Behavioral
Breakthrough Behavior, LLC
Breakthrough Behavior, LLC was paid $6.55M by Medicaid between Jul 2019 and Nov 2024, across 8 billing codes. Its largest line is H2019, therapeutic behavioral services, billed per 15 minutes — 68% of everything it billed.
33Billing provider infoBREAKTHROUGH BEHAVIOR, LLC
MONTEREY, CA 93940
MONTEREY, CA 93940
33aNPI1306202940assigned 01/12/2016
33bProvider typeAssistant Behavior Analyst
28Total paid$6.55M
24GClaims43,905
24DCodes billed8
24AFirst – last monthJul 2019 – Nov 2024
Compared with peers
Next to other Assistant Behavior Analyst providers in California
Rank by total paid#3 of 17
Median peer was paid$605K
This provider vs. median11×
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 | 1,567 | $218K | |
| 2020 | 7,523 | $1.07M | |
| 2021 | 12,387 | $1.55M | |
| 2022 | 8,196 | $1.16M | |
| 2023 | 8,029 | $1.28M | |
| 2024incomplete | 6,203 | $1.28M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| H2019 | Therapeutic behavioral services, billed per 15 minutesTherapeutic behavioral services, per 15 minutes | 68% | 23,890 | 1,997 | $4.45M |
| H2012 | Behavioral health day treatment, per hour | 19% | 8,626 | 1,883 | $1.24M |
| H2014 | Skills training and development, per 15 minutes | 4.3% | 4,220 | 630 | $282K |
| H0032 | Mental health service plan development by non-physician | 4.1% | 1,803 | 713 | $271K |
| S5111 | Home care training, family; per session | 2.4% | 1,921 | 1,205 | $156K |
| 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | 1.6% | 3,039 | 223 | $102K |
| 97153 | Applied behavior analysis (autism therapy), per 15 minutesAdaptive behavior treatment by protocol, administered by technician, each 15 minutes | <1% | 394 | 47 | $44K |
| H0031 | Mental health assessment, by non-physician | <1% | 12 | 12 | $5K |
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 officialPIERCE, MAEGEN PIERCE (OWNER)