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

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

Odyssey House Inc (NPI 1033143706)

Field	Value
Entity Type	Organization
Organization	Odyssey House Inc
Address	340 E 100 S
City	Salt Lake City
State	UT
ZIP	84111
Taxonomy	Substance Use Disorder Rehabilitation Clinic/Center
NPI Enumerated	July 10, 2006

Payer Source	Total Paid
Medicaid	$84.5M
Medicare	$0

Key Findings

ODYSSEY HOUSE INC is effectively a single-payer Medicaid provider: there is no Medicare billing on file and its lifetime Medicaid revenue is $84.5M, indicating the organization’s scale and financial exposure are concentrated in Medicaid reimbursement rather than a dual Medicare/Medicaid mix. This payer concentration means network participation and state Medicaid policy will materially affect topline revenue.

Revenue concentration is high: the precomputed top-3 Medicaid codes by revenue account for 84.2% of this provider's total Medicaid revenue, with H0018 alone representing $54.8M (64.9% of Medicaid revenue). This level of concentration signals that a small set of per-diem residential and program codes drive the vast majority of cash flow.

The code mix points to a facility-centered substance use disorder and residential services model: the largest revenue drivers are H0018, H2013, and H2036 — codes tied to short-term residential, psychiatric health facility per diems, and alcohol/drug treatment per diems. Combined with significant claims for group psychotherapy (90853), this profile is consistent with an operation that runs high-volume residential programs supported by structured group therapy and per-diem program billing.

Competitive standing by code is mixed but notable in key areas: H0018 ranks #3 of 30 providers in-state (93th percentile; typical, unremarkable volume for this code) and generates $54.8M, indicating one of the largest state-level residential revenue streams despite the dataset labeling that volume as typical. H2013 ($9.1M, rank #4 of 11, 70th percentile) and H2036 ($7.3M, rank #4 of 14, 77th percentile) similarly place the provider among the top few in Utah for per-diem psychiatric and AOD program services.

Group psychotherapy (90853) is an outlier relative to peers: 64.1K claims produced $5.3M (6.3% of Medicaid revenue) and the provider ranks #3 of 150 in-state (99th percentile; extreme outlier, far above typical state volume for this code). That unusually high group-therapy volume suggests programmatic emphasis on group-based treatment pathways and substantial capacity for group sessions compared with other Utah providers.

Operational breadth beyond per-diem residential care is present but smaller in revenue: codes such as H0040 (2.8K claims, $3.2M, 3.8% of Medicaid revenue), 90837 (9K claims, $1.2M, 1.4% of Medicaid revenue), and 99214 (3.4K claims, $487.1K, 0.6% of Medicaid revenue) show the provider also bills assertive community treatment, extended individual psychotherapy, and outpatient E/M visits. These secondary service lines indicate a mixed delivery model that supplements core residential programming with community-based and outpatient services.

The provider is an established organization with a long tenure: the NPI was enumerated on 2006-07-10 (~20 years ago), and the cumulative Medicaid receipts of $84.5M reflect sustained engagement with state Medicaid programs. Given the concentration in a few per-diem codes and lack of Medicare activity, payers and analysts should view ODYSSEY HOUSE as a long-standing, Medicaid-focused SUD/residential service provider whose financial health is closely tied to per-diem residential and high-volume group psychotherapy reimbursements.

Medicaid: Complete Services Breakdown

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

39 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	62,260	$880	$54.8M
H2013	Psychiatric health facility service, per diem	7,900	$1,150	$9.1M
H2036	Alcohol and/or other drug treatment program, per diem	9,660	$750	$7.3M
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…	64,090	$80	$5.3M
H0040	Assertive community treatment program, per diem	2,780	$1,150	$3.2M
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…	8,990	$130	$1.2M
H2016	Comprehensive community support services, per diem	10,090	$90	$877.7K
H2019	Therapeutic behavioral services, per 15 minutes	10,060	$60	$623.8K
H2017	Psychosocial rehabilitation services, per 15 minutes	8,120	$60	$495.3K
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…	3,430	$140	$487.1K

Showing 1–10 of 39

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Utah Distribution

Odyssey House Inc — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Utah

Full comparison — all codes billed, vs. Utah median

39 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	3	30	1,340	$330	$5.8M
H2016	Comprehensive community support services, per diem	8	10	11,170	$90	$4.3M
H2013	Psychiatric health facility service, per diem	4	10	1,960	$520	$3.5M
H0040	Assertive community treatment program, per diem	3	10	1,500	$1,050	$2.5M
H2036	Alcohol and/or other drug treatment program, per diem	4	10	2,920	$330	$2M
H2014	Skills training and development, per 15 minutes	37	50	1,320	$130	$1.1M
H2017	Psychosocial rehabilitation services, per 15 minutes	19	90	340	$70	$713.8K
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…	37	370	690	$140	$704.2K
H2019	Therapeutic behavioral services, per 15 minutes	19	90	560	$80	$649.9K
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…	3	150	1,060	$70	$528.1K

Showing 1–10 of 39

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratory Corporation Of America Holdings	NC	Clinical Medical Laboratory	$214.6M	$1.4B
Laboratory Corporation Of America Holdings	NJ	Clinical Medical Laboratory	$143.3M	$717.5M
Natera, Inc.	CA	Clinical Medical Laboratory	$133.1M	$641.5M
Unilab Corporation	CA	Clinical Medical Laboratory	$94M	$668.5M
Bioreference Health, LLC	NJ	Clinical Medical Laboratory	$66.8M	$620.1M
Laboratory Corporation Of America Holdings	OH	Clinical Medical Laboratory	$56.9M	$617M
Millennium Health, LLC	CA	Clinical Medical Laboratory	$20.4M	$579.3M
Exact Sciences Laboratories, LLC	WI	Clinical Medical Laboratory	$299.3M	$276.5M
Aeroflow Inc.	NC	Durable Medical Equipment & Medical Supplies	$0	$571.9M
Zoll Services LLC	PA	Durable Medical Equipment & Medical Supplies	$0	$503.8M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Confederated Tribes Of The Goshute Reservation	UT	Clinical Medical Laboratory	$0	$15.1M
Confederated Tribes Of The Goshute Reservation	UT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$13.9M
Confederated Tribes Of The Goshute Reservation	UT	Clinic/Center	$0	$6.4M
Confederated Tribes Of The Goshute Reservation	UT	Dental Clinic/Center	$0	$4.5M
Children's Center	UT	Mental Health Counselor	$0	$4M
Board Of Education Salt Lake City Schools	UT	Local Education Agency (LEA)	$0	$3.3M
Tranquility Place Of Utah LLC	UT	Substance Use Disorder Rehabilitation Clinic/Center	$96.9K	$2.7M
Ma Bo Inc	UT	Family Medicine Physician	$0	$971.2K
Community Health Centers, Inc.	UT	Federally Qualified Health Center (FQHC)	$0	$795.4K
Charles L Diviney Iii Mc Lpc Ncc LLC	UT	Professional Counselor	$0	$751.3K

Odyssey House 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

Related Providers

Nearby Providers

Frequently Asked Questions

References