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.

Access Ohio, LLC (NPI 1689763740)

Field	Value
Entity Type	Organization
Organization	Access Ohio, LLC
Address	6400 E Broad St Ste 400
City	Columbus
State	OH
ZIP	43213
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	October 12, 2006

Payer Source	Total Paid
Medicaid	$72.4M
Medicare	$0

Key Findings

ACCESS OHIO, LLC is effectively a single‑payer Medicaid provider: it reports no Medicare billing on file and $72.4M in lifetime Medicaid revenue, so Medicaid overwhelmingly drives its documented business and financial footprint. This concentration means payer-specific policy or rate changes in Medicaid would disproportionately affect the organization.

Medicaid revenue is highly concentrated in a small set of services: the precomputed top three Medicaid codes (H2019, H0036, 99214) together account for 71.9% of the provider’s total Medicaid revenue. Individually those codes generate $19.7M (27.2%), $17M (23.4%), and $15.4M (21.3%) respectively, indicating a few service lines dominate receipts.

The code mix points to a community behavioral health operating model focused on high-volume, short‑interval behavioral interventions plus outpatient medical management. H2019 (Therapeutic behavioral services, per 15 minutes) and H0036 (Community psychiatric supportive treatment, per 15 minutes) together represent very large per‑unit, time‑based service volumes (308.2K and 302.9K claims) while 99214 (established outpatient E/M) contributes 162.1K claims, signaling concurrent emphasis on therapy/supportive field services and face‑to‑face clinical management.

ACCESS OHIO is a statewide volume leader for multiple core Medicaid codes: H0036 ranks #4 of 735 providers in‑state (100th percentile; extreme outlier), H2019 ranks #11 of 840 (99th percentile; extreme outlier), and 99214 ranks #25 of 4514 (99th percentile; extreme outlier). These rank/percentile positions characterize the organization as a dominant provider of these specific behavioral health and E/M services within Ohio.

Beyond the top three, the provider also reports very large volumes of other behavioral health services consistent with an ambulatory/community model: H2017 (Psychosocial rehabilitation) has 111.9K claims and $4.8M revenue (6.6%, rank #5 of 238, 98th percentile) and psychotherapy codes such as 90837 (46K claims, $4M, 5.6%) and 90834/90832 (15.2K and 16.9K claims) contribute additional, smaller shares of revenue. This mix suggests both intensive rehabilitation and standard psychotherapy are meaningful secondary components of the service portfolio.

Not all specialized programs are dominant for this provider: H0040 (Assertive community treatment, per diem) represents $1.2M (1.7% of Medicaid revenue) and ranks #11 of 24 providers in‑state (57th percentile), indicating ACCESS OHIO is not a leading statewide ACT provider and likely emphasizes other outpatient/field services instead.

The provider’s billing scale and longevity reinforce its market position: the NPI was enumerated on 2006-10-12 (~20 years ago), consistent with an established operator that has developed large volume footprints in selected Medicaid service lines over time. This tenure, together with extreme outlier volumes on core codes, supports the view of an entrenched community behavioral health agency in Ohio.

Because the top three codes (H2019, H0036, 99214) generate 71.9% of Medicaid revenue, the organization is exposed to concentrated operational and reimbursement risk: changes to per‑15‑minute billing rules, unit definitions, or Medicaid rates for those codes could materially affect overall revenue. Analysts and payers evaluating network contracts or rate arrangements should prioritize review of utilization patterns for these specific codes given their outsized contribution to the $72.4M Medicaid total.

Medicaid: Complete Services Breakdown

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

38 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2019	Therapeutic behavioral services, per 15 minutes	308,160	$60	$19.7M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	302,920	$60	$17M
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…	162,100	$100	$15.4M
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…	83,130	$70	$5.4M
H2017	Psychosocial rehabilitation services, per 15 minutes	111,880	$40	$4.8M
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…	45,960	$90	$4M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	15,420	$90	$1.4M
H0040	Assertive community treatment program, per diem	5,360	$230	$1.2M
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…	15,190	$60	$926.7K
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…	16,910	$50	$811.5K

Showing 1–10 of 38

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

Access Ohio, 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

38 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0040	Assertive community treatment program, per diem	11	20	3,770	$260	$2.8M
H2019	Therapeutic behavioral services, per 15 minutes	11	840	240	$90	$1.8M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	4	740	480	$60	$669.5K
H2017	Psychosocial rehabilitation services, per 15 minutes	5	240	1,090	$50	$509.2K
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…	55	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…	25	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…	67	5,080	560	$40	$323.9K
T1002	Rn services, up to 15 minutes	100	290	620	$50	$192.8K
T1003	Lpn/lvn services, up to 15 minutes	135	240	960	$30	$155.6K
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…	41	1,320	290	$50	$148.6K

Showing 1–10 of 38

Nearby Providers

Other providers in the same ZIP code as Access Ohio, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lighthouse Behavioral Health Solutions, LLC	OH	Substance Use Disorder Rehabilitation Clinic/Center	$0	$116.4M
Mount Carmel Health System	OH	General Acute Care Hospital	$0	$66.7M
Independent Home Care Inc.	OH	Home Health Agency	$0	$47.5M
The Buckeye Ranch, Inc	OH	Adolescent and Children Mental Health Clinic/Center	$0	$32.5M
Caring Heart Home Health Agency LLC	OH	Home Health Agency	$0	$24.3M
Golden Rule Home Health Care LLC	OH	Home Health Agency	$0	$13.8M
Columbia Home Health Care Inc	OH	Home Health Agency	$0	$11.7M
Alta Home Health Care, LLC	OH	Home Health Agency	$0	$10.4M
Hospitalist Medicine Physicians Of Ohio, Professional Corporation	OH	Internal Medicine Physician	$0	$9.7M
Lifesaver Health Care, LLC	OH	Home Health Agency	$0	$9.6M

Access Ohio, LLC — Billing Profile & Reimbursement Data

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Access Ohio, 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