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

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

Stepworks Recovery Centers LLC (NPI 1922497130)

Field	Value
Entity Type	Organization
Organization	Stepworks Recovery Centers LLC
Address	1207 Woodland Dr
City	Elizabethtown
State	KY
ZIP	42701
Taxonomy	Substance Use Disorder Rehabilitation Clinic/Center
NPI Enumerated	January 12, 2015

Payer Source	Total Paid
Medicaid	$67.7M
Medicare	$0

Key Findings

STEPWORKS RECOVERY CENTERS LLC is effectively a Medicaid-focused provider: it reports $67.7M in lifetime Medicaid revenue and has no Medicare billing on file, making Medicaid the de facto sole public payer in its claims footprint. This concentration in a single payer should shape how payers and partners evaluate reimbursement, utilization management, and network inclusion decisions for this entity.

Revenue for this provider is highly concentrated in three codes: H0011 ($45.9M, 67.8%), H0018 ($14M, 20.6%), and H2034 ($3.5M, 5.2%), which together account for 93.6% of its Medicaid revenue. That top-3 concentration indicates the business is driven by a narrow set of residential and transitional services rather than a broad mix of low-dollar outpatient encounters.

The code mix identifies STEPWORKS as primarily a residential substance use disorder operator: H0011 is acute detoxification in a residential addiction program and H0018 is short-term residential treatment without room and board, while H2034 is halfway house per diem. This combination — heavy on residential detox and short-term residential stays with a smaller transitional/halfway-house footprint — suggests the facility operates a stepped-care continuum centered on inpatient/residential episodes.

On competitive standing within Kentucky, STEPWORKS is a major provider for residential detox: H0011 ranks #3 of 72 providers in-state (97th percentile) and is described as notably above typical state volume for this code. By contrast, its H0018 volume (rank #23 of 49, 54th percentile) and H2034 volume (rank #10 of 38, 76th percentile) are characterized as typical or unremarkable statewide, indicating leadership in detox specifically but more ordinary participation in short-term residential and halfway-house services.

Although H0018 and H2034 generate meaningful revenue, several outpatient and ancillary codes appear as small revenue contributors: H0015 (intensive outpatient) accounts for $2.1M (3.0% of Medicaid revenue) and ranks #21 of 225 providers in-state (91th percentile) but is labeled typical, unremarkable volume for that code. The presence of H0015, H0035 (partial hospitalization), and psychotherapy codes indicates the provider offers outpatient and day-program options alongside residential care, albeit at much lower revenue shares compared with detox and short-term residential.

Laboratory testing and routine E/M visits represent marginal revenue streams: 80307 (instrumented presumptive drug test) accounts for $294.7K (0.4% of Medicaid revenue) and 99213 accounts for $228.6K (0.3% of Medicaid revenue). These smaller line items show clinical support services and outpatient follow-up exist but are not primary revenue drivers, reinforcing that estimates of capacity and utilization should focus on residential-coded services.

STEPWORKS has an established operational presence, with its NPI enumerated on 2015-01-12 (~11 years ago), which supports interpreting the observed code mix as a sustained service model rather than a short-term anomaly. Tenure of this length suggests the provider has had time to develop referral pathways and state-level utilization patterns consistent with the high H0011 volume.

For payer and network strategy, the combination of dominant H0011 revenue and the 93.6% top-3 code concentration implies negotiations, utilization review, and capacity planning should prioritize residential detox and short-term residential authorization rules. Given the providers outsized role in H0011 (notably above typical state volume), Medicaid programs and managed care plans will want to monitor utilization patterns for inpatient detox capacity and consider targeted quality and outcomes metrics tied to those specific services.

Medicaid: Complete Services Breakdown

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

24 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	113,030	$410	$45.9M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	5,750	$2,430	$14M
H2034	Alcohol and/or drug abuse halfway house services, per diem	10,430	$340	$3.5M
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…	19,350	$110	$2.1M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	7,040	$200	$1.4M
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	6,410	$50	$294.7K
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…	6,930	$30	$228.6K
H0038	Self‑help/peer services, per 15 minutes	7,580	$10	$83.4K
T2023	Targeted case management; per month	260	$320	$82.4K
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…	1,130	$30	$33.8K

Showing 1–10 of 24

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Stepworks Recovery Centers LLC — 1 of 24 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

24 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	3	70	7,180	$270	$6.8M
H2034	Alcohol and/or drug abuse halfway house services, per diem	10	40	3,120	$220	$3M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	23	50	4,480	$220	$2.4M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	21	60	3,270	$170	$2.2M
T2023	Targeted case management; per month	333	530	530	$300	$1.1M
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…	21	230	1,750	$110	$793.5K
H0038	Self‑help/peer services, per 15 minutes	105	320	3,070	$50	$678.3K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	120	340	2,700	$40	$673.3K
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…	996	1,270	760	$80	$447.2K
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…	707	3,340	1,020	$30	$296K

Showing 1–10 of 24

Nearby Providers

Other providers in the same ZIP code as Stepworks Recovery Centers LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Communicare Inc	KY	Community/Behavioral Health Agency	$0	$205.5M
Baptist Healthcare System Inc	KY	General Acute Care Hospital	$0	$95.7M
Communicare Inc	KY	Community/Behavioral Health Agency	$0	$49.5M
Hardin Memorial Hospital	KY	General Acute Care Hospital	$0	$37.2M
Pinnacle Treatment Centers Ky-1, LLC	KY	Substance Abuse Rehabilitation Facility	$0	$33.6M
Lincoln Trail Area Development District	KY	Supports Brokerage Agency	$0	$31.4M
Astra Behavioral Health LLC	KY	Psychiatry Physician	$0	$26.1M
Renest Recovery Support Services	KY	Community/Behavioral Health Agency	$0	$19.9M
Baptist Health Medical Group Inc	KY	Internal Medicine Physician	$0	$13.7M
Elizabethtown Emergency Physicians, LLC	KY	Emergency Medicine Physician	$0	$11.9M

Stepworks Recovery Centers 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