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

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

Edgewater Systems For Balanced Living, Inc (NPI 1932732955)

Edgewater Systems For Balanced Living, Inc is a mental health clinic/center (including community mental health center) provider located in Gary, Indiana. This profile covers 0 Medicare and 11 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	Edgewater Systems For Balanced Living, Inc
Address	1110 W 5th Ave
City	Gary
State	IN
ZIP	46402
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	February 18, 2020

Payer Source	Total Paid
Medicaid	$3.6M
Medicare	$0

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	134,280	$20	$2.1M
G2067	Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed…	7,470	$180	$1.3M
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…	1,350	$90	$114.4K
G2077	Periodic assessment; assessing periodically by an otp practitioner and includes a review of moud dosing, treatment response, other substance use disorder treatment needs, responses and…	220	$70	$15.2K
H0038	Self‑help/peer services, per 15 minutes	800	$20	$13.7K
G2078	Take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure	170	$30	$4.3K
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	$50	$2.8K
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…	40	$60	$2.4K
86580	The lab analyst performs an intradermal skin test on a patient to test for tuberculosis.	240	$1	$470
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…	10	$20	$260

Showing 1–10 of 11

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Indiana Distribution

Edgewater Systems For Balanced Living, Inc — 0 of 11 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Indiana

Full comparison — all codes billed, vs. Indiana median

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	19	30	240,980	$20	$6.4M
G2067	Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed…	19	20	24,350	$170	$4.1M
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…	505	580	710	$60	$582.9K
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…	311	690	1,070	$80	$422.3K
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…	2,362	2,380	920	$50	$376.8K
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…	203	220	1,380	$20	$360.2K
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…	393	430	630	$40	$243.8K
H0038	Self‑help/peer services, per 15 minutes	45	80	1,080	$60	$219.4K
G2078	Take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure	19	20	1,490	$30	$75K
G2077	Periodic assessment; assessing periodically by an otp practitioner and includes a review of moud dosing, treatment response, other substance use disorder treatment needs, responses and…	12	10	780	$60	$64.5K

Showing 1–10 of 11

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Methodist Hospitals, Inc	IN	General Acute Care Hospital	$0	$75.6M
Edgewater Systems For Balanced Living, Inc	IN	Community/Behavioral Health Agency	$0	$17.8M
City Of Gary Indiana	IN	Ambulance	$442.6K	$7.2M
Cep America LLC	IN	Emergency Medicine Physician	$0	$6.9M
Community Healthnet Inc	IN	Community Health Clinic/Center	$0	$6M
Sound Physicians Of Indiana, LLC	IN	Hospitalist Physician	$0	$4.2M
Edgewater Systems For Balanced Living, Inc.	IN	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$2.8M
Akeem Kareem	IN	Family Nurse Practitioner	$80.4K	$0
Amanda Neary	IN	Certified Registered Nurse Anesthetist	$13K	$10.9K
Elizabeth Baldys	IN	Physician Assistant	$17.8K	$0

Edgewater Systems For Balanced Living, Inc — Billing Profile & Reimbursement Data

Sign up for Edgewater Systems For Balanced Living, Inc — Billing Profile & Reimbursement Data policy alerts

Edgewater Systems For Balanced Living, Inc — Billing Profile & Reimbursement Data

Sign up for Edgewater Systems For Balanced Living, Inc — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References