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

Why is the Medicaid comparison limited to Louisiana 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. Louisiana (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 Substance Abuse, L.L.C. (NPI 1578117297)

Field	Value
Entity Type	Organization
Organization	Pathways Substance Abuse, L.L.C.
Address	5505 Shreveport Hwy
City	Pineville
State	LA
ZIP	71360
Taxonomy	Substance Abuse Rehabilitation Facility
NPI Enumerated	July 31, 2019

Payer Source	Total Paid
Medicaid	$19.8M
Medicare	$0

Medicaid: Complete Services Breakdown

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2036	Alcohol and/or other drug treatment program, per diem	180,090	$110	$19.1M
H2034	Alcohol and/or drug abuse halfway house services, per diem	7,840	$30	$258.7K
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	1,240	$140	$171.4K
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…	1,080	$120	$125.2K
H0001	Alcohol and/or drug assessment	3,730	$30	$111.9K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	1,170	$20	$25.7K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	1,050	$20	$18.9K
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…	750	$20	$15.1K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	20	$10	$230
0202U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the…	30	$0	$0

Showing 1–10 of 11

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Louisiana Distribution

Pathways Substance Abuse, L.L.C. — 0 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Louisiana

Full comparison — all codes billed, vs. Louisiana median

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2036	Alcohol and/or other drug treatment program, per diem	4	60	42,430	$150	$11.3M
H2034	Alcohol and/or drug abuse halfway house services, per diem	10	10	22,970	$60	$3.5M
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	30	40	3,520	$150	$1.4M
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…	85	130	2,290	$90	$928.9K
0202U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the…	56	60	1,160	$280	$690.6K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	163	170	1,360	$30	$190K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	118	510	250	$70	$89.6K
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…	100	390	180	$50	$49.5K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	463	840	440	$20	$36.6K
H0001	Alcohol and/or drug assessment	4	60	210	$30	$31.8K

Showing 1–10 of 11

Nearby Providers

Other providers in the same ZIP code as Pathways Substance Abuse, L.L.C., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Leading Health Care Of La	LA	In Home Supportive Care Agency	$0	$37.3M
Accessible Healthcare Solutions	LA	Personal Care Attendant	$0	$22.7M
Shahid Mansoor, Md. A Professional Medical Corporation	LA	Rural Health Clinic/Center	$0	$15.1M
Evergreen Presbyterian Ministries, Inc.	LA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$10.4M
Steps Recovery Solutions, LLC	LA	Substance Abuse Rehabilitation Facility	$0	$8.7M
Leading Health Care Of La	LA	In Home Supportive Care Agency	$0	$6.3M
Easter Seals Louisiana Inc.	LA	Case Management Agency	$0	$5.1M
James Ralston	LA	Ophthalmology Physician	$165.9K	$577.6K
Natasha Edwards	LA	Family Nurse Practitioner	$147.7K	$0
Joanna Holton	LA	Family Medicine Physician	$133.9K	$0

Pathways Substance Abuse, L.L.C. — Billing Profile & Reimbursement Data

Sign up for Pathways Substance Abuse, L.L.C. — Billing Profile & Reimbursement Data policy alerts

Pathways Substance Abuse, L.L.C. — Billing Profile & Reimbursement Data

Sign up for Pathways Substance Abuse, L.L.C. — 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