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NPI 1629560230 · Columbus, OH · Substance Use Disorder Rehabilitation Clinic/Center
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Lighthouse Behavioral Health Solutions, LLC is a substance use disorder rehabilitation clinic/center provider located in Columbus, Ohio. This profile covers 0 Medicare and 53 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 | Lighthouse Behavioral Health Solutions, LLC |
| Address | 4000 E Main St |
| City | Columbus |
| State | OH |
| ZIP | 43213 |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| NPI Enumerated | May 31, 2018 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $116.4M |
| Medicare | $0 |
This provider is effectively a Medicaid-focused SUD operator: total Medicaid revenue is $116.4M and there is no Medicare billing on file, so its entire reported government payer footprint in the dataset is Medicaid. The NPI was enumerated on 2018-05-31 (~8 years ago), indicating several years of operations under the current enrollment period.
Revenue is highly concentrated in a small set of SUD service codes: the top three Medicaid codes account for 74.1% of the provider’s Medicaid revenue, led by H0015 at $64.1M (55.1% of Medicaid revenue), followed by H0006 at $14.4M (12.4%) and H0038 at $7.7M (6.6%). This concentration means a handful of SUD outpatient and care-coordination services drive the vast majority of billing and reimbursement.
The code mix points to a clinic model focused on structured outpatient addiction treatment and care coordination: H0015 (intensive outpatient) dominates revenue, supported by high-volume case management (H0006) and peer/self-help services (H0038). Substantial claims and revenue for psychotherapy (90837) and E/M codes (99214, 99204) show the organization also provides clinician-led psychotherapy and medical evaluation services in addition to programmatic SUD care.
Competitive standing in Ohio is unusually strong for multiple SUD-specific services: H0006 ranks #1 of 714 providers in-state (100th percentile; extreme outlier), H0038 ranks #1 of 226 (100th percentile; extreme outlier), and H0015 ranks #2 of 608 (100th percentile; extreme outlier). These ranks indicate the provider is a dominant statewide participant for case management, peer services, and intensive outpatient SUD treatment.
Operational volume is very large, reflecting high patient-touch intensity: H0015 shows 438.8K claims and H0006 shows 276.4K claims, while H0038 has 106.4K claims. These claim counts, paired with the revenue totals, suggest the organization manages large cohorts through repeated outpatient encounters rather than episodic acute care.
The provider runs a robust toxicology and specimen-collection footprint alongside clinical services: high-volume lab and testing codes include 80307 (121.8K claims, $5.1M revenue; rank #4 of 343, 99th percentile, notably above typical), H0048 (230.2K claims, $3.2M revenue; rank #4 of 644, 100th percentile, extreme outlier), G0481 ($2.8M revenue; rank #4 of 70, 96th percentile) and 82075 (55K claims, $880.1K revenue; rank #3 of 111, 98th percentile, extreme outlier). The scale and ranks of these testing codes indicate intensive drug-monitoring operations that likely support the outpatient treatment programs.
Clinical psychotherapy and E/M billing represent meaningful secondary revenue streams consistent with integrated behavioral health: 90837 generated $6.1M (62.5K claims, rank #36 of 2643, 99th percentile, extreme outlier) and 99214 generated $5.3M (45.7K claims, rank #104 of 4514, 98th percentile). This mix suggests the provider combines programmatic SUD services with one-on-one psychotherapy and medical management visits.
Because Medicaid is the sole government payer represented and the top three codes drive 74.1% of Medicaid revenue, the provider’s financial profile is exposed to shifts in Medicaid policy or reimbursement for intensive outpatient, case management, and peer-service codes. The concentration also highlights that any state-level changes to coverage, prior authorization, or unit definitions for H0015/H0006/H0038 would disproportionately affect this provider’s revenue base.
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.
53 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 438,810 | $150 | $64.1M |
| H0006 | Alcohol and/or drug services; case management | 276,440 | $50 | $14.4M |
| H0038 | Self‑help/peer services, per 15 minutes | 106,410 | $70 | $7.7M |
| 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… | 62,530 | $100 | $6.1M |
| 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… | 45,740 | $120 | $5.3M |
| 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. | 121,790 | $40 | $5.1M |
| H0048 | Alcohol and/or other drug testing: collection and handling only, specimens other than blood | 230,250 | $10 | $3.2M |
| G0481 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 28,850 | $100 | $2.8M |
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 11,630 | $130 | $1.5M |
| T1003 | Lpn/lvn services, up to 15 minutes | 26,710 | $50 | $1.2M |
Showing 1–10 of 53
How this provider's Medicaid billing volume and revenue compare to other Ohio providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Ohio median
53 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| H2036 | Alcohol and/or other drug treatment program, per diem | 118 | 130 | 13,910 | $220 | $5.2M |
| 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… | 2 | 610 | 1,350 | $150 | $1.9M |
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 11 | 80 | 910 | $110 | $884.9K |
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 31 | 50 | 310 | $110 | $817.2K |
| 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… | 36 | 2,640 | 620 | $90 | $408.2K |
| 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. | 4 | 340 | 2,260 | $30 | $398.2K |
| 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… | 104 | 4,510 | 500 | $60 | $377.8K |
| 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… | 1,363 | 5,080 | 560 | $40 | $323.9K |
| H0006 | Alcohol and/or drug services; case management | 1 | 710 | 520 | $50 | $307.3K |
| G0481 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 4 | 70 | 560 | $70 | $292.9K |
Showing 1–10 of 53
Other providers in the same ZIP code as Lighthouse Behavioral Health Solutions, LLC, ranked by combined Medicare and Medicaid revenue.
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