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

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

Pathway Healthcare- Mississippi LLC (NPI 1013425503)

Pathway Healthcare- Mississippi LLC is a addiction medicine (family medicine) physician provider located in Laurel, Mississippi. This profile covers 0 Medicare and 26 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	Pathway Healthcare- Mississippi LLC
Address	5 Dunnbarr Ste 1
City	Laurel
State	MS
ZIP	39440
Taxonomy	Addiction Medicine (Family Medicine) Physician
NPI Enumerated	January 18, 2018

Payer Source	Total Paid
Medicaid	$2.6M
Medicare	$0

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

26 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	25,630	$40	$1.1M
G2087	Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; at least 60 minutes in a subsequent calendar month	4,760	$150	$704.3K
G0481	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	4,020	$60	$249.1K
G0483	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	2,250	$80	$175.1K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	26,360	$10	$131.8K
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…	1,100	$70	$74K
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…	1,120	$40	$43.8K
99406	The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes.	10,460	$1	$41.8K
G0482	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	620	$70	$41.8K
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…	220	$70	$15.2K

Showing 1–10 of 26

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Mississippi Distribution

Pathway Healthcare- Mississippi LLC — 7 of 23 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Mississippi

Full comparison — all codes billed, vs. Mississippi median

26 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	236	280	600	$100	$681.9K
G2087	Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; at least 60 minutes in a subsequent calendar month	1	10	2,640	$150	$397K
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…	1,299	1,910	930	$60	$278.7K
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…	93	160	380	$70	$223.2K
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…	84	80	650	$50	$215.4K
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…	33	1,670	720	$50	$196.4K
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…	37	120	340	$50	$148.2K
G0483	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	4	20	370	$100	$114.2K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	44	60	560	$60	$79.4K
G0482	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	6	20	420	$60	$61.7K

Showing 1–10 of 26

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Duke Wood	MS	Addiction Medicine (Family Medicine) Physician	$119.7K	$0
Billy Davis	AL	Addiction Medicine (Family Medicine) Physician	$65.8K	$0
Deborah Gross	MS	Addiction Medicine (Psychiatry & Neurology) Physician	$37.4K	$0
Raven Campbell-smith	MS	Primary Care Nurse Practitioner	$32.2K	$0
Edith Faulkner	MS	Family Nurse Practitioner	$31.2K	$0
Ryane Doty	MS	Psychiatric/Mental Health Nurse Practitioner	$30.2K	$0
Youlanda Jones	MS	Family Nurse Practitioner	$20.2K	$0
Allan Rowe	MS	Clinical Social Worker	$8.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
South Central Regional Medical Center	MS	General Acute Care Hospital	$0	$48.1M
Chateau Adult Day Center, LLC	MS	In Home Supportive Care Agency	$0	$14.8M
Jones Family Medicine Clinic PLLC	MS	Primary Care Clinic/Center	$0	$9.4M
Asap Ems Corporation	MS	Land Ambulance	$850.3K	$5.4M
Magnolia Gardens Assisted Living	MS	Assisted Living Facility (Behavioral Disturbances)	$0	$5.4M
Shannon Weathers	MS	Family Nurse Practitioner	$4.6M	$0
South Central Clinics, Inc	MS	Emergency Medicine Physician	$0	$4.5M
South Central Clinics, Inc	MS	Rural Health Clinic/Center	$0	$4.4M
Tender Loving Care Homecare LLC	MS	In Home Supportive Care Agency	$0	$4.1M
Laurel Surgery & Endoscopy Center, LLC	MS	Ambulatory Surgical Clinic/Center	$520.6K	$3.4M

Pathway Healthcare- Mississippi LLC — Billing Profile & Reimbursement Data

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Pathway Healthcare- Mississippi LLC — 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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