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.

Berks Counseling Center, Inc. (NPI 1881620250)

Field	Value
Entity Type	Organization
Organization	Berks Counseling Center, Inc.
Address	645 Penn Street
City	Reading
State	PA
ZIP	19601
Taxonomy	Addiction (Substance Use Disorder) Counselor
NPI Enumerated	June 25, 2006

Payer Source	Total Paid
Medicaid	$43.9M
Medicare	$0

Key Findings

This provider is effectively single‑payer at scale: there is no Medicare billing on file for this NPI, while total Medicaid revenue is $43.9M. The absence of Medicare activity paired with material Medicaid receipts indicates the organization’s operations and revenues are concentrated entirely within the Medicaid system.

Revenue is extremely concentrated in a single Medicaid code cluster: the precomputed top three Medicaid codes together account for 100.0% of the provider’s Medicaid revenue, with W0500 alone generating $43.2M (98.5% of Medicaid revenue). This concentration means that reimbursement changes or policy actions affecting W0500 would have an outsized impact on the provider’s financials.

W0500 is the dominant revenue driver despite a middling in‑state competitive rank: W0500 shows 51.3K claims at $842 avg paid/claim, producing $43.2M and ranking #3 of 7 providers in-state (67th percentile; typical, unremarkable volume for this code). The combination of high average paid/claim and a typical in‑state rank suggests the provider captures substantial revenue from each paid instance of W0500 rather than by unusually large share of statewide volume.

H0034 (Medication training and support, per 15 minutes) is a clear activity outlier for this provider: it accounts for $650.6K (1.5% of Medicaid revenue) across 21K claims at $31 avg paid/claim and ranks #5 of 257 providers in-state (98th percentile; extreme outlier). This indicates the provider delivers medication training/support at volumes far above typical state peers and highlights a significant service-line specialization in medication-related SUD supports.

90837 (psychotherapy, 53+ minutes) posts meaningful claim volume but negligible revenue: 5.2K claims at $3 avg paid/claim produce $15.7K (0.0% of Medicaid revenue) and rank the provider #117 of 555 in-state (79th percentile; typical, unremarkable volume). The pattern of relatively high claim counts but very low per‑claim payments suggests these long psychotherapy sessions are either lightly reimbursed, bundled, or otherwise not the principal source of fee‑for‑service revenue for this organization.

A large set of behavioral‑health and case‑management codes show nonzero claim counts yet report $0 avg paid/claim and $0 revenue (examples include 90834, 90832, 90853, 99211, H0006, H0015 and others). This reporting pattern may reflect capitated/encounter‑based payment arrangements, administrative reporting practices, or other non‑fee‑for‑service settlement mechanisms rather than absence of service delivery; analysts should treat these volumes as operational activity that is not captured in Medicaid fee‑for‑service revenue tallies.

The provider has long tenure in the public programs: the NPI was enumerated 2006-06-25 (~20 years ago), supporting the view that this is an established Medicaid participant with a stable enrollment history. Taken together with the revenue concentration and the H0034 outlier status, the picture is of a long‑standing, Medicaid‑focused addiction/SUD counseling operation that relies heavily on one high‑value code and on above‑typical volumes of medication training/support services.

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
W0500	N/A	51,300	$840	$43.2M
H0034	Medication training and support, per 15 minutes	20,990	$30	$650.6K
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…	5,230	$1	$15.7K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	70	$20	$1.3K
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…	2,610	$0	$0
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…	21,100	$0	$0
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…	41,020	$0	$0
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…	60	$0	$0
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…	17,460	$0	$0
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.	14,490	$0	$0

Showing 1–10 of 17

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

Berks Counseling Center, Inc. — 1 of 4 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

17 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
W0500	N/A	3	10	29,320	$620	$30.5M
H0039	Assertive community treatment, face-to-face, per 15 minutes	33	40	27,890	$150	$6.2M
T1017	Targeted case management, each 15 minutes	177	210	18,200	$100	$2.9M
H2030	Mental health clubhouse services, per 15 minutes	15	20	7,340	$120	$1.2M
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…	60	690	2,240	$80	$1M
H0038	Self‑help/peer services, per 15 minutes	38	160	2,290	$150	$865.4K
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	34	150	2,970	$100	$699.4K
H0006	Alcohol and/or drug services; case management	5	40	2,140	$110	$606.6K
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…	117	560	1,400	$90	$485.7K
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…	37	540	1,490	$50	$316.4K

Showing 1–10 of 17

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Service Access And Management Inc	PA	Case Management Agency	$0	$129M
Service Access And Management Inc	PA	Case Management Agency	$0	$36.5M
Service Access And Management Inc	PA	Case Management Agency	$0	$24.9M
Community Education Centers, Inc.	PA	Community/Behavioral Health Agency	$0	$9.8M
The Progressions Companies, Inc.	PA	Clinic/Center	$0	$9.3M
Familicare Counseling Center LLC	PA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$8.1M
Chor Youth And Family Services	PA	Psychiatric Residential Treatment Facility	$0	$8M
Opportunity Behavioral Health	PA	Community/Behavioral Health Agency	$0	$7.8M
Service Access And Management Inc	PA	Case Management Agency	$0	$6.6M
City Of Reading	PA	Ambulance	$478K	$5.8M

Berks Counseling Center, Inc. — Billing Profile & Reimbursement Data

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Berks Counseling Center, 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