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NPI 1407897309 · Minneapolis, MN · General Acute Care Hospital
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Hennepin Healthcare System, Inc is a general acute care hospital provider located in Minneapolis, Minnesota. This profile covers 2 Medicare and 813 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Hennepin Healthcare System, Inc |
| Address | 701 Park Ave, P1-finance |
| City | Minneapolis |
| State | MN |
| ZIP | 55415 |
| Taxonomy | General Acute Care Hospital |
| NPI Enumerated | June 10, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $708.9M |
| Medicare | $420.8K |
HENNEPIN HEALTHCARE SYSTEM, INC is effectively Medicaid‑dominant: reported lifetime Medicaid revenue is $708.9M versus total Medicare revenue of $420.8K, indicating the provider’s payer mix is heavily weighted toward Medicaid dollars rather than Medicare. This scale differential means analyses of utilization, network impact, and cost drivers should prioritize Medicaid activity.
Medicare revenue is extremely concentrated in opioid treatment program services: the precomputed top 3 Medicare codes by revenue account for 100.0% of this provider's total Medicare revenue, with G2067 alone comprising $389.4K (92.5%) and G2078 contributing $31.7K (7.5%). Operationally, this indicates that nearly all Medicare billing is coming from medication‑assisted treatment/methadone services rather than general acute care CPTs.
Medicaid revenue shows a concentrated but different mix: the precomputed top 3 Medicaid codes by revenue account for 45.3% of total Medicaid revenue, with G0463 ($104.8M, 19.0%), A0429 ($78.1M, 14.1%), and A0427 ($67.7M, 12.2%) together driving that share. This combination points to very large hospital outpatient clinic volume alongside substantial emergency ambulance transport billing as primary Medicaid revenue drivers.
Competitive standing differs sharply by payer and code: on Medicare OTP codes the provider posts typical national volumes (G2067 ranks #113 of 830 providers, 86th percentile; G2078 ranks #69 of 493 providers, 86th percentile), so it is a modest national participant for those Medicare services. By contrast, the provider is a dominant in‑state Medicaid actor for several high‑revenue codes — for example, G0463 is ranked #1 of 81 providers in‑state (100th percentile, labeled an extreme outlier) and A0429 is ranked #1 of 78 (100th percentile, extreme outlier) — signaling market leadership in clinic and ambulance services within Minnesota.
Emergency and inpatient E/M services are major operational lines under Medicaid: high volumes and revenues are reported for ED and inpatient codes such as 99284 ($53.2M, 9.6%), 99285 ($49.7M, 9.0%), 99283 ($32.3M, 5.8%), and subsequent inpatient care codes 99232 ($13.6M, 2.5%) and 99233 ($10.1M, 1.8%). Many of these codes rank at or near the top statewide (e.g., 99284 #2 of 206, 100th percentile; 99285 #3 of 160, 99th percentile), indicating a very high ED throughput and substantial inpatient follow‑up volume relative to peers.
The provider’s service mix also includes substantial critical care and specialized behavioral health procedures under Medicaid: 99291 (critical care) produced $13.5M and ranks #1 of 48 in‑state (100th percentile, extreme outlier), 90870 (ECT) produced $7.1M and ranks #1 of 16 (100th percentile), and behavioral‑health/methadone administration appears in Medicaid as H0020 with $12.9M (2.3%) and 807.1K claims. Together with the Medicare OTP billing (G2067/G2078), this pattern indicates integrated addiction treatment and high‑acuity services are meaningful parts of the provider’s portfolio.
The heavy presence of ambulance and transportation codes (A0429 $78.1M, A0427 $67.7M, A0425 $14.0M and A0427 ranking #3 of 60, 97th percentile) plus high ground mileage claims suggests either an affiliated or closely coordinated EMS operation that generates substantial Medicaid revenue. This operational footprint has important implications for network negotiations and Medicaid managed care contracting, since ambulance and transport services are concentrated and rank well above in‑state peers.
HENNEPIN HEALTHCARE SYSTEM, INC has a long enrollment history (NPI enumerated 2006-06-10, ~20 years), which aligns with its entrenched, high statewide volumes across many Medicaid codes. The combination of long tenure and repeated extreme outlier rankings in Medicaid implies established operational capacity and sustained delivery of high‑volume outpatient, ED, transport, and specialized behavioral health services in Minnesota.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 1,660 | $240 | $389.4K |
| G2078 | Take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure | 840 | $40 | $31.7K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 2 CPT/HCPCS codes.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
813 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 1,139,420 | $90 | $104.8M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 118,670 | $660 | $78.1M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 94,270 | $720 | $67.7M |
| 99284 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making. | 262,220 | $200 | $53.2M |
| 99285 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making. | 202,780 | $250 | $49.7M |
| 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… | 460,730 | $70 | $32.7M |
| 99283 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making. | 190,000 | $170 | $32.3M |
| 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… | 298,030 | $50 | $14.6M |
| A0425 | Ground mileage, per statute mile | 218,690 | $60 | $14M |
| 99232 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 261,070 | $50 | $13.6M |
Showing 1–10 of 813
How this provider's Medicaid billing volume and revenue compare to other Minnesota providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Minnesota median
813 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | 6 | 20 | 343,060 | $10 | $6.5M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 3 | 60 | 780 | $470 | $5M |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 1 | 80 | 6,550 | $80 | $4.4M |
| H2012 | Behavioral health day treatment, per hour | 11 | 40 | 6,530 | $140 | $3.7M |
| H0035 | Mental health partial hospitalization, treatment, less than 24 hours | 8 | 10 | 1,690 | $300 | $2.4M |
| G9002 | Coordinated care fee, maintenance rate | 16 | 20 | 6,640 | $150 | $2.4M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1 | 80 | 410 | $430 | $2.3M |
| J2357 | Injection, omalizumab, 5 mg | 1 | 10 | 2,380 | $860 | $2M |
| T1001 | Nursing assessment / evaluation | 9 | 10 | 120 | $160 | $2M |
| T1016 | Case management, each 15 minutes | 114 | 240 | 1,870 | $50 | $1.9M |
Showing 1–10 of 813
Other providers in the same ZIP code as Hennepin Healthcare System, Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| University Of Minnesota Physicians | MN | Clinical Medical Laboratory | $3.7K | $2M |
| Arjun Arya | MN | Emergency Medicine Physician | $96.9K | $143.1K |
| Kristina Borgen | MN | Anatomic Pathology & Clinical Pathology Physician | $81.6K | $80.3K |
| Ameer Khowaja | MN | Endocrinology, Diabetes & Metabolism Physician | $160.6K | $0 |
| Joshua Heaton | MN | Diagnostic Radiology Physician | $138.2K | $0 |
| Mary Lynne Lucido | MN | Gastroenterology Physician | $110.8K | $0 |
| Keith Eidman | MN | Nephrology Physician | $91.6K | $0 |
| Erica Mitchell | MN | Psychiatry Physician | $71.6K | $0 |
| Lauren Klein | MN | Emergency Medicine Physician | $61.5K | $6.6K |
| Gregory Staeheli | MN | Orthopaedic Trauma Physician | $66K | $0 |
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