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

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

Roadways To Recovery Inc., (NPI 1740856483)

Roadways To Recovery Inc., is a mental health clinic/center (including community mental health center) provider located in Bedford, Indiana. This profile covers 0 Medicare and 16 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	Roadways To Recovery Inc.,
Address	2620 Industrial Park Drive
City	Bedford
State	IN
ZIP	47421
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	June 2, 2021

Payer Source	Total Paid
Medicaid	$4.1M
Medicare	$0

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0035	Mental health partial hospitalization, treatment, less than 24 hours	6,420	$210	$1.3M
H0038	Self‑help/peer services, per 15 minutes	8,510	$80	$688.9K
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…	8,480	$80	$644.7K
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…	4,700	$80	$366.9K
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…	2,500	$120	$297.6K
82075	The lab analyst performs the technical lab test to analyze the quantitative amount of alcohol in a patient’s breath and correlates the measurement to blood alcohol content.	10,790	$20	$248.1K
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…	1,380	$150	$204.8K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	11,030	$10	$121.4K
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…	760	$60	$48.9K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	460	$100	$45.5K

Showing 1–10 of 16

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Indiana Distribution

Roadways To Recovery Inc., — 1 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Indiana

Full comparison — all codes billed, vs. Indiana median

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1016	Case management, each 15 minutes	39	50	8,980	$30	$3.8M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	10	20	5,840	$200	$2.1M
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…	311	2,120	870	$60	$450.6K
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…	36	70	1,520	$100	$429.2K
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…	166	690	1,070	$80	$422.3K
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…	1,247	2,380	920	$50	$376.8K
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…	104	220	1,380	$20	$360.2K
H0038	Self‑help/peer services, per 15 minutes	10	80	1,080	$60	$219.4K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	198	520	240	$80	$165K
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…	33	220	190	$90	$112.1K

Showing 1–10 of 16

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Transitions Recovery, LLC	IN	Clinic/Center	$0	$22.2M
Elite Home Healthcare LLC	IN	Home Health Agency	$0	$12M
Bedford Transitions, LLC	IN	General Practice Physician	$0	$11.5M
Indiana University Health Bedford, Inc	IN	Critical Access Hospital	$0	$8.5M
Fc Indiana, LLC	IN	Nurse Practitioner	$0	$7.2M
Ovais Raza	IN	Interventional Cardiology Physician	$561.6K	$0
Kamal Girgis	IN	Internal Medicine Physician	$175.6K	$0
Penny Clark	IN	Physical Therapist	$127.7K	$0
Timothy Lach	IN	Diagnostic Radiology Physician	$117.6K	$0
Drew Davis	IN	Ophthalmology Physician	$116.3K	$0

Roadways To Recovery Inc., — Billing Profile & Reimbursement Data

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Roadways To Recovery 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

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