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.

Bedford Somerset Developmental And Behavioral Health Services (NPI 1881818672)

Bedford Somerset Developmental And Behavioral Health Services is a community/behavioral health agency provider located in Somerset, Pennsylvania. This profile covers 0 Medicare and 13 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	Bedford Somerset Developmental And Behavioral Health Services
Address	245 W Race St
City	Somerset
State	PA
ZIP	15501
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	April 12, 2007

Payer Source	Total Paid
Medicaid	$8.3M
Medicare	$0

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	30,260	$90	$2.8M
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.	22,510	$80	$1.9M
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	3,140	$220	$675.7K
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…	4,750	$120	$550.8K
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…	1,500	$360	$543.4K
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…	2,960	$150	$455.7K
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…	4,280	$100	$423.2K
H0034	Medication training and support, per 15 minutes	6,180	$70	$419.9K
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…	6,040	$40	$265.8K
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…	3,070	$60	$190.5K

Showing 1–10 of 13

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

Bedford Somerset Developmental And Behavioral Health Services — 3 of 13 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

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	81	690	2,240	$80	$1M
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…	136	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…	123	540	1,490	$50	$316.4K
H0034	Medication training and support, per 15 minutes	48	260	1,710	$80	$279.8K
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…	123	420	650	$180	$270.2K
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…	138	340	2,010	$50	$269.8K
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…	109	180	860	$70	$195.9K
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.	24	980	310	$50	$136.6K
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…	689	8,160	210	$60	$68.4K
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…	544	8,870	240	$40	$56.1K

Showing 1–10 of 13

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Twin Lakes Center Inc	PA	Substance Use Disorder Rehabilitation Clinic/Center	$0	$12M
Bedford-somerset Developmental And Behavioral Health Services	PA	Case Management Agency	$0	$5.6M
Somerset Area Ambulance Association, Inc	PA	Land Ambulance	$399.2K	$1.3M
Genevieve Everett-sigwalt	PA	Clinical Cardiac Electrophysiology Physician	$148K	$5.1K
Raymond Woshner	PA	Anatomic Pathology & Clinical Pathology Physician	$55.3K	$20.6K
Taesun Moon	PA	Surgery Physician	$30.5K	$29.8K
James Mckay	PA	Optometrist	$41.1K	$17.5K
Victor Novak	PA	Surgery Physician	$36.1K	$12.9K

Bedford Somerset Developmental And Behavioral Health Services — Billing Profile & Reimbursement Data

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Bedford Somerset Developmental And Behavioral Health Services — 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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References