Montefiore Medical Center

Montefiore Medical Center was paid $10.35M by Medicaid between Jan 2018 and Nov 2024, across 24 billing codes. Its largest line is S9123, Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used) — 36% of everything it billed.

33Billing provider infoMONTEFIORE MEDICAL CENTER
BRONX, NY 10458

33aNPI1265591168assigned 12/06/2006

33bProvider typeHome Health Agency

28Total paid$10.35M

24GClaims91,146

24DCodes billed24

24AFirst – last monthJan 2018 – Nov 2024

Compared with peers

Next to other Home Health Agency providers in New York

Rank by total paid#480 of 851

Median peer was paid$15.00M

This provider vs. median0.7×

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	3,549	$434K
2019	11,474	$1.39M
2020	18,449	$2.08M
2021	18,511	$2.16M
2022	16,949	$1.90M
2023	12,152	$1.21M
2024incomplete	10,062	$1.18M

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
S9123	Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)	36%	34,828	9,199	$3.72M
S9131	Physical therapy; in the home, per diem	35%	32,050	9,140	$3.65M
T1030	Nursing care, in the home, by registered nurse, per diem	15%	9,737	2,875	$1.53M
S9127	Social work visit, in the home, per diem	5.2%	3,983	2,997	$538K
S9129	Occupational therapy, in the home, per diem	5.0%	5,119	2,408	$522K
S9122	Home health aide or certified nurse assistant, providing care in the home; per hour	3.1%	3,979	998	$317K
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%	280	264	$30K
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%	433	398	$24K
99285	Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life	<1%	14	14	$3K
99284	Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity	<1%	28	28	$3K
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	<1%	26	25	$3K
T1001	Nursing assessment / evaluation	<1%	17	16	$3K

12 more codes

99215	Doctor's office visit, returning patient (complex)	<1%	12	$2K
99283	Emergency room visit (moderate)	<1%	30	$2K
88305	Level IV - Surgical pathology, gross and microscopic examination	<1%	17	$2K
71046	Radiologic examination, chest; 2 views	<1%	78	$1K
88112		<1%	16	$880.32
G0151	Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes	<1%	65	$855.00
93010	Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only	<1%	70	$746.54
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	13	$704.60
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	<1%	12	$132.30
Q5001	Hospice or home health care provided in patient's home/residence	<1%	40	$0.36
1CHK1		0%	286	$0.00
1BHK1		0%	13	$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 officialMENASHY, DAVID (VICE PRESIDENT, FINANCE)