified community behavioral health clinic services, per diem	4,330	$140	$584.7K
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…	6,150	$60	$375.4K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	8,830	$30	$264.8K
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…	6,310	$10	$82K
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…	510	$100	$52.6K
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…	1,160	$40	$46.4K
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	1,950	$20	$40.9K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	800	$50	$36.7K

Showing 1–10 of 84

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

Outer Cape Health Services, Inc. — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

84 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1502	Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit	102	130	34,780	$60	$7.4M
T1040	Medicaid certified community behavioral health clinic services, per diem	50	170	950	$200	$1.8M
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	288	310	8,710	$40	$1.6M
T1015	Clinic visit/encounter, all-inclusive	42	550	90	$140	$1.5M
G0470	Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc…	19	80	1,720	$150	$800.5K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	310	410	140	$110	$742.2K
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…	206	1,620	580	$80	$599.6K
D9450	N/A	67	150	2,450	$30	$506.8K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	32	110	3,490	$40	$309.9K
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…	483	1,020	460	$100	$293.7K

Showing 1–10 of 84

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Outer Cape Health Services	MA	Federally Qualified Health Center (FQHC)	$0	$6.6M
John Kalin	MA	Cardiovascular Disease Physician	$617.9K	$0
Ingrid Hyder	MA	Diagnostic Radiology Physician	$262.2K	$0
Alexander Adduci	MA	Diagnostic Radiology Physician	$215.8K	$0
Carissa Kelly	MA	Adult Health Nurse Practitioner	$100.8K	$770
Rosalie Cuozzo	MA	Physician Assistant	$66.5K	$0

Outer Cape Health Services, Inc. — Billing Profile & Reimbursement Data

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Outer Cape Health 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

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