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 District of Columbia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to District of Columbia 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. District of Columbia (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.

Pathways To Housing Dc (NPI 1396886883)

Field	Value
Entity Type	Organization
Organization	Pathways To Housing Dc
Address	1151 Bladensburg Rd Ne Ste 101
City	Washington
State	DC
ZIP	20002
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	February 9, 2007

Payer Source	Total Paid
Medicaid	$15.1M
Medicare	$0

Key Findings

PATHWAYS TO HOUSING DC is effectively a single-payer Medicaid provider: it has no Medicare billing on file and reports $15.1M in lifetime Medicaid revenue, indicating its billed activity and revenue base are concentrated in state Medicaid programs rather than Medicare. Its taxonomy as a Mental Health Clinic/Center (Including Community Mental Health Center) aligns with this Medicaid-focused footprint.

Revenue is highly concentrated in a very small set of service codes: the precomputed top 3 Medicaid codes account for 97.9% of the provider's total Medicaid revenue, signaling heavy dependence on a few service lines for nearly all Medicaid receipts. This concentration suggests the provider’s financial performance is sensitive to payment and authorization changes for those specific codes.

H0039 is by far the dominant revenue driver: 112.6K claims produced $13.1M in revenue (86.6% of Medicaid revenue) with an $116 avg paid/claim, which is consistent with frequent, short-interval billing for face-to-face assertive community treatment services (billed per 15 minutes). That volume and unit-payment pattern point to an operational model centered on intensive, time-based community mental health contact rather than episodic or inpatient care.

The secondary revenue streams are H0040 ($923.3K, 6.1% of Medicaid revenue; 927 claims; $996 avg paid/claim) and H0036 ($775K, 5.1% of Medicaid revenue; 11.1K claims; $70 avg paid/claim). Together with H0039 these three codes make up the 97.9% concentration noted above, reinforcing that the provider’s service mix is dominated by assertive community treatment, per-diem ACT program billing, and community psychiatric supportive treatment.

Competitive standing varies by code at the state level: for the largest code H0039 the provider ranks #4 of 27 in-state (88th percentile), which places it among the higher-volume providers statewide for that service even as the data characterizes the volume as "typical, unremarkable." For H0040 the provider ranks #5 of 7 (33th percentile) and for H0036 it ranks #41 of 56 (27th percentile), both indicating more modest participation in those specific statewide markets.

There are a few niche strengths: the provider ranks #1 of 2 in-state for H2021 (100th percentile) with $234.9K in revenue across 3.6K claims ($66 avg paid/claim), showing it is the leading reporter of community-based wrap-around services where only one other peer bills the code. That 100th-percentile standing is meaningful but should be viewed in context of a very small peer pool.

Operational implications from the unit and claim counts suggest intensity and frequency: 112.6K claims for H0039 and 11.1K claims for H0036 indicate sustained high-frequency, time-based contacts consistent with an assertive community treatment model that bills in 15-minute increments. The presence of H0034 (medication training and support) and H2021 (wrap-around services) alongside H0039 reinforces a comprehensive outpatient/community support orientation rather than hospital- or procedure-centric services.

The provider has been enumerated for a long tenure: NPI registered on 2007-02-09 (~19 years ago), indicating nearly two decades of operation in the community mental health space. That longevity, combined with a concentrated Medicaid revenue base and prominent H0039 volume, suggests entrenched delivery of ACT-style services in Washington, DC, but also a vulnerability to policy or reimbursement shifts affecting a small set of codes.

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0039	Assertive community treatment, face-to-face, per 15 minutes	112,620	$120	$13.1M
H0040	Assertive community treatment program, per diem	930	$1,000	$923.3K
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	11,070	$70	$775K
H2021	Community-based wrap-around services, per 15 minutes	3,560	$70	$234.9K
H0034	Medication training and support, per 15 minutes	1,490	$50	$80.4K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. District of Columbia Distribution

Pathways To Housing Dc — 1 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — District of Columbia

Full comparison — all codes billed, vs. District of Columbia median

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	41	60	82,090	$90	$13.9M
H0039	Assertive community treatment, face-to-face, per 15 minutes	4	30	150	$110	$5.8M
H0040	Assertive community treatment program, per diem	5	10	1,460	$970	$2M
H0034	Medication training and support, per 15 minutes	36	50	5,030	$90	$1M
H2021	Community-based wrap-around services, per 15 minutes	1	10	2,080	$60	$117.7K

Nearby Providers

Other providers in the same ZIP code as Pathways To Housing Dc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Government Of The District Of Columbia Office Of Tax And Revenue	DC	Land Ambulance	$5.2M	$213.4M
Rcm Of Washington, Inc	DC	Intellectual Disabilities Intermediate Care Facility	$0	$53.9M
Dcps - Public Schools	DC	Local Education Agency (LEA)	$0	$46.2M
Wellness Health Services, LLC	DC	Home Health Agency	$0	$44.1M
Mcclendon Center	DC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$31.9M
Office Of The State Superintendent Of Education	DC	Bus	$0	$30.7M
Mt&g Enterprise, Inc	DC	Developmental Disabilities Clinic/Center	$0	$24.3M
D.c. Department Of Behavioral Health	DC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$19.7M
Amazing Love Health Services	DC	Community/Behavioral Health Agency	$0	$18.5M
Absolute Healthcare Resources, LLC	DC	Case Management Agency	$0	$13.1M

Pathways To Housing Dc — Billing Profile & Reimbursement Data

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Pathways To Housing Dc — 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

Nearby Providers

Frequently Asked Questions

References