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.

Malvern Institute For Psychiatric And Alcoholic Studies, Inc. (NPI 1922141167)

Field	Value
Entity Type	Organization
Organization	Malvern Institute For Psychiatric And Alcoholic Studies, Inc.
Address	940 W King Rd
City	Malvern
State	PA
ZIP	19355
Taxonomy	Special Hospital
NPI Enumerated	February 15, 2007

Payer Source	Total Paid
Medicaid	$91.7M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and is effectively a single-payer (Medicaid) facility for the periods reflected; total Medicaid revenue on file is $91.7M, and there is no recorded Medicare revenue to contextualize against that figure. The absence of Medicare activity indicates the organization’s patient mix and contracting are heavily oriented toward Medicaid-covered populations or services not typically billed to Medicare.

Revenue is highly concentrated in three Medicaid procedure codes that together account for 99.4% of this provider’s Medicaid revenue, indicating a narrow service portfolio or a dominant focus on a few high-revenue service lines. The largest driver is H2036, which alone represents $55.1M (60.1% of Medicaid revenue), followed by H0018 at $22.4M (24.4%) and H0013 at $13.6M (14.9%).

The code mix shows the provider primarily operates substance use and residential behavioral health programs: H2036 (per diem alcohol and/or other drug treatment program), H0018 (short-term residential behavioral health per diem without room and board), and H0013 (acute detoxification). Together these codes imply an operational focus on residential and detoxification services rather than outpatient medical specialty care or Medicare-typical services.

Competitive standing within Pennsylvania is mixed but not dominant. For H2036 the provider ranks #33 of 117 (72nd percentile), a solid statewide position but not top-tier dominance; for H0018 it ranks #47 of 95 (51st percentile), placing it near the median for that service; for H0013 it ranks #11 of 61 (83rd percentile), indicating a relatively strong position on acute detoxification compared with in-state peers. Overall, the provider is a meaningful regional participant for detox and per-diem substance use services but not a statewide leader across all its top codes.

Payment levels per claim vary substantially across the top codes and reflect the intensity/duration differences of services billed: H2036 shows a very high avg paid/claim of $3466 (per diem residential program), H0018 averages $4281 per claim (short-term residential per diem without room and board), and H0013 averages $1473 per claim (acute detoxification outpatient). These different unit values are consistent with residential/day-rate billing driving most revenue rather than high-volume low-unit outpatient encounters.

Operational profile is concentrated on higher-acuity, structured treatment settings rather than brief office visits: lower-revenue outpatient codes such as 90853 (group psychotherapy) and 99211 (established outpatient visit) together contribute negligible Medicaid revenue ($120.6K and $3.2K respectively), reinforcing that the organization’s scale and strategy center on residential and detoxification programming.

The provider has an established presence, with its NPI enumerated on 2007-02-15 (~19 years ago), which supports that the organization is a long-standing operator in its market and likely has built referral relationships and capacity for residential substance use and behavioral health services over time.

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
H2036	Alcohol and/or other drug treatment program, per diem	15,890	$3,470	$55.1M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	5,230	$4,280	$22.4M
H0013	Alcohol and/or drug services: acute detox (residential addiction program outpatient)	9,260	$1,470	$13.6M
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…	4,890	$90	$445K
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…	2,510	$50	$120.6K
H2035	Alcohol and/or other drug treatment program, per hour	90	$90	$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…	70	$100	$7.3K
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.	60	$60	$3.2K

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

Malvern Institute For Psychiatric And Alcoholic Studies, Inc. — 0 of 8 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

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2036	Alcohol and/or other drug treatment program, per diem	33	120	7,190	$420	$8.7M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	47	100	5,130	$370	$4.5M
H0013	Alcohol and/or drug services: acute detox (residential addiction program outpatient)	11	60	2,400	$450	$2.6M
H2035	Alcohol and/or other drug treatment program, per hour	23	20	1,150	$180	$1.2M
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…	56	150	2,970	$100	$699.4K
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…	347	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…	152	340	2,010	$50	$269.8K
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.	713	980	310	$50	$136.6K

Nearby Providers

Other providers in the same ZIP code as Malvern Institute For Psychiatric And Alcoholic Studies, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cardionet, LLC	PA	Physiological Laboratory	$11M	$63.2M
Childrens Surgery Center Of Malvern, LLC	PA	Ambulatory Surgical Clinic/Center	$0	$11.3M
Ramsis Holdings, Hands From The Heart Home Healthcare Services	PA	Home Health Agency	$0	$8.3M
Danielle Young	PA	Family Nurse Practitioner	$3.7M	$0
Coram Alternate Site Services Inc	PA	Home Infusion Therapy Pharmacy	$54.7K	$2.6M
Jennifer Kwan-morley	PA	Rheumatology Physician	$2.5M	$0
Caitlin Trainor	PA	Family Nurse Practitioner	$1.3M	$0
Main Line PA Endoscopy Asc LP	PA	Ambulatory Surgical Clinic/Center	$1.1M	$0
Stephanie Morris	PA	Rheumatology Physician	$742.6K	$0
Jeffrey Rihn	PA	Orthopaedic Surgery Physician	$472.1K	$0

Malvern Institute For Psychiatric And Alcoholic Studies, Inc. — Billing Profile & Reimbursement Data

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Malvern Institute For Psychiatric And Alcoholic Studies, 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