Behavioral
Addiction Medical Facility, LLC
Addiction Medical Facility, LLC was paid $9.00M by Medicaid between Oct 2018 and Dec 2024, across 31 billing codes. Its largest line is 99211, Office or other outpatient visit for the evaluation and management of an established patient, minimal severity — 44% of everything it billed.
33Billing provider infoADDICTION MEDICAL FACILITY, LLC
SEAFORD, DE 19973
SEAFORD, DE 19973
33aNPI1063921047assigned 09/22/2017
33bProvider typeAddiction (Substance Use Disorder) Counselor
28Total paid$9.00M
24GClaims457,959
24DCodes billed31
24AFirst – last monthOct 2018 – Dec 2024
Compared with peers
Next to other Addiction (Substance Use Disorder) Counselor providers in Delaware
Rank by total paid#2 of 13
Median peer was paid$300K
This provider vs. median30×
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 | |
|---|---|---|---|
| 2018 | 57 | $0.00 | |
| 2019 | 9,312 | $380K | |
| 2020 | 80,942 | $1.21M | |
| 2021 | 108,585 | $1.85M | |
| 2022 | 106,580 | $2.28M | |
| 2023 | 76,146 | $1.73M | |
| 2024incomplete | 76,337 | $1.56M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 44% | 178,901 | 17,957 | $3.92M |
| H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | 42% | 234,949 | 19,324 | $3.81M |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | 4.1% | 4,102 | 3,203 | $366K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | 1.9% | 3,593 | 2,984 | $167K |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 1.8% | 2,457 | 2,186 | $164K |
| H0001 | Alcohol and/or drug assessment | <1% | 1,043 | 911 | $87K |
| 90791 | Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation | <1% | 613 | 574 | $65K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 1,681 | 1,012 | $63K |
| J0571 | Buprenorphine, oral, 1 mg | <1% | 18,612 | 680 | $53K |
| 99408 | <1% | 1,854 | 1,373 | $52K | |
| 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 | <1% | 665 | 497 | $50K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | <1% | 883 | 727 | $47K |
19 more codes
| 90853 | Group psychotherapy (other than of a multiple-family group) | <1% | 1,770 | $31K |
| 80305 | <1% | 5,471 | $28K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 165 | $17K |
| 90838 | <1% | 211 | $17K | |
| 99205 | Prolong outpt/office vis | <1% | 172 | $14K |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | <1% | 157 | $12K |
| 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 assessment, counseling; crisis intervention, and activity therapies or education | <1% | 121 | $10K |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | <1% | 148 | $8K |
| 99285 | Emergency room visit (most serious) | <1% | 49 | $8K |
| 99284 | Emergency room visit (serious) | <1% | 24 | $2K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 12 | $2K |
| 98968 | <1% | 35 | $681.53 | |
| 99053 | <1% | 19 | $420.00 | |
| 99354 | <1% | 18 | $299.40 | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 13 | $282.33 |
| 86580 | <1% | 65 | $255.96 | |
| Q3014 | Telehealth originating site facility fee | <1% | 63 | $190.00 |
| 81025 | <1% | 36 | $103.12 | |
| T1015 | A visit at a community health center or clinic (one all-in rate) | 0% | 57 | $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 officialTHARP, TAMMY (BILLING SPECIALIST MANAGER)