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

Why is the Medicaid comparison limited to North Carolina 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. North Carolina (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.

Coastal Horizons Center, Inc (NPI 1033420153)

Field	Value
Entity Type	Organization
Organization	Coastal Horizons Center, Inc
Address	615 Shipyard Blvd
City	Wilmington
State	NC
ZIP	28412
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	June 23, 2010

Payer Source	Total Paid
Medicaid	$44.6M
Medicare	$0

Key Findings

COASTAL HORIZONS CENTER, INC is effectively a single‑payer Medicaid provider: it reports no Medicare billing on file and $44.6M in lifetime Medicaid revenue, indicating the organization’s operations and revenue base are concentrated in the Medicaid program rather than Medicare. This payer mix suggests its patient population and service offerings are oriented toward Medicaid‑eligible behavioral health needs.

Revenue is highly concentrated in a small set of service lines: the provider’s top three Medicaid codes account for 85.3% of its total Medicaid revenue, led by H2022 at $27.7M (62.0% of Medicaid revenue), followed by H0020 at $6M (13.4%) and H0015 at $4.4M (9.9%). Such concentration signals that a few programmatic services drive the bulk of billing and financial performance.

The code mix indicates a core focus on intensive community behavioral health and substance‑use treatment: H2022 is a community‑based wrap‑around per diem, H0015 is intensive outpatient treatment, and H0020 covers methadone administration/services. Together these codes describe an operational model centered on community wraparound supports and structured substance‑use treatment rather than primarily short office visits or inpatient care.

COASTAL HORIZONS is a major statewide provider for several high‑impact behavioral health services: it ranks #6 of 216 for H2022 (98th percentile; notably above typical state volume) and #4 of 111 for H0015 (97th percentile; notably above typical state volume), reflecting a dominant role in delivering wrap‑around and intensive outpatient services in North Carolina. By contrast, its H0020 rank (#32 of 93, 66th percentile) is closer to typical state volume, indicating more modest relative scale in methadone services compared with its wrap‑around and IOP offerings.

Telehealth activity is an outlier relative to peers: the provider submitted 18.3K claims for Q3014 (telehealth originating site facility fee), generating $292.9K and ranking #5 of 187 (98th percentile; extreme outlier). This unusually high use of the telehealth originating site fee suggests the organization relies heavily on telehealth locations or remote delivery sites as part of its service model.

Outpatient evaluation-and-management activity is also substantial: 99214 appears with 25.1K claims and $1.9M in revenue (4.3% of Medicaid revenue), ranking #128 of 4404 providers in-state (97th percentile; notably above typical state volume). High volume of 99214 encounters points to significant established‑patient follow‑up and medically oriented visits supporting behavioral health care management.

Psychotherapy and counseling codes complement the substance‑use and wrap‑around mix: 90837 (13.6K claims, $1M, 2.3% of revenue) ranks #96 of 1709 (94th percentile) and shorter psychotherapy codes 90832/90834 also rank in high percentiles (97th). These volumes indicate a broad psychotherapy service menu across session lengths that likely supports both individual and group behavioral health treatment pathways alongside IOP and wrap‑around services.

The provider has sustained presence in the market, with an NPI enumerated on 2010‑06‑23 (~16 years ago), suggesting established relationships within the state Medicaid network and institutional experience delivering behavioral health services. Given its long tenure and the $44.6M Medicaid footprint combined with the concentrated code mix, the organization appears strategically focused on Medicaid‑funded behavioral health and substance use programs rather than Medicare or other payer markets.

Medicaid: Complete Services Breakdown

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

28 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2022	Community-based wrap-around services, per diem	63,590	$440	$27.7M
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	96,600	$60	$6M
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	34,560	$130	$4.4M
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…	25,110	$80	$1.9M
T1017	Targeted case management, each 15 minutes	6,350	$270	$1.7M
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…	13,620	$80	$1M
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…	10,600	$40	$455.8K
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…	8,430	$50	$421.6K
Q3014	Telehealth originating site facility fee	18,300	$20	$292.9K
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…	1,930	$130	$243.1K

Showing 1–10 of 28

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Carolina Distribution

Coastal Horizons Center, Inc — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. North Carolina median

28 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)	32	90	45,620	$40	$3.5M
H2022	Community-based wrap-around services, per diem	6	220	3,330	$290	$3.3M
H0038	Self‑help/peer services, per 15 minutes	206	310	2,820	$120	$1.3M
T1017	Targeted case management, each 15 minutes	37	220	1,700	$150	$1.3M
T1016	Case management, each 15 minutes	159	230	3,210	$110	$1.1M
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	4	110	1,070	$130	$628.2K
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	1,641	2,850	10,910	$10	$330.3K
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…	96	1,710	810	$80	$274.5K
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…	128	4,400	960	$60	$271.3K
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…	949	4,130	670	$50	$219.9K

Showing 1–10 of 28

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Coastal Horizons Center Inc.	NC	Community/Behavioral Health Agency	$0	$8.7M
Bernard Gottschalk	NC	Addiction Medicine (Internal Medicine) Physician	$178.3K	$0
Michael Odibo	NC	Internal Medicine Physician	$37.1K	$0

Nearby Providers

Other providers in the same ZIP code as Coastal Horizons Center, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Leon Charkoudian	NC	Ophthalmology Physician	$2.9M	$0
Kevin Bray	NC	Retina Specialist (Ophthalmology) Physician	$2.6M	$0
Coastal Carolina Pathology, PA	NC	Clinical Medical Laboratory	$1.2M	$229.8K
Robert Wann	NC	Ophthalmology Physician	$1M	$0
Fan Xi	NC	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$898.5K	$0
Jeffrey Warhaftig	NC	Internal Medicine Physician	$694.2K	$0
Dean Karras	NC	Internal Medicine Physician	$566.6K	$0
Shawn Hocker	NC	Sports Medicine (Orthopaedic Surgery) Physician	$485.4K	$0
Shona Martin	NC	Internal Medicine Physician	$436.1K	$0
Jeremy Hoff	NC	Physical Medicine & Rehabilitation Physician	$374.9K	$0

Coastal Horizons Center, Inc — Billing Profile & Reimbursement Data

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Coastal Horizons Center, 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