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NPI 1780738971 · Washington, DC · Geriatric Medicine (Internal Medicine) Physician
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Paul Rhodes is a geriatric medicine (internal medicine) physician provider located in Washington, District of Columbia. This profile covers 21 Medicare and 9 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Paul Rhodes |
| Address | 1902 R St Nw |
| City | Washington |
| State | DC |
| ZIP | 20009 |
| Taxonomy | Geriatric Medicine (Internal Medicine) Physician |
| NPI Enumerated | January 23, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $506.2K |
| Medicaid | $16.1K |
PAUL RHODES’s billing mix is concentrated in home-based geriatric and longitudinal care services: high-revenue Medicare codes include home/residence E/M visits (99350, 99349) and multiple chronic care management codes (99487, 99490, 99489, 99439), alongside remote physiologic monitoring codes (99454, 99458, 99457, 99453). The presence of advance care planning (99497) and transition-of-care (99496) codes further indicates an operational focus on complex, coordinated care for older patients rather than short episodic office visits. Total Medicare revenue on file is $506.2K, consistent with a clinician-oriented, longitudinal geriatric practice model rather than procedure-driven specialties.
Revenue concentration on Medicare is materially driven by a small set of services: the precomputed top three Medicare codes — 99487 ($93.2K, 18.4%), 99350 ($60.1K, 11.8%), and 99439 ($55.1K, 10.9%) — together account for 41.1% of this provider’s total Medicare revenue. This concentration underscores that chronic care management and home-visit E/M are the primary revenue drivers on Medicare rather than a broad mix of unrelated high-cost procedures.
Medicaid revenue is very small relative to Medicare and highly concentrated: total Medicaid revenue is $16.1K and the top three Medicaid codes account for 99.9% of that amount. Medicaid billing is dominated by 99349 ($14.1K, 87.0%) with 99442 contributing $2K (12.6%), which indicates the provider’s Medicaid footprint is essentially limited to home visit E/M services within the state.
The provider’s payer mix is effectively Medicare-dominant: Medicare revenue of $506.2K dwarfs Medicaid revenue of $16.1K, so the practice’s financial and operational behavior will be driven primarily by Medicare reimbursement rules and programs. From a contracting or risk-adjustment perspective, the small Medicaid volume suggests limited leverage or exposure in state Medicaid networks.
PAUL RHODES shows strong national volume on several care-management and advanced-planning codes, with notable percentile standings: 99497 reports $53.5K (10.5% of Medicare revenue) and ranks #126 of 27157 (100th percentile; extreme outlier, far above typical national volume), while 99439 ($55.1K, 10.9%) ranks #171 of 8395 (98th percentile; typical, unremarkable volume) and 99487 ($93.2K, 18.4%) ranks #84 of 2701 (97th percentile; typical, unremarkable volume). These rankings portray the provider as an unusually large national biller for advance care planning and very high-volume for CCM-related services, even if some labels in the data mark the volumes as typical.
Within the state Medicaid competitive landscape the provider is a modest participant: 99349 ranks #4 of 8 in-state (57th percentile; typical, unremarkable volume) and 99442 ranks #22 of 32 in-state (32nd percentile; typical, unremarkable volume). At the same time, multiple Medicaid entries for chronic care management and related supervision codes show nonzero claim counts but $0 avg paid (for example, 99487: 562 claims, $0 avg paid/claim; 99489: 402 claims, $0 avg paid/claim; 99490: 140 claims, $0 avg paid/claim; G0181: 72 claims, $0 avg paid/claim), suggesting that Medicaid reimbursement for these programmatic codes is either limited, not captured in the data extract, or paid under different mechanisms.
The provider also bills for behavioral health integration and psychiatric collaborative care management: 99493 ($13.3K, 2.6%) ranks #104 of 329 (69th percentile; typical, unremarkable volume) and 99492 ($8.9K, 1.7%) ranks #20 of 232 (91st percentile; typical, unremarkable volume), with 99494 additionally reported. This code mix indicates an integrated approach that includes CoCM services alongside primary geriatric care and remote monitoring, which could be valuable for payers evaluating behavioral-health-enabled primary care models.
PAUL RHODES has an established billing history with NPI enumerated 2007-01-23 (~19 years ago), consistent with a long-tenured practice profile that has shifted into programmatic chronic care, remote monitoring, and advance care planning over time. For payers and providers assessing contracting or care-management partnerships, the tenure plus the concentrated Medicare footprint suggests stable operational experience in longitudinal geriatric care and programmatic billing workflows.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
21 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99487 | 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… | 830 | $110 | $93.2K |
| 99350 | The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves high medical decision making or the provider spends at least 60… | 370 | $160 | $60.1K |
| 99439 | 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… | 1,310 | $40 | $55.1K |
| 99497 | The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30… | 730 | $70 | $53.5K |
| 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… | 940 | $50 | $48.7K |
| 99349 | The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least… | 430 | $100 | $44.9K |
| 99489 | 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… | 680 | $60 | $42K |
| 99458 | The provider manages treatment using data from remote physiologic monitoring. The service requires at least one real–time interactive communication with the patient or caregiver during the month.… | 470 | $40 | $16.3K |
| 99496 | The provider manages the care of a patient during the transition to home care after discharge from a healthcare facility. The patient’s care requires high–level medical decision making, contact… | 60 | $240 | $14.6K |
| 99454 | The provider supplies one or more devices for remote physiologic monitoring that occurs for 16 to 30 days in a 30–day period. | 300 | $50 | $14.2K |
Showing 1–10 of 21
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 21 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
9 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99349 | The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least… | 300 | $50 | $14.1K |
| 99442 | N/A | 40 | $60 | $2K |
| 99439 | 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… | 60 | $1 | $60 |
| G0444 | Annual depression screening, 5 to 15 minutes | 10 | $1 | $10 |
| 99487 | 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… | 560 | $0 | $0 |
| 99489 | 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… | 400 | $0 | $0 |
| 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… | 140 | $0 | $0 |
| 99497 | The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30… | 10 | $0 | $0 |
| G0181 | Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and… | 70 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other District of Columbia providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. District of Columbia median
9 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99349 | The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least… | 4 | 10 | 270 | $20 | $48.7K |
| 99442 | N/A | 22 | 30 | 60 | $20 | $4.7K |
| G0444 | Annual depression screening, 5 to 15 minutes | 10 | 10 | 120 | $1 | $360 |
| 99487 | 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… | 2 | 10 | 2,660 | $1 | $260 |
| 99489 | 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… | 2 | 10 | 1,110 | $1 | $110 |
| 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… | 6 | 10 | 160 | $1 | $70 |
| 99439 | 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… | 3 | 10 | 90 | $1 | $10 |
| 99497 | The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30… | 8 | 10 | 80 | $0 | $0 |
| G0181 | Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and… | 1 | 10 | 40 | $0 | $0 |
Other providers in the same ZIP code as Paul Rhodes, ranked by combined Medicare and Medicaid revenue.
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