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

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

American Behavioral Health Systems, Inc. (NPI 1073648374)

Field	Value
Entity Type	Organization
Organization	American Behavioral Health Systems, Inc.
Address	44 E Cozza Dr
City	Spokane
State	WA
ZIP	99208
Taxonomy	Substance Abuse Rehabilitation Facility
NPI Enumerated	February 23, 2007

Payer Source	Total Paid
Medicaid	$60.5M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-focused operator: there is no Medicare billing on file and lifetime Medicaid revenue is $60.5M. The NPI was enumerated on 2007-02-23 (~19 years ago), indicating a long-tenured presence in the state Medicaid market.

Revenue is highly concentrated in a small set of residential and detoxification codes: the top three Medicaid codes (H0018, H0017, H0011) account for 80.6% of the provider’s total Medicaid revenue. That $60.5M Medicaid total is therefore driven overwhelmingly by per-diem and inpatient residential behavioral-health services rather than dispersed outpatient billing.

The code mix and descriptions indicate the core business is residential addiction and behavioral-health treatment. H0018 (short-term residential, per diem) accounts for $33.5M (55.4% of Medicaid revenue), H0017 (hospital residential, per diem) accounts for $8.9M (14.7%), and H0011 (acute detoxification inpatient) accounts for $6.3M (10.5%); together these three codes reflect operations centered on non-ambulatory/residential care and medically managed detox.

Operational intensity varies by code: H0018 shows very high claim volume (28K claims) with an average paid/claim of $1198, consistent with large-scale short-term residential per-diem throughput, while H0017 shows far fewer claims (1.1K) but a much higher avg paid/claim of $7961, consistent with higher-intensity hospital residential stays. H0011 records 6K claims at $1062 avg paid/claim, reinforcing a substantial detoxification workload.

State-level competitive standing is mixed across service lines. H0018 ranks #13 of 59 (79th percentile; typical, unremarkable volume for this code), indicating solid but not dominant volume; H0017 ranks #2 of 5 (75th percentile; typical, unremarkable volume for this code), which suggests a meaningful position within a smaller hospital-residential niche; and H0011 ranks #7 of 18 (65th percentile; typical, unremarkable volume for this code), placing the provider as a moderate competitor in acute detox within the state.

The provider also bills a nontrivial amount of outpatient evaluation and management services alongside its residential work, though these are a small share of revenue. For example, 99214 has 7.2K claims at $77 avg paid/claim ($558.1K, 0.9% of Medicaid revenue) and 99213 has 10.7K claims at $44 avg paid/claim ($472.8K, 0.8%), indicating routine E&M encounters that supplement the core residential and detox services.

Beyond the top three, the provider participates in crisis-intervention and per-diem AOD programs. S9485 (crisis intervention) contributes $5M (8.3% of Medicaid revenue) and ranks #11 of 19 (44th percentile; typical, unremarkable volume for this code), while H2036 (AOD treatment program, per diem) contributes $2.6M (4.2%) and ranks #18 of 68 (75th percentile; typical, unremarkable volume for this code), signaling diversification into crisis and per-diem outpatient/residential program types.

A few reported codes show claims but zero recorded Medicaid payments, which is notable for operational reconciliation and payer-contract review. H0047 and H0046 both show claims with $0 avg paid/claim (and no recorded revenue), while supported housing H0043 posts small revenue ($64.4K, 0.1%), suggesting some billed services may route through non-fee-for-service arrangements or require follow-up on payment adjudication.

Medicaid: Complete Services Breakdown

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

21 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	27,990	$1,200	$33.5M
H0017	Behavioral health; residential (hospital residential treatment program), without room and board, per diem	1,120	$7,960	$8.9M
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	5,970	$1,060	$6.3M
S9485	Crisis intervention mental health services, per diem	1,520	$3,290	$5M
H2036	Alcohol and/or other drug treatment program, per diem	17,470	$150	$2.6M
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	630	$3,610	$2.3M
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…	7,250	$80	$558.1K
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…	10,750	$40	$472.8K
96153	N/A	8,310	$50	$423.6K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	1,650	$100	$162.9K

Showing 1–10 of 21

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Washington Distribution

American Behavioral Health Systems, Inc. — 0 of 19 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. Washington median

21 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	13	60	8,670	$280	$4.9M
H0017	Behavioral health; residential (hospital residential treatment program), without room and board, per diem	2	10	460	$2,650	$3.5M
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	7	20	3,670	$300	$2M
S9485	Crisis intervention mental health services, per diem	11	20	3,730	$310	$1.8M
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	43	50	4,000	$60	$1.5M
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	15	20	1,460	$130	$610.3K
H0043	Supported housing, per diem	103	140	1,690	$110	$602.5K
H0004	Behavioral health counseling and therapy, per 15 minutes	177	320	2,080	$60	$495.5K
96165	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of the patients’ physical health…	146	220	2,880	$50	$431K
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…	252	1,820	480	$60	$379.6K

Showing 1–10 of 21

Related Providers

Other providers that share a Tax Identification Number (TIN) with American Behavioral Health Systems, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
American Behavioral Health Systems, Inc.	WA	Substance Abuse Rehabilitation Facility	$0	$3.3M
American Behavioral Health Systems, Inc.	WA	Substance Abuse Rehabilitation Facility	$0	$3.2M
Adora Akwuba	CO	Family Nurse Practitioner	$33.2K	$430
Brenda Alexander-o'neil	OH	Psychiatric/Mental Health Nurse Practitioner	$5.8K	$0

Nearby Providers

Other providers in the same ZIP code as American Behavioral Health Systems, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Providence Health & Services - Washington	WA	General Acute Care Hospital	$0	$43.2M
Community Health Association Of Spokane	WA	Federally Qualified Health Center (FQHC)	$0	$22.5M
Excelsior Wellness	WA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$11.8M
Center For Pediatric Therapy	WA	Physical Therapy Clinic/Center	$0	$9M
Emergency Physician Services Ps Holy Emergency Center	WA	Emergency Medicine Physician	$0	$8.2M
Patrick Bradley, Dds, PLLC	WA	Dental Clinic/Center	$0	$5.7M
Community Health Association Of Spokane	WA	Federally Qualified Health Center (FQHC)	$0	$5.5M
Ortc, LLC	WA	Methadone Clinic	$0	$3.4M
Arvind Chaudhry	WA	Hematology & Oncology Physician	$2.9M	$0
Mirela Andrei	WA	Medical Oncology Physician	$1M	$0

American Behavioral Health Systems, Inc. — Billing Profile & Reimbursement Data

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American Behavioral Health Systems, 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