Commonwealth Clinical Alliance, INC
Commonwealth Clinical Alliance, INC was paid $247K by Medicaid between Jan 2019 and Sep 2024, across 53 billing codes. Its largest line is 99396, Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years — 33% of everything it billed.
33Billing provider infoCOMMONWEALTH CLINICAL ALLIANCE, INC
SPRINGFIELD, MA 01107
SPRINGFIELD, MA 01107
33aNPI1679605091assigned 03/12/2007
33bProvider typeCase Manager/Care Coordinator
28Total paid$247K
24GClaims57,295
24DCodes billed53
24AFirst – last monthJan 2019 – Sep 2024
Compared with peers
Next to other Case Manager/Care Coordinator providers in Massachusetts
Rank by total paid#5 of 13
Median peer was paid$202K
This provider vs. median1.2×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2019 | 14,101 | $0.00 | |
| 2020 | 11,966 | $0.00 | |
| 2021 | 4,386 | $1K | |
| 2022 | 7,773 | $15K | |
| 2023 | 13,924 | $775.52 | |
| 2024incomplete | 5,145 | $230K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 33% | 1,638 | 1,630 | $82K |
| 99397 | 20% | 5,350 | 5,125 | $50K | |
| 99456 | 7.7% | 4,215 | 4,177 | $19K | |
| 97162 | 6.8% | 4,469 | 4,290 | $17K | |
| 97161 | 5.5% | 5,448 | 5,333 | $14K | |
| T1028 | Assessment of home, physical and family environment, to determine suitability to meet patient's medical needs | 5.5% | 1,872 | 1,815 | $14K |
| 90791 | Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation | 5.2% | 525 | 512 | $13K |
| S9485 | Crisis intervention mental health services, per diem | 3.1% | 4,458 | 1,714 | $8K |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | 2.3% | 211 | 162 | $6K |
| 97165 | 1.9% | 3,788 | 3,745 | $5K | |
| 99417 | Prolong home eval add 15m | 1.9% | 760 | 617 | $5K |
| 99350 | Prolong home eval add 15m | 1.7% | 2,414 | 2,052 | $4K |
41 more codes
| 90832 | Psychotherapy session, about 30 minutes | 1.1% | 1,338 | $3K |
| 97163 | <1% | 485 | $2K | |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | <1% | 3,457 | $2K |
| 99497 | <1% | 745 | $2K | |
| 99443 | <1% | 309 | $994.52 | |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | <1% | 3,070 | $918.27 |
| 97116 | <1% | 1,693 | $918.27 | |
| 99349 | <1% | 1,466 | $819.00 | |
| 99348 | <1% | 408 | $344.19 | |
| 99347 | <1% | 127 | $38.39 | |
| 3044F | <1% | 45 | $0.08 | |
| 1170F | 0% | 800 | $0.00 | |
| 97166 | 0% | 57 | $0.00 | |
| 1125F | 0% | 593 | $0.00 | |
| 1157F | 0% | 12 | $0.00 | |
| 99214 | Doctor's office visit, returning patient (more involved) | 0% | 111 | $0.00 |
| 90834 | Psychotherapy session, about 45 minutes | 0% | 84 | $0.00 |
| 91301 | 0% | 51 | $0.00 | |
| 1126F | 0% | 138 | $0.00 | |
| 99441 | 0% | 102 | $0.00 | |
| 3074F | 0% | 123 | $0.00 | |
| 0011A | 0% | 53 | $0.00 | |
| 97535 | Self-care/home management training, each 15 minutes | 0% | 50 | $0.00 |
| 99213 | Doctor's office visit, returning patient (routine) | 0% | 83 | $0.00 |
| 1159F | 0% | 1,141 | $0.00 | |
| 1160F | 0% | 1,179 | $0.00 | |
| 97167 | 0% | 644 | $0.00 | |
| 96158 | 0% | 78 | $0.00 | |
| 3078F | 0% | 201 | $0.00 | |
| 99442 | 0% | 101 | $0.00 | |
| S9484 | Crisis intervention mental health services, per hour | 0% | 2,770 | $0.00 |
| 1124F | 0% | 95 | $0.00 | |
| 97039 | 0% | 30 | $0.00 | |
| 99354 | 0% | 14 | $0.00 | |
| 90836 | 0% | 12 | $0.00 | |
| 1158F | 0% | 333 | $0.00 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 0% | 56 | $0.00 |
| 3077F | 0% | 33 | $0.00 | |
| 99498 | 0% | 14 | $0.00 | |
| 97542 | 0% | 28 | $0.00 | |
| 98968 | 0% | 18 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialSIMON, LOIS (CHIEF OPERATING OFFICER)