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

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

Transitions, Inc. (NPI 1528466877)

Field	Value
Entity Type	Organization
Organization	Transitions, Inc.
Address	313 Madison Pike
City	Erlanger
State	KY
ZIP	41017
Taxonomy	Substance Abuse Rehabilitation Facility
NPI Enumerated	December 18, 2014

Payer Source	Total Paid
Medicaid	$31.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	75,780	$260	$19.6M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	50,910	$140	$7.1M
H2036	Alcohol and/or other drug treatment program, per diem	6,510	$190	$1.2M
H2034	Alcohol and/or drug abuse halfway house services, per diem	3,260	$260	$831.3K
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…	9,750	$90	$828.5K
H0038	Self‑help/peer services, per 15 minutes	27,990	$20	$671.8K
T2023	Targeted case management; per month	2,740	$200	$551.5K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	6,500	$50	$337.8K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	2,240	$40	$78.3K
T1007	Alcohol and/or substance abuse services, treatment plan development and/or modification	1,150	$50	$52.9K

Showing 1–10 of 15

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Transitions, Inc. — 2 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	8	70	7,180	$270	$6.8M
H2034	Alcohol and/or drug abuse halfway house services, per diem	19	40	3,120	$220	$3M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	2	50	4,480	$220	$2.4M
T2023	Targeted case management; per month	124	530	530	$300	$1.1M
H2036	Alcohol and/or other drug treatment program, per diem	2	10	930	$420	$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…	38	230	1,750	$110	$793.5K
H0038	Self‑help/peer services, per 15 minutes	40	320	3,070	$50	$678.3K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	385	1,270	760	$80	$447.2K
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…	231	600	600	$40	$207.8K
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…	247	500	250	$60	$152.8K

Showing 1–10 of 15

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Elizabeth Medical Center, Inc	KY	General Acute Care Hospital	$41.7K	$188.3M
Compass Emergency Physicians Psc	KY	Emergency Medicine Physician	$0	$28.8M
Bluegrass Behavioral Health Group, LLC	KY	Behavior Analyst	$0	$23.7M
Redwood School And Rehabilitation Center	KY	Child Intellectual and/or Developmental Disabilities Respite Care	$0	$12M
Radiology Associates Of Northern Kentucky, PLLC	KY	Diagnostic Radiology Physician	$0	$9.4M
Orthocincy Orthopaedics & Sports Medicine Psc	KY	Orthopaedic Surgery Physician	$0	$9.4M
Redwood School And Rehabilitation Center	KY	Community Health Clinic/Center	$0	$9.2M
Interim Healthcare Of Cincinnati, Inc	KY	Home Health Agency	$0	$7.9M
New Perceptions Inc	KY	Developmentally Disabled Services Day Training Agency	$0	$6.5M
St Elizabeth Medical Center, Inc	KY	Community Based Hospice Care Agency	$0	$3M

Transitions, Inc. — Billing Profile & Reimbursement Data

Sign up for Transitions, Inc. — Billing Profile & Reimbursement Data policy alerts

Transitions, Inc. — Billing Profile & Reimbursement Data

Sign up for Transitions, Inc. — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References