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

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

Pb Texas Behavioral Care, LLC (NPI 1659858033)

Field	Value
Entity Type	Organization
Organization	Pb Texas Behavioral Care, LLC
Address	12350 Wood Bayou Dr
City	Houston
State	TX
ZIP	77013
Taxonomy	Substance Abuse Rehabilitation Facility
NPI Enumerated	July 27, 2018

Payer Source	Total Paid
Medicaid	$13.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2035	Alcohol and/or other drug treatment program, per hour	23,140	$440	$10.1M
H0047	Alcohol and/or other drug abuse services, not otherwise specified	9,280	$230	$2.1M
H0012	Behavioral health day treatment, per hour	1,340	$440	$585.5K
S9445	Patient education, not otherwise classified, non-physician provider, individual, per session	600	$300	$180.6K
T1007	Alcohol and/or substance abuse services, treatment plan development and/or modification	570	$300	$168.4K
H0031	Mental health assessment, by non-physician	590	$270	$161.6K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Texas Distribution

Pb Texas Behavioral Care, LLC — 0 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. Texas median

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2035	Alcohol and/or other drug treatment program, per hour	3	30	810	$170	$758.1K
H0012	Behavioral health day treatment, per hour	4	10	730	$90	$419K
H0047	Alcohol and/or other drug abuse services, not otherwise specified	3	20	700	$40	$152.6K
H0031	Mental health assessment, by non-physician	4	10	280	$30	$137K
S9445	Patient education, not otherwise classified, non-physician provider, individual, per session	4	10	540	$80	$127.8K
T1007	Alcohol and/or substance abuse services, treatment plan development and/or modification	4	10	120	$60	$36.3K

Pb Texas Behavioral Care, LLC — Billing Profile & Reimbursement Data

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Pb Texas Behavioral Care, LLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Frequently Asked Questions

References