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

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

Inroads To Recovery, Inc (NPI 1336588441)

Key Findings

Field	Value
Entity Type	Organization
Organization	Inroads To Recovery, Inc
Address	2808 N 75th St
City	Omaha
State	NE
ZIP	68134
Taxonomy	Addiction (Substance Use Disorder) Counselor
NPI Enumerated	June 21, 2013

Payer Source	Total Paid
Medicaid	$7.1M
Medicare	$0

INROADS TO RECOVERY, INC reports no Medicare billing on file and is effectively a single-payer Medicaid provider, with $7.1M in total Medicaid revenue. This concentration of revenue within Medicaid means payer-specific policy or rate changes in Nebraska could materially affect the organization’s financials.

Revenue is highly concentrated in a very small set of services: the precomputed top three Medicaid codes (H0018, 99213, 90792) account for 95.2% of the provider’s Medicaid revenue. H0018 alone represents $4M (56.5% of Medicaid revenue), 99213 represents $2.2M (31.2%), and 90792 represents $530.4K (7.5%), indicating limited diversification across billing lines.

The top revenue driver, H0018 (short-term residential, per diem), at $4M and 56.5% of Medicaid revenue, indicates the provider operates a significant short-term residential behavioral health program (non-hospital residential treatment). The per-diem nature of H0018 revenue suggests facility-based bed capacity and utilization are central to the organization’s business model.

High-volume outpatient evaluation-and-management activity is also a core element of the operation: 99213 accounts for $2.2M across 53.7K claims (31.2% of Medicaid revenue). The provider ranks #10 of 696 in-state for 99213 (99th percentile), which signals an unusually large outpatient/office-visit volume relative to peers and likely reflects routine follow-up, medication management, or high patient throughput.

Clinical assessment and therapy are meaningful secondary services: 90792 (psychiatric evaluation) brings $530.4K (7.5% of revenue) and 90834 (psychotherapy, 38–52 minutes) contributes $269.3K (3.8%). 90792 ranks #5 of 87 in-state (95th percentile, notably above typical state volume) while 90834 ranks #85 of 510 (83rd percentile), together indicating a substantive role for psychiatric evaluation plus psychotherapy within the care mix.

On competitive standing within Nebraska, the provider is a leading participant for its core service lines: H0018 ranks #3 of 17 (88th percentile, notably above typical state volume) and 99213 ranks #10 of 696 (99th percentile, notably above typical state volume). These rank positions identify INROADS TO RECOVERY as a major state-level provider for short-term residential services and a dominant outpatient E/M claimant compared with in-state peers.

Operationally relevant ancillary services appear in the coding mix: 80305 (presumptive drug test) accounts for $19.2K and ranks #2 of 18 in-state (94th percentile), suggesting frequent use of point-of-care drug screening despite its small revenue share. Other smaller codes (e.g., 90832, 90791, 96372) collectively represent modest revenue but point to a broader clinical footprint that supports both residential and outpatient treatment pathways.

The provider’s NPI was enumerated on 2013-06-21 (~13 years ago), indicating an established presence in the market. Combined with the Medicaid-only revenue profile and the concentration in a few high-volume codes, this tenure suggests operational maturity but also exposure to Medicaid policy, reimbursement, or utilization shifts that could disproportionately affect the organization.

Medicaid: Complete Services Breakdown

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

10 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	16,860	$240	$4M
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…	53,740	$40	$2.2M
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…	3,180	$170	$530.4K
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…	2,810	$100	$269.3K
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…	470	$50	$23.4K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	2,750	$10	$19.2K
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…	130	$90	$12.3K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	1,040	$10	$6.2K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	40	$130	$5.2K
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…	60	$60	$3.4K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Nebraska Distribution

Inroads To Recovery, Inc — 2 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nebraska

Full comparison — all codes billed, vs. Nebraska median

10 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	20	1,430	$580	$2.6M
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	700	660	$70	$305.1K
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…	330	600	610	$70	$251.4K
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…	85	510	450	$100	$168.1K
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…	5	90	70	$200	$120.4K
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…	9	10	420	$70	$62K
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…	87	130	140	$60	$36.4K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	73	150	40	$130	$26.8K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	33	130	150	$10	$11.6K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	2	20	400	$10	$9.9K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Syed Sattar	NE	Psychiatry Physician	$115.5K	$0
Rachel Tincher	NE	Physician Assistant	$850	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
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Oneworld Community Health Centers, Inc.	NE	Federally Qualified Health Center (FQHC)	$0	$3.9M
Summit Dental Health - Blondo LLC	NE	General Practice Dentistry	$0	$2.2M
Friendship Program Inc	NE	Community/Behavioral Health Agency	$0	$1.7M
Makovicka Harms Group PC	NE	Physical Therapist	$0	$1.1M
Nebraska Smiles, LLC	NE	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$677.5K
Chi National Home Care, LLC	NE	Home Health Agency	$0	$552.5K
Earl H. Brown Iii	NE	Mental Health Counselor	$0	$531K
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Diamond Chiropractic North LLC	NE	Chiropractor	$0	$392.7K

Inroads To Recovery, Inc — Billing Profile & Reimbursement Data

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Inroads To Recovery, 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