Clinic
Pathway Healthcare Alabama LLC
Pathway Healthcare Alabama LLC was paid $874K by Medicaid between Mar 2019 and Nov 2024, across 16 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 54% of everything it billed.
33Billing provider infoPATHWAY HEALTHCARE ALABAMA LLC
BIRMINGHAM, AL 35235
BIRMINGHAM, AL 35235
33aNPI1053855122assigned 12/08/2016
33bProvider typeRural Health Clinic/Center
28Total paid$874K
24GClaims52,592
24DCodes billed16
24AFirst – last monthMar 2019 – Nov 2024
Compared with peers
Next to other Rural Health Clinic/Center providers in Alabama
Rank by total paid#38 of 80
Median peer was paid$818K
This provider vs. median1.1×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2019 | 12,650 | $82K | |
| 2020 | 12,643 | $126K | |
| 2021 | 9,692 | $153K | |
| 2022 | 9,522 | $237K | |
| 2023 | 6,080 | $217K | |
| 2024incomplete | 2,005 | $60K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 54% | 17,233 | 9,505 | $473K |
| 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 not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed | 32% | 4,780 | 3,403 | $281K |
| 80305 | 8.3% | 17,562 | 9,722 | $73K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 2.3% | 1,234 | 665 | $21K |
| 99205 | Prolong outpt/office vis | 1.7% | 296 | 166 | $15K |
| 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 not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed | <1% | 93 | 89 | $5K |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | <1% | 216 | 149 | $3K |
| 99484 | <1% | 1,652 | 1,204 | $2K | |
| 81025 | <1% | 1,063 | 490 | $1K | |
| 90791 | Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation | <1% | 17 | 12 | $1K |
| 99406 | <1% | 6,740 | 2,854 | $239.08 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 102 | 73 | $102.00 |
4 more codes
| G0444 | Annual depression screening, 5 to 15 minutes | 0% | 194 | $0.00 |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | 0% | 932 | $0.00 |
| G2086 | Office-based treatment for opioid use disorder, including development of the treatment plan, care coordination, individual therapy and group therapy and counseling; at least 70 minutes in the first calendar month | 0% | 29 | $0.00 |
| G2087 | Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; at least 60 minutes in a subsequent calendar month | 0% | 449 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialROX, RITA (REVENUE CYCLE MANAGER)
Parent organizationPATHWAY HEALTHCARE ALABAMA LLC