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

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

Community Pathways Unlimited Inc (NPI 1659328284)

Field	Value
Entity Type	Organization
Organization	Community Pathways Unlimited Inc
Address	4045 Nw 64th St
City	Oklahoma City
State	OK
ZIP	73116
Taxonomy	Clinical Psychologist
NPI Enumerated	May 28, 2006

Payer Source	Total Paid
Medicaid	$27.7M
Medicare	$0

Key Findings

This provider is effectively single-payer: there is no Medicare billing on file and the lifetime Medicaid revenue is $27.7M, so all reported fee-for-service activity in the dataset is Medicaid-based. Analysts should treat Medicaid reimbursement and policy changes as the primary drivers of this entity's financial performance.

Revenue is extremely concentrated in a very small set of service lines: the precomputed top 3 Medicaid codes account for 99.7% of total Medicaid revenue, with H0004 representing 98.0%, 90834 representing 1.1%, and 90832 representing 0.6%. That degree of concentration indicates the organization’s income is almost entirely tied to a narrow set of behavioral health services.

The code mix indicates an operational focus on high-frequency, short-session behavioral health counseling and psychotherapy: H0004 is billed as behavioral health counseling and therapy per 15 minutes, while 90834 and 90832 are psychotherapy sessions of longer and shorter durations respectively. The presence of H0032 (mental health service plan development by non-physician) and other assessment/add-on codes suggests the provider delivers non-physician care coordination and routine outpatient psychotherapy rather than physician-led medical services.

COMMUNITY PATHWAYS UNLIMITED INC is a dominant statewide provider for the H0004 service: it reported 603.8K claims for H0004, with a $45 avg paid/claim and $27.2M revenue, and ranks #1 of 621 providers in-state (100th percentile) and is described as an extreme outlier. This positions the provider as the clear market leader in 15-minute behavioral health counseling within Oklahoma Medicaid.

The provider also shows exceptionally high volume on psychotherapy CPTs: 90834 appears with 34K claims ($9 avg paid/claim, $306K revenue) and 90832 with 24.5K claims ($7 avg paid/claim, $171.8K revenue); both codes rank at the 98th percentile in-state and 90834 is labeled an extreme outlier while 90832 is described as notably above typical. These ranks indicate the organization is among the very highest-volume state providers for standard psychotherapy services, though reimbursement per claim on these CPTs is low relative to H0004.

Other billed codes contribute only a marginal share of revenue but reflect service breadth: H0032 (1.2K claims, $57 avg paid/claim, $66.9K revenue) ranks #22 of 366 (94th percentile) and 90785 appears with 9K claims but only $9K revenue ($1 avg paid/claim) and ranks #5 of 99 (96th percentile). These entries suggest some investment in plan development and add-on complexity coding, but they do not materially change the provider's Medicaid revenue concentration.

The provider has a long tenure in the NPI file (NPI enumerated 2006-05-28, ~20 years ago), which combined with $27.7M in lifetime Medicaid revenue describes a well-established Medicaid behavioral health operator in Oklahoma. Longevity plus extreme volume in a single code suggests an entrenched operational model focused on repeat, short-interval behavioral health encounters.

Strategic implications for payers and competitors: the extreme dependence on H0004 (98.0% of Medicaid revenue) creates both scale advantages in delivering high-volume counseling and exposure to any Medicaid rate or policy changes affecting that code. Competitors and managed care organizations evaluating network strategy should note the provider’s outsized in-state share for a single service line and consider concentration risk, capacity for high-volume delivery, and potential sensitivity to short-session reimbursement adjustments.

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0004	Behavioral health counseling and therapy, per 15 minutes	603,770	$50	$27.2M
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…	34,000	$10	$306K
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…	24,540	$10	$171.8K
H0032	Mental health service plan development by non-physician	1,170	$60	$66.9K
90785	This add–on code represents increased work intensity of psychotherapy services that adds difficulty to delivery of service.	8,980	$1	$9K
H0031	Mental health assessment, by non-physician	30	$100	$2.6K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	60	$10	$810
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	50	$1	$100

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Oklahoma Distribution

Community Pathways Unlimited Inc — 4 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oklahoma

Full comparison — all codes billed, vs. Oklahoma median

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0004	Behavioral health counseling and therapy, per 15 minutes	1	620	6,640	$70	$1.2M
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	8	10	100	$40	$57.6K
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…	2	60	100	$30	$49.8K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	70	130	60	$120	$41.3K
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…	2	50	160	$10	$35.1K
H0032	Mental health service plan development by non-physician	22	370	80	$60	$21.2K
H0031	Mental health assessment, by non-physician	196	280	50	$90	$17.5K
90785	This add–on code represents increased work intensity of psychotherapy services that adds difficulty to delivery of service.	5	100	350	$1	$8.1K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Community Pathways Unlimited Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Angela Shandy	OK	Clinical Social Worker	$115.9K	$0
Vickie Caldwell	CA	Clinical Social Worker	$79.3K	$0
Cara Martin	OK	Clinical Social Worker	$75.3K	$0
Patrick Murphy	OK	Clinical Social Worker	$59.2K	$0
Therese Klopfenstein	OK	Clinical Social Worker	$55.1K	$0
Megan Jackson	OK	Clinical Social Worker	$35.3K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Generations Community Services LLC	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$11.7M
Sensational Kids, Inc.	OK	Contractor	$0	$6.8M
Qitek Labs Of Oklahoma LLC	OK	Clinical Medical Laboratory	$6.2M	$10.1K
New Horizon Youth & Family Services, LLC	OK	Community/Behavioral Health Agency	$0	$4.5M
Guidance Counseling Of Oklahoma LLC	OK	Community/Behavioral Health Agency	$0	$4.1M
Latisha Heinlen	OK	Rheumatology Physician	$3.6M	$0
Dental Depot Of 63rd & Nw Expressway, PLLC	OK	Dental Clinic/Center	$0	$3.4M
Dental Depot Orthodontics Central Okc PLLC	OK	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$3.3M
3-j Enterprises, LLC	OK	Durable Medical Equipment & Medical Supplies	$0	$2.8M
Holloway Group Inc	OK	Multi-Specialty Clinic/Center	$0	$1.7M

Community Pathways Unlimited Inc — Billing Profile & Reimbursement Data

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Community Pathways Unlimited Inc — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References