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

Why is the Medicaid comparison limited to Iowa 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. Iowa (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 Behavioral Services Inc (NPI 1689734451)

Pathways Behavioral Services Inc is a community/behavioral health agency provider located in Waterloo, Iowa. This profile covers 0 Medicare and 11 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Pathways Behavioral Services Inc
Address	3362 University Ave
City	Waterloo
State	IA
ZIP	50701
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	December 11, 2006

Payer Source	Total Paid
Medicaid	$4.5M
Medicare	$0

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
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…	16,280	$90	$1.5M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	6,200	$240	$1.5M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	4,690	$120	$549.1K
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…	4,560	$60	$264.7K
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…	2,220	$90	$208.8K
H0017	Behavioral health; residential (hospital residential treatment program), without room and board, per diem	620	$340	$207K
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…	3,780	$50	$181.2K
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…	1,550	$90	$136.6K
H2019	Therapeutic behavioral services, per 15 minutes	90	$100	$8.5K
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	50	$110	$5.7K

Showing 1–10 of 11

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Iowa Distribution

Pathways Behavioral Services Inc — 0 of 11 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Iowa

Full comparison — all codes billed, vs. Iowa median

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	53	60	16,120	$150	$3.8M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	12	20	11,060	$220	$3.7M
H2019	Therapeutic behavioral services, per 15 minutes	86	90	5,380	$100	$1.5M
H0017	Behavioral health; residential (hospital residential treatment program), without room and board, per diem	4	10	1,660	$390	$958K
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…	46	680	670	$70	$343.5K
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…	11	20	2,150	$80	$334.3K
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…	29	120	980	$50	$230.3K
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…	170	610	550	$70	$145.9K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	27	400	110	$100	$101.1K
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…	48	280	530	$40	$80.1K

Showing 1–10 of 11

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Exceptional Persons Inc	IA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$80.3M
Vgm Group, Inc.	IA	Durable Medical Equipment & Medical Supplies	$0	$54.4M
Goodwill Industries Of Ne Iowa Inc	IA	Community Based Hospice Care Agency	$0	$52.5M
Veridian Fiscal Solutions LLC	IA	Community/Behavioral Health Agency	$0	$47M
North Star Community Services, Inc	IA	Developmentally Disabled Services Day Training Agency	$0	$26.7M
Families First Counseling Services Of Iowa, L.L.C.	IA	Community/Behavioral Health Agency	$0	$16.3M
Resources For Human Development	IA	Community/Behavioral Health Agency	$0	$13.1M
Cedar Valley Community Support Services	IA	Developmentally Disabled Services Day Training Agency	$0	$11.1M
Vgm Group, Inc.	IA	Case Management Agency	$0	$5.4M
Kenny Rodriguez	IA	Otolaryngology Physician	$3.2M	$0

Pathways Behavioral Services Inc — Billing Profile & Reimbursement Data

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Pathways Behavioral Services Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pathways Behavioral Services Inc	IA	Community/Behavioral Health Agency	$0	$9.9M
Raja Akbar	IA	Psychiatry Physician	$43.8K	$0