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

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

New Directions Northwest, Inc (NPI 1235124462)

Field	Value
Entity Type	Organization
Organization	New Directions Northwest, Inc
Address	3425 13th St
City	Baker City
State	OR
ZIP	97814
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	September 14, 2005

Payer Source	Total Paid
Medicaid	$18.5M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-centric operation: Total Medicaid revenue is $18.5M and there is no Medicare billing on file. That makes the organization functionally single-payer (Medicaid) in the available claims data and therefore highly sensitive to state Medicaid policy and reimbursement changes.

Revenue is extremely concentrated in three residential/addiction codes: H0019 ($9.9M, 53.5% of Medicaid revenue), H0018 ($6.2M, 33.5%), and H0011 ($1.7M, 9.1%); together these top three codes account for 96.1% of this provider's total Medicaid revenue. This concentration means most of the provider’s financial performance flows through a narrow set of per‑diem residential and detox services.

The code mix and descriptions indicate the business is focused on residential substance‑use treatment rather than medical/senior care: H0019 and H0018 are long‑term and short‑term residential behavioral health per‑diems, and H0011 is acute residential detoxification. This operational profile aligns with the provider taxonomy of Community/Behavioral Health Agency and suggests the provider’s staffing, facilities, and utilization patterns center on inpatient/residential addiction services.

Despite the heavy revenue concentration in residential addiction services, the provider’s statewide competitive standing on those top codes is modest rather than dominant: H0019 ranks #11 of 31 in‑state (67th percentile, characterized as typical), H0018 ranks #4 of 7 (50th percentile, typical), and H0011 ranks #6 of 8 (29th percentile, typical). In other words, the provider draws most of its revenue from residential per‑diems but does not appear to be a clear market leader in Oregon for those specific codes.

There is a notable mismatch between claim volume and dollars for outpatient psychotherapy: 90834 shows 15.7K claims and $172.7K revenue (0.9% of Medicaid revenue) and ranks #12 of 399 in‑state (97th percentile; notably above typical). This suggests unusually high utilization or reporting of 90834 relative to peers but with very low average paid per claim ($11), meaning these high volumes contribute little to overall revenue.

Ambulatory and ancillary services appear present but are low revenue contributors relative to residential services: examples include H0005 (8.1K claims, $121.1K), 99214 (6.7K claims, $39.9K), and H0048 (8.7K claims, $43.6K). These high claim counts paired with low average paid per claim indicate the organization delivers substantial non‑per‑diem outpatient activity (counseling, testing, E/M visits) that supplements but does not drive total Medicaid revenue.

The provider shows operational longevity with an NPI enumerated on 2005-09-14 (~21 years ago), indicating an established presence in Baker City/region. Given the long tenure and heavy dependence on a small set of residential codes, payers and analysts should monitor per‑diem reimbursement policy and utilization trends for residential addiction services when evaluating risk and contracting opportunities.

Medicaid: Complete Services Breakdown

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

38 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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	7,940	$1,250	$9.9M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	5,250	$1,180	$6.2M
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	560	$2,980	$1.7M
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…	15,700	$10	$172.7K
H0005	Alcohol and/or drug services; group counseling by a clinician	8,070	$20	$121.1K
H0004	Behavioral health counseling and therapy, per 15 minutes	4,850	$20	$87.4K
H0012	Behavioral health day treatment, per hour	280	$250	$71K
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…	4,990	$10	$64.8K
H0048	Alcohol and/or other drug testing: collection and handling only, specimens other than blood	8,730	$10	$43.6K
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…	6,660	$10	$39.9K

Showing 1–10 of 38

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Oregon Distribution

New Directions Northwest, Inc — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oregon

Full comparison — all codes billed, vs. Oregon median

38 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	6	10	1,250	$1,640	$9M
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	11	30	2,560	$400	$8.9M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	4	10	5,250	$410	$4M
H0012	Behavioral health day treatment, per hour	5	10	550	$940	$947K
H0005	Alcohol and/or drug services; group counseling by a clinician	62	180	3,250	$40	$783.8K
H0004	Behavioral health counseling and therapy, per 15 minutes	85	270	1,660	$90	$681K
H0038	Self‑help/peer services, per 15 minutes	70	150	1,030	$80	$417.2K
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…	53	60	420	$60	$405.1K
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…	143	1,380	540	$140	$363.3K
H2014	Skills training and development, per 15 minutes	48	120	1,010	$40	$323.2K

Showing 1–10 of 38

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cody Haas	ID	Psychiatric/Mental Health Nurse Practitioner	$315.8K	$0
Kelli Wright	OR	Clinical Social Worker	$26.4K	$0
Reta Warner	OR	Psychiatric/Mental Health Nurse Practitioner	$10.7K	$0
Jeremy Wade	ID	Family Nurse Practitioner	$1.5K	$0

Nearby Providers

Other providers in the same ZIP code as New Directions Northwest, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Saint Alphonsus Medical Center Baker City, Inc	OR	Critical Access Hospital	$0	$4.3M
St Lukes Clinic-treasure Valley LLC	OR	Rural Health Clinic/Center	$0	$2.1M
County Of Baker	OR	State or Local Public Health Clinic/Center	$8.7K	$235K
Brian Sanders	OR	Podiatrist	$175.8K	$0
Logan Frederickson	OR	Family Medicine Physician	$158.9K	$0
Blake Marlia	OR	Physical Therapist	$95.8K	$0
Jodi Flanagan	OR	Physical Therapist	$77.8K	$0
Robert Bachman	OR	Physical Therapist	$53.5K	$0
Kara Del Curto	OR	Psychiatric/Mental Health Clinical Nurse Specialist	$24.7K	$0
Tara Reese	OR	Physician Assistant	$20.1K	$0

New Directions Northwest, Inc — Billing Profile & Reimbursement Data

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New Directions Northwest, 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