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

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

Pinnacletreatment Centers In-1, LLC (NPI 1457897647)

Field	Value
Entity Type	Organization
Organization	Pinnacletreatment Centers In-1, LLC
Address	2060 North State Rd 1
City	Cambridge City
State	IN
ZIP	47327
Taxonomy	Substance Abuse Rehabilitation Facility
NPI Enumerated	January 11, 2017

Payer Source	Total Paid
Medicaid	$62.5M
Medicare	$0

Key Findings

PINNACLETREATMENT CENTERS IN-1, LLC is effectively a single-payer Medicaid provider: it has no Medicare billing on file and reports $62.5M in lifetime Medicaid revenue, indicating Medicaid is the sole material public payer on record for this entity. The provider’s NPI was enumerated on 2017-01-11 (~9 years ago), so this profile reflects roughly nine years of potential Medicaid activity.

Revenue is highly concentrated in a narrow set of service lines: the precomputed top 3 Medicaid codes by revenue account for 100.0% of this provider’s total Medicaid revenue. H0010 alone represents $53.8M (86.1% of Medicaid revenue) with 133.4K claims and a $403 avg paid/claim, demonstrating that the bulk of dollars flow through a single dominant code.

The code mix indicates the operation is primarily a residential/sub-acute addiction treatment provider with complementary intensive and partial hospitalization services. H0010 (sub-acute detoxification/residential addiction program inpatient) and H0035 (mental health partial hospitalization) together make up the vast majority of activity and revenue, while H0015 (intensive outpatient) and H0038 (self-help/peer services) are comparatively small components of the service mix.

Competitive standing in-state is strong for the provider’s core services: H0010 ranks #2 of 57 providers in Indiana and is described as notably above typical state volume, placing the provider in the 98th percentile for that code. Likewise, H0035 ranks #2 of 21 providers and is in the 95th percentile, indicating the provider is a major participant statewide for both residential detox and partial hospitalization services.

Smaller service lines are present but not material to revenue or differentiation: H0015 generates $386.9K (0.6% of Medicaid revenue) with 3.3K claims and a $117 avg paid/claim, and ranks #21 of 69 providers (71th percentile) which the data labels as typical, unremarkable volume. H0038 contributes only $11.3K and 1.3K claims with a $9 avg paid/claim and sits near the median statewide rank (#39 of 82, 53th percentile), reinforcing that peer/self-help services are ancillary rather than revenue drivers.

The provider’s claim volumes underscore operational scale in residential detox: 133.4K claims for H0010 and 36.8K claims for H0035 reflect a high-volume inpatient/residential and partial hospitalization footprint, respectively, which likely requires substantial bed capacity, staffing, and clinical infrastructure relative to in-state peers. These volumes, coupled with the high average paid/claim for H0010 ($403), explain the provider’s dominant revenue share from that code.

Concentration risk and strategic implications are notable: with H0010 accounting for 86.1% of Medicaid revenue and the top three codes covering 100.0% of revenue, the provider’s financial performance is highly sensitive to changes in reimbursement, utilization policy, or payer mix for those specific service lines. From a payer or competitive-analytics perspective, monitoring policy changes or utilization trends for H0010 and H0035 in Indiana will be critical to understanding this provider’s future revenue trajectory.

Medicaid: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	133,410	$400	$53.8M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	36,780	$230	$8.3M
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…	3,310	$120	$386.9K
H0038	Self‑help/peer services, per 15 minutes	1,260	$10	$11.3K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Indiana Distribution

Pinnacletreatment Centers In-1, LLC — 1 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Indiana

Full comparison — all codes billed, vs. Indiana median

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	2	60	23,940	$380	$12.8M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	2	20	5,840	$200	$2.1M
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…	21	70	1,520	$100	$429.2K
H0038	Self‑help/peer services, per 15 minutes	39	80	1,080	$60	$219.4K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Pinnacletreatment Centers In-1, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pinnacle Treatment Centers In-1, LLC D/b/a Recovery Works Merrillville	IN	Substance Abuse Rehabilitation Facility	$0	$43.1M
Pinnacle Treatment Centers In-i, LLC	IN	Substance Abuse Rehabilitation Facility	$0	$20.8M
Chijioke Kalu	IN	Family Medicine Physician	$89.2K	$0

Nearby Providers

Other providers in the same ZIP code as Pinnacletreatment Centers In-1, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nrs Pharmacies Of Indiana LLC	IN	Community/Retail Pharmacy	$79.4K	$0

Pinnacletreatment Centers In-1, LLC — Billing Profile & Reimbursement Data

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Pinnacletreatment Centers In-1, LLC — Billing Profile & Reimbursement Data

Sign up for Pinnacletreatment Centers In-1, LLC — Billing Profile & Reimbursement Data policy alerts

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