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    v1.0.28
    OpenPayerNPI Medicare & MedicaidPhilhaven
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    Philhaven — Billing Profile & Reimbursement Data

    NPI 1972598076 · Lebanon, PA · Psychiatric Hospital

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    Philhaven is a psychiatric hospital provider located in Lebanon, Pennsylvania. This profile covers 0 Medicare and 18 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationPhilhaven
    Address283 S Butler Rd
    CityLebanon
    StatePA
    ZIP17042
    TaxonomyPsychiatric Hospital
    NPI EnumeratedSeptember 14, 2005

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$5.9M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    18 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    H0039Assertive community treatment, face-to-face, per 15 minutes36,150$160$5.8M
    H2015Comprehensive community support services, per 15 minutes2,360$30$61.2K
    90834In 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…180$70$11.6K
    90837In 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…80$90$7K
    H0004Behavioral health counseling and therapy, per 15 minutes390$20$6.3K
    H0046Mental health services, not otherwise specified3,910$1$3.9K
    99214The 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…50$50$2.6K
    99255The provider sees a patient for an inpatient or observation consultation involving evaluation and management (E/M). The E/M involves a high level of medical decision making or the provider spends at…90$30$2.2K
    H0035Mental health partial hospitalization, treatment, less than 24 hours300$1$900
    99231The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…90$1$350

    Showing 1–10 of 18

    Medicaid: Competitive Analysis & Benchmarks

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

    Full comparison — all codes billed, vs. Pennsylvania median

    18 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    H0039Assertive community treatment, face-to-face, per 15 minutes184027,890$150$6.2M
    97153A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…1221508,280$220$4.1M
    H0035Mental health partial hospitalization, treatment, less than 24 hours971108,460$150$2.1M
    H2021Community-based wrap-around services, per 15 minutes1122203,810$100$1.5M
    97155The provider, a physician or other qualified healthcare professional, administers adaptive behavior treatment face–to–face with one patient and makes modifications in the protocol targets and…1351502,770$200$1.4M
    H0032Mental health service plan development by non-physician1262103,020$130$1.3M
    90834In 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…5616902,240$80$1M
    H0046Mental health services, not otherwise specified521701,200$130$909.6K
    H2015Comprehensive community support services, per 15 minutes520830$140$791.2K
    H2019Therapeutic behavioral services, per 15 minutes1431803,510$80$685K

    Showing 1–10 of 18

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Philhaven, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Wellspan Medical GroupPAPsychiatry Physician$0$22.3M
    PhilhavenPAClinic/Center$0$19.8M
    PhilhavenPAClinic/Center$0$10.9M
    PhilhavenPAClinic/Center$0$7.1M
    Alfred SylvesterPAPsychiatry Physician$41.1K$0
    Thomas FenstermacherPAPsychiatry Physician$30.2K$0
    April Mandeville-palmPAClinical Social Worker$17K$0

    Nearby Providers

    Other providers in the same ZIP code as Philhaven, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    The Good Samaritan Hospital Of Lebanon, PennsylvaniaPAGeneral Acute Care Hospital$0$18.2M
    Wicare Home Care Agency, LLC.PAHome Health Agency$0$5.5M
    Lebanon Fire Department First Aid And Safety PatrolPAAmbulance$1M$3.8M
    Surgery Center Of Lebanon, LPPAAmbulatory Surgical Clinic/Center$945.9K$0
    Mark MariaPAOphthalmology Physician$581K$0
    Lebanon Internal Medicine Associates PCPAClinical Medical Laboratory$529.8K$7.5K
    Thomas KantorPARheumatology Physician$448.3K$0
    Francis GallagherPARheumatology Physician$399.9K$0
    Ernesto GutierrezPARheumatology Physician$382.6K$310
    Raymond DemaioPAOphthalmology Physician$314.5K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Pennsylvania Providers
    2 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Pennsylvania Distribution
    Philhaven — 0 of 11 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Pennsylvania