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

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

Pinnacle Treatment Centers Oh-i, LLC (NPI 1649631086)

Field	Value
Entity Type	Organization
Organization	Pinnacle Treatment Centers Oh-i, LLC
Address	7400 Huntington Park Dr
City	Columbus
State	OH
ZIP	43235
Taxonomy	Substance Abuse Rehabilitation Facility
NPI Enumerated	March 13, 2016

Payer Source	Total Paid
Medicaid	$96.1M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-focused operator with no Medicare billing on file and $96.1M in lifetime Medicaid revenue; the absence of Medicare activity means analyses of its commercial or Medicare mix should treat it as a single‑payer (Medicaid) entity for the available data. Its NPI was enumerated on 2016-03-13 (~10 years ago), so the observed Medicaid scale has been built since that enrollment date.

Revenue is highly concentrated in a small set of service codes: the precomputed top three Medicaid codes account for 73.9% of the provider’s Medicaid revenue, led by H0020 (41.1M revenue, 42.9%), H0011 (17.6M revenue, 18.4%), and H0010 (12M revenue, 12.5%). This concentration indicates that a majority of the provider’s Medicaid dollars come from methadone administration and residential detoxification services.

The code mix and dollar distribution point to a core service line of opioid treatment and residential detox: H0020 (methadone administration) is the single largest revenue driver, and H0011/H0010 reflect both acute and sub‑acute residential detoxification. Supplementary codes for intensive outpatient (H0015), per diem treatment (H2036), and frequent drug testing (H0048) further indicate a vertically integrated substance‑use treatment model that spans medication administration, inpatient detox, outpatient therapy, and point-of-care testing.

On competitive standing in-state, PINNACLE TREATMENT CENTERS OH-I, LLC is a dominant provider for methadone services: H0020 ranks #1 of 117 in the state and is labeled an extreme outlier, signaling far higher volume than typical peers. The provider also ranks at the top for drug‑testing collection H0048 (rank #2 of 644; extreme outlier) and is among the highest for psychotherapy-related billing (90832 rank #4 of 1317; extreme outlier), which together portray a major statewide presence across multiple high‑volume treatment activities.

Several outpatient therapy and counseling codes show very high utilization relative to peers: 90832 has 121.8K claims and $3M revenue and is marked an extreme outlier, H0004 has 81.4K claims and $1.4M revenue and is also an extreme outlier, and H0005 has 55.9K claims and $1.1M revenue and is at the 99th percentile. These patterns suggest a large-scale behavioral health counseling operation alongside its medication and detox services rather than a narrow, episodic program.

Medication‑assisted treatment (MAT) appears as an explicit revenue stream: J0574 shows 53.4K claims and $1.1M revenue (rank #4 of 36, 91st percentile) and J0575 has 28.3K claims and $85K revenue while ranking #1 of 11 and labeled notably above typical. In addition, T1502 (medication administration) has 64.5K claims and $2.1M revenue (rank #4 of 42, 93rd percentile), reinforcing that on‑site medication delivery is a material part of operations.

Operational scale is reflected in extremely high claim volumes for dosing and testing: H0020 reports 2.1M claims and H0048 reports 294.2K claims, which together indicate a high‑frequency delivery model consistent with daily/regular dosing programs and routine specimen collection. These volumes, combined with the revenue concentration in a few codes, imply a high-throughput treatment setting that relies on repeat visits and per‑encounter billing.

Not all high‑revenue codes are extreme outliers: H0011 (acute residential detox) generates $17.6M and ranks #6 of 60 with a descriptor of typical, unremarkable volume, while H0010 (sub‑acute detox) is $12M and ranks #2 of 22 described as notably above typical. This mix suggests that while methadone administration and testing are disproportionately large compared with peers, residential detox services are present at elevated but more mixed competitive positions across the state.

Medicaid: Complete Services Breakdown

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

36 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	2,055,180	$20	$41.1M
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	46,620	$380	$17.6M
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	49,420	$240	$12M
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…	22,590	$210	$4.8M
H2036	Alcohol and/or other drug treatment program, per diem	18,740	$220	$4M
H0048	Alcohol and/or other drug testing: collection and handling only, specimens other than blood	294,190	$10	$3.2M
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…	121,840	$30	$3M
T1502	Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit	64,490	$30	$2.1M
H0004	Behavioral health counseling and therapy, per 15 minutes	81,440	$20	$1.4M
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	29,450	$40	$1.1M

Showing 1–10 of 36

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Ohio Distribution

Pinnacle Treatment Centers Oh-i, LLC — 11 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. Ohio median

36 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	6	60	8,280	$370	$5.8M
H2036	Alcohol and/or other drug treatment program, per diem	55	130	13,910	$220	$5.2M
T1502	Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit	4	40	2,350	$140	$4.4M
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	1	120	7,190	$30	$2.6M
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	2	20	3,200	$240	$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…	85	610	1,350	$150	$1.9M
H0012	Behavioral health day treatment, per hour	19	30	650	$340	$476.3K
J0574	Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine	4	40	5,650	$20	$435.4K
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…	349	2,640	620	$90	$408.2K
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…	1,711	4,510	500	$60	$377.8K

Showing 1–10 of 36

Nearby Providers

Other providers in the same ZIP code as Pinnacle Treatment Centers Oh-i, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Maxim Healthcare Services, Inc.	OH	Home Health Agency	$0	$36.6M
Phoenix Home Health Care Of Central Ohio LLC	OH	Home Health Agency	$0	$35.1M
Ohio Medical Transportation, Inc.	OH	Air Ambulance	$4.3M	$12.1M
Worthington Pediatric Dentists Inc.	OH	Dentist	$0	$7M
Parveenco International LLC	OH	Community/Behavioral Health Agency	$0	$6.8M
Aaron Boster	OH	Neurology Physician	$968.7K	$0
Andrew Quillin	OH	Dermatology Physician	$224.7K	$0
Julia Cameron-morrison	OH	Diagnostic Radiology Physician	$174.1K	$0
Kyle Williamson	OH	Diagnostic Radiology Physician	$169.7K	$0
Sara Boyd Falvo	OH	Diagnostic Radiology Physician	$160.3K	$0

Pinnacle Treatment Centers Oh-i, LLC — Billing Profile & Reimbursement Data

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Pinnacle Treatment Centers Oh-i, LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References