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NPI 1932586427 · Hicksville, NY · Clinical Medical Laboratory
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Acutis Diagnostics Inc is a clinical medical laboratory provider located in Hicksville, New York. This profile covers 41 Medicare and 115 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 | Organization |
| Organization | Acutis Diagnostics Inc |
| Address | 400 Karin Ln |
| City | Hicksville |
| State | NY |
| ZIP | 11801 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | May 4, 2015 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $60.6M |
| Medicare | $5.2M |
ACUTIS DIAGNOSTICS INC is operating as a high-volume clinical diagnostic laboratory with a clear focus on molecular infectious disease testing and extensive toxicology panels; Medicare top codes include 87798, 87635 and multiple drug-testing codes (G0480, G0481, G0482, G0483 and 80307) and the Medicaid top codes are dominated by U0004 and broad panels and definitive drug testing (G0481, 80307, G0480, G0483). The code mix (many amplified nucleic acid probe techniques and high-throughput SARS-CoV-2 codes) indicates the lab performs large-scale molecular PCR and confirmatory mass-spec style drug-identification testing rather than point-of-care immunoassays. This combination signals a business built around centralized, high-throughput lab services for infectious disease and substance-testing workflows.
Revenue concentration is pronounced within each payer: precomputed results show the top three Medicare codes account for 53.8% of Medicare revenue and the top three Medicaid codes account for 56.1% of Medicaid revenue. For Medicare the single largest contributor is 87798 ($1.9M, 35.9% of Medicare revenue), while Medicaid is heavily concentrated in U0004 ($15.7M, 28.5% of Medicaid revenue) and two drug-testing codes (G0481 and 80307 together drive a further ~27.6% of Medicaid revenue). These splits indicate a small number of high-volume services drive the majority of payer income.
On payer mix, ACUTIS DIAGNOSTICS reports $5.2M in total Medicare revenue versus $60.6M in total Medicaid revenue, indicating Medicaid is the overwhelmingly dominant revenue source. This is effectively a Medicaid-centric operation by scale; Medicare represents a much smaller share of reported lifetime revenue while Medicaid claims volumes (and dollar totals) dominate the business footprint.
Competitive standing for key Medicare codes shows the provider is a high-volume national participant on several tests: 87798 ranks #34 of 1319 (97th percentile) and G0480 ranks #29 of 1590 (98th percentile), meaning the lab is well above typical national volume for those services. For some Medicare molecular COVID codes ACUTIS is an extreme outlier nationally (87635 ranks at the 100th percentile, described as "extreme outlier, far above typical national volume"), indicating unusually large Medicare volumes for certain PCR-based COVID tests compared with peers.
Competitive standing in New York Medicaid is exceptionally strong and in several instances dominant: U0004 ranks #2 of 98 (99th percentile, labeled an "extreme outlier, far above typical state volume"), G0481 ranks #1 of 42 (100th percentile, "extreme outlier"), and G0483 ranks #1 of 34 (100th percentile, "extreme outlier"). Multiple toxicology and synthetic drug panels (80352, 80333, 80337, 80371 and others) also rank at or near the top of in-state peers, which positions ACUTIS as a leading statewide provider for both definitive drug testing and large-volume COVID/respiratory molecular testing.
Several codes are flagged as statistical outliers versus peers: Medicare 87635 is listed as an "extreme outlier, far above typical national volume," and on the Medicaid side U0004, G0481 and G0483 are all characterized as "extreme outlier, far above typical state volume." Numerous other test codes are described as "notably above typical" or high-percentile placements (e.g., 87798, G0480, 80307), reinforcing that ACUTIS frequently bills at volumes well above typical peers for both infectious disease panels and drug-testing services. These descriptors suggest the provider’s operational scale for specific assays is substantially larger than most competitors.
The provider’s NPI was enumerated on 2015-05-04 (~11 years ago), indicating roughly a decade of Medicare/Medicaid billing history under the current NPI. That tenure, combined with the very large Medicaid volumes, suggests the organization has scaled laboratory operations and payer relationships over multiple years rather than being a recent entrant.
From a service-line perspective the billing patterns imply ACUTIS serves both public-health/mass testing needs (high-throughput SARS-CoV-2 codes U0004, U0005 and multiplex respiratory codes like 87631/87633) and payer-driven toxicology/monitoring markets (large volumes for G0481, G0480, G0482, G0483 and many 80xxx series drug panels). This dual emphasis supports use-cases such as contracted state testing programs and managed-care substance-use monitoring, aligning with the Medicaid-heavy revenue profile.
Given the concentration of revenue in a handful of high-volume codes and the provider’s top-tier in-state ranks for those services, payers and provider networks should view ACUTIS as a major laboratory partner for Medicaid populations in New York and as a significant national participant for specific Medicare molecular tests. Contracting or utilization-management discussions should focus on the firm’s capacity for large-scale molecular and definitive toxicology testing and the implications of its outsized volumes for network balance and cost control.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
41 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 87798 | The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified… | 54,590 | $30 | $1.9M |
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 4,470 | $110 | $500.4K |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by… | 5,770 | $70 | $426.9K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 11,010 | $30 | $374.3K |
| 87635 | Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus… | 7,270 | $50 | $363.4K |
| 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. | 5,820 | $60 | $355.2K |
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 1,360 | $200 | $266K |
| G0481 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 1,560 | $150 | $238.4K |
| 87640 | The lab analyst performs the technical lab test to look for Staphylococcus aureus nucleic acid using an amplified probe technique. | 4,230 | $30 | $143.7K |
| 87653 | The lab analyst performs a test for Streptococcus, group B, using amplified nucleic acid probe technique. The amplified probe provides a rapid means to assess colonization by Streptococcus, group B,… | 4,220 | $30 | $143.3K |
Showing 1–10 of 41
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 41 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.
115 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by… | 279,860 | $60 | $15.7M |
| G0481 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 85,430 | $90 | $7.7M |
| 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. | 299,370 | $30 | $7.5M |
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 113,970 | $50 | $5.7M |
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 28,350 | $140 | $3.9M |
| 87633 | The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for… | 30,010 | $100 | $2.9M |
| 87798 | The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified… | 24,730 | $90 | $2.3M |
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 30,020 | $70 | $2M |
| U0005 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc,… | 103,610 | $10 | $1.3M |
| 87631 | The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,… | 20,160 | $30 | $584.5K |
Showing 1–10 of 115
How this provider's Medicaid billing volume and revenue compare to other New York providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New York median
115 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by… | 2 | 100 | 1,490 | $70 | $1.3M |
| G0481 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 1 | 40 | 440 | $90 | $511.9K |
| 87633 | The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for… | 5 | 140 | 360 | $130 | $492.1K |
| U0005 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc,… | 13 | 300 | 1,710 | $20 | $458.6K |
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 4 | 110 | 690 | $50 | $442K |
| 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. | 4 | 290 | 1,900 | $30 | $390.6K |
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 1 | 30 | 550 | $100 | $359.8K |
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 2 | 20 | 240 | $70 | $302K |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 358 | 590 | 1,160 | $20 | $277.2K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 80 | 410 | 1,190 | $20 | $209.8K |
Showing 1–10 of 115
Other providers in the same ZIP code as Acutis Diagnostics Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Sunrise Medical Laboratories, Inc. | NY | Clinical Medical Laboratory | $30.3M | $101.5M |
| Cottage Homecare, Services, Inc | NY | Home Health Agency | $0 | $121.8M |
| Aides At Home Inc | NY | Home Health Agency | $0 | $56.4M |
| Central Nassau Guidance & Counseling Services, Inc. | NY | Community/Behavioral Health Agency | $0 | $46M |
| James Maisel | NY | Ophthalmology Physician | $4.4M | $8.9K |
| Leena Doshi | NY | Diagnostic Radiology Physician | $914.5K | $500 |
| Stephanie Becker | NY | Ophthalmology Physician | $757.2K | $41.4K |
| Michael Sable | NY | Ophthalmology Physician | $671K | $470 |
| Florante Melchor | NY | Internal Medicine Physician | $211.5K | $102.2K |
| Richard Obedian | NY | Orthopaedic Surgery Physician | $268.3K | $0 |
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