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

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

Pathfinder, Inc. (NPI 1326004466)

Field	Value
Entity Type	Organization
Organization	Pathfinder, Inc.
Address	2520 W Main St
City	Jacksonville
State	AR
ZIP	72076
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	April 26, 2006

Payer Source	Total Paid
Medicaid	$69.8M
Medicare	$0

Key Findings

PATHFINDER, INC. is effectively a Medicaid-centric provider: it has no Medicare billing on file and reports Total Medicaid revenue of $69.8M. Its NPI was enumerated on 2006-04-26 (~20 years ago), indicating a long-tenured presence in the state Medicaid market.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 79.2% of this provider's total Medicaid revenue. Those top three are T1015 ($42.4M, 60.8% of Medicaid revenue), A0120 ($6.9M, 9.9%), and 92507 ($5.9M, 8.5%), so a small set of service lines drives the majority of receipts.

T1015 dominance (771.3K claims, $42.4M revenue, 60.8%) signals that PATHFINDER operates large-scale, all-inclusive clinic visit/encounter activity consistent with a Developmentally Disabled Services Day Training Agency model; the raw claim volume implies routine, recurring encounters rather than episodic high-dollar procedures. T1015 also ranks #5 of 532 providers in-state (99th percentile; extreme outlier), which underscores the provider's unusually large clinic/encounter footprint relative to peers.

The code mix shows an integrated service model combining encounters with logistics and therapy: A0120 (192.1K claims, $6.9M, 9.9%) indicates substantial non-emergency transportation capacity is embedded in operations, while 92507 (100.2K claims, $5.9M, 8.5%) and 97530 (93.9K claims, $5.8M, 8.3%) reflect heavy utilization of speech and functional therapy services. Both A0120 and 92507 are state-level outliers (A0120 ranks #2 of 103, 99th percentile; extreme outlier; 92507 ranks #12 of 567, 98th percentile; extreme outlier), suggesting these are core program services rather than minor add-ons.

Supplemental therapy codes further characterize the clinical mix: 97110 (57.9K claims, $3.1M, 4.4%) and 97530 (93.9K claims, $5.8M, 8.3%) point to substantial therapeutic exercise and activity-based rehabilitation/habilitation capacity. These therapy volumes are notably above typical state volume for several codes (97110 ranks #9 of 499, 98th percentile; 97530 ranks #10 of 581, 98th percentile), reinforcing a multi-disciplinary rehabilitation focus.

While a few programmatic per-diem services are present, they are less dominant: H2016 (8.3K claims, $4.9M, 7.1%) contributes meaningful per-diem community support revenue but ranks #24 of 62 providers in-state (62th percentile; typical, unremarkable volume for this code). This contrast—very high-volume encounter and transport codes versus typical per-diem support—suggests PATHFINDER’s business model emphasizes high-frequency, encounter-based day services complemented by some community support.

From a competitive and operational risk perspective, PATHFINDER is a statewide dominant player on several high-volume Medicaid codes (multiple codes in the 98th–99th percentile and labeled extreme outlier). That concentration—top 3 codes = 79.2% of Medicaid revenue—creates sensitivity to policy, rate, or audit changes tied to T1015, A0120, and 92507, and indicates that analysts should prioritize monitoring those specific lines for revenue impact and operational capacity (e.g., transportation fleet and therapy staffing).

Operational scale is evident in absolute claim counts: 771.3K claims for T1015 and 192.1K claims for A0120 reflect a sustained, high-throughput delivery model that likely requires significant day-to-day logistics and workforce management. Combined with the provider’s long tenure (NPI enumerated 2006-04-26), these volumes point to an established, high-capacity Medicaid operator rather than a small, episodic service provider.

Medicaid: Complete Services Breakdown

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

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	771,260	$60	$42.4M
A0120	Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems	192,090	$40	$6.9M
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	100,220	$60	$5.9M
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	93,930	$60	$5.8M
H2016	Comprehensive community support services, per diem	8,250	$600	$4.9M
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	57,870	$50	$3.1M
96112	The provider administers various standardized tests to diagnose developmental problems in children. He interprets the results and prepares a report. Report this code for the first hour of test…	2,760	$90	$240.3K
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	1,560	$90	$139.1K
97532	N/A	1,330	$80	$110K
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	1,400	$80	$108.9K

Showing 1–10 of 17

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Arkansas Distribution

Pathfinder, Inc. — 7 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Arkansas

Full comparison — all codes billed, vs. Arkansas median

17 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2025	Waiver services; not otherwise specified (nos)	6	10	110	$150	$12.4M
H2016	Comprehensive community support services, per diem	24	60	4,560	$230	$10.7M
T1015	Clinic visit/encounter, all-inclusive	5	530	4,960	$70	$2.6M
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	12	570	2,470	$70	$801.4K
A0120	Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems	2	100	10,500	$40	$791K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	10	580	3,620	$60	$712.7K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	9	500	3,410	$60	$523.5K
97532	N/A	54	60	5,070	$30	$189.4K
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	55	70	4,530	$30	$172.5K
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…	1,668	1,740	550	$30	$88.8K

Showing 1–10 of 17

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pathfinder, Inc.	AR	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$1.5M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Families, Inc. Of Arkansas	AR	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$12.2M
Arcare	AR	Federally Qualified Health Center (FQHC)	$0	$2.5M
City Of Jacksonville	AR	Land Ambulance	$216.1K	$1.2M
Mark Peterson	AR	Family Medicine Physician	$394.8K	$25K
John Phillips	AR	Ophthalmology Physician	$327.8K	$370
Ryan Friedman	AR	Ophthalmology Physician	$319.3K	$4.1K
Aaron Roberds	AR	Family Medicine Physician	$250.6K	$12.8K
Richard Hayes	AR	Family Medicine Physician	$228.7K	$14.4K
John Wilkins	AR	Family Medicine Physician	$231.6K	$910
Harold Short	AR	Family Medicine Physician	$188.4K	$5.1K

Pathfinder, Inc. — Billing Profile & Reimbursement Data

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Pathfinder, 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