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

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

The Grove Of La, LLC (NPI 1700237237)

Field	Value
Entity Type	Organization
Organization	The Grove Of La, LLC
Address	7384 John Leblanc Blvd
City	Sorrento
State	LA
ZIP	70778
Taxonomy	Substance Abuse Rehabilitation Facility
NPI Enumerated	June 27, 2016

Payer Source	Total Paid
Medicaid	$29.2M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-focused substance use treatment operator: it reports no Medicare billing on file and $29.2M in lifetime Medicaid revenue, indicating that Medicaid is by far the material payer for this entity. The absence of Medicare activity suggests payer exposure is concentrated in state behavioral health programs rather than dual-eligibility markets.

Revenue is highly concentrated in three Medicaid service lines: H2036 ($17M, 58.3% of Medicaid revenue), H0015 ($9.9M, 34.0%), and H0011 ($1.8M, 6.2%), which together account for 98.5% of the provider’s total Medicaid revenue. This concentration means the business’s financial performance is driven almost entirely by per-diem/residential and intensive outpatient detox/treatment billing rather than by a broad mix of outpatient E/M or psychotherapy codes.

The mix of principal codes (H2036, H0015, H0011) describes an operation built around program-day and structured substance use services: H2036 is a per-diem alcohol/drug treatment program, H0015 is intensive outpatient programming (multi-hour, multi-day treatment), and H0011 is residential acute detoxification. Together these codes indicate the provider runs both residential detox and high-volume intensive outpatient programming rather than a primarily office-based behavioral health clinic.

H0015 performance is a notable statewide outlier: the provider ranks #2 of 128 in-state and sits at the 99th percentile for volume on H0015, a label recorded as an "extreme outlier." That ranking indicates this provider is a leading statewide supplier of intensive outpatient substance use services and likely captures a disproportionate share of that market segment.

By contrast, H2036 and H0011 show solid but not dominant statewide footing: H2036 ranks #9 of 57 (86th percentile) and H0011 ranks #9 of 37 (78th percentile), both characterized in the data as typical or unremarkable volumes. These positions suggest the provider is an established mid-to-upper-tier participant for residential per-diem and inpatient detox services but not monopolistic in those lines.

Traditional psychotherapy and evaluation codes generate only a small share of revenue relative to program-day billing: 90837 produced $171.7K (0.6% of Medicaid revenue), 90791 $121.8K (0.4%), and 90853 $60.9K (0.2%). The low dollar contribution from these E/M and psychotherapy codes underscores that the organization’s economics are driven by structured treatment-program billing rather than high-volume individual psychotherapy or primary-care E/M visits.

The provider’s NPI was enumerated on 2016-06-27 (~10 years ago), indicating roughly a decade of billing activity under the current identifier. This tenure aligns with the sustained Medicaid revenue totals and the development of large-scale intensive outpatient capacity reflected in H0015 volumes.

From a payer/portfolio-management perspective, the combination of near-exclusive Medicaid reliance and the 98.5% revenue concentration in three codes creates both operational focus and financial risk: changes in Medicaid policy, rates, or utilization management for H0015 or H2036 could materially affect revenues. Given H0015’s extreme outlier status, analysts should prioritize monitoring utilization trends and program documentation for that code when assessing this provider’s ongoing risk and network value.

Medicaid: Complete Services Breakdown

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

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2036	Alcohol and/or other drug treatment program, per diem	142,950	$120	$17M
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…	86,150	$120	$9.9M
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	12,430	$150	$1.8M
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…	3,580	$50	$171.7K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	1,690	$70	$121.8K
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…	4,350	$10	$60.9K
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…	530	$50	$25.7K
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…	360	$60	$20.8K
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…	400	$50	$18.3K
H0001	Alcohol and/or drug assessment	270	$40	$10K

Showing 1–10 of 14

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Louisiana Distribution

The Grove Of La, LLC — 1 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Louisiana

Full comparison — all codes billed, vs. Louisiana median

14 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2036	Alcohol and/or other drug treatment program, per diem	9	60	42,430	$150	$11.3M
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	9	40	3,520	$150	$1.4M
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	130	2,290	$90	$928.9K
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…	1,885	2,890	980	$40	$246.8K
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…	1,958	3,230	1,120	$30	$204.3K
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…	96	910	440	$40	$61.6K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	374	390	180	$50	$49.5K
H0001	Alcohol and/or drug assessment	23	60	210	$30	$31.8K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	232	250	350	$20	$29.4K
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…	217	460	310	$20	$26.1K

Showing 1–10 of 14

The Grove Of La, LLC — Billing Profile & Reimbursement Data

Sign up for The Grove Of La, LLC — Billing Profile & Reimbursement Data policy alerts

The Grove Of La, LLC — Billing Profile & Reimbursement Data

Sign up for The Grove Of La, LLC — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Frequently Asked Questions

References