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

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

Pathway Family Services LLC (NPI 1790013241)

Field	Value
Entity Type	Organization
Organization	Pathway Family Services LLC
Address	4101 Sw Martin Dr
City	Topeka
State	KS
ZIP	66609
Taxonomy	Psychiatric Residential Treatment Facility
NPI Enumerated	November 20, 2009

Payer Source	Total Paid
Medicaid	$31.3M
Medicare	$0

Key Findings

PATHWAY FAMILY SERVICES LLC reports $31.3M in lifetime Medicaid revenue and has no Medicare billing on file, making its public payer mix effectively single-payer Medicaid. The absence of Medicare activity means analysts should treat Medicaid reimbursement rules and state-level policies as primary drivers of the provider's financial performance.

Revenue is extremely concentrated: the precomputed top-3 Medicaid codes account for 100.0% of the provider's total Medicaid revenue, and a single code, T2048, is shown with $31.3M revenue (100.0% of this provider's total Medicaid revenue). This indicates the organization’s Medicaid receipts are overwhelmingly tied to one service line rather than a diversified set of billable procedures.

The top revenue-driving code, T2048 (Behavioral health; long-term care residential with room and board, per diem), appears to be the core business model: the record shows 31.9K claims at a $981 avg paid/claim generating $31.3M. That code description and per‑diem payment pattern are consistent with operating as a psychiatric residential treatment facility providing extended stays where room-and-board is bundled into daily rates.

Competitive standing on the leading code is relatively strong in-state: T2048 ranks #2 of 10 providers in Kansas (89th percentile), which places PATHWAY near the top among the small set of in-state peers for this specific residential per‑diem service. At the same time, the underlying comparator labels the volume for this code as "typical, unremarkable," so while the provider is a major participant among a limited peer group, the activity level should not be interpreted as an extreme outlier.

Secondary service lines are negligible in revenue: 90853 (group psychotherapy) shows 45 claims, $18 avg paid/claim, and $810 revenue (0.0% of this provider's total Medicaid revenue), and it ranks #35 of 46 in-state (24th percentile). This suggests group psychotherapy is a marginal or ancillary offering for this entity rather than a material revenue center.

Tenure is long enough to assess trend stability: the NPI was enumerated on 2009-11-20 (~17 years ago), indicating the provider has been active in the national registry for well over a decade. That longevity supports using multi-year Medicaid patterns to evaluate utilization and revenue risks.

From a risk and operational-planning perspective, the combination of a single dominant per-diem code (T2048) and no Medicare activity concentrates exposure to Medicaid policy changes, per-diem rate adjustments, and state oversight of residential behavioral-health programs. Analysts evaluating sustainability or contract negotiations should prioritize monitoring Medicaid rate-setting, utilization reviews, and any state-level changes affecting residential treatment reimbursement.

Medicaid: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2048	Behavioral health; long-term care residential (non-acute care in a residential treatment program where stay is typically longer than 30 days), with room and board, per diem	31,920	$980	$31.3M
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…	50	$20	$810

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kansas Distribution

Pathway Family Services LLC — 0 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kansas

Full comparison — all codes billed, vs. Kansas median

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2048	Behavioral health; long-term care residential (non-acute care in a residential treatment program where stay is typically longer than 30 days), with room and board, per diem	2	10	8,030	$760	$12.9M
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…	35	50	140	$10	$5.8K

Pathway Family Services LLC — Billing Profile & Reimbursement Data

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Pathway Family Services 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

Frequently Asked Questions

References