Clinic
Pathways
Pathways was paid $89.12M by Medicaid between Jan 2018 and Nov 2024, across 42 billing codes. Its largest line is H2015, community support for mental illness or disability, per 15 minutes — 19% of everything it billed.
33Billing provider infoPATHWAYS
MARQUETTE, MI 49855
MARQUETTE, MI 49855
33aNPI1487683546assigned 07/01/2006
28Total paid$89.12M
24GClaims379,900
24DCodes billed42
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Mental Health Clinic/Center (Including Community Mental Health Center) providers in Michigan
Rank by total paid#6 of 117
Median peer was paid$339K
This provider vs. median263×
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 | 69,463 | $10.05M | |
| 2019 | 61,169 | $9.12M | |
| 2020 | 42,003 | $6.53M | |
| 2021 | 49,526 | $12.83M | |
| 2022 | 53,072 | $19.72M | |
| 2023 | 53,793 | $16.37M | |
| 2024incomplete | 50,874 | $14.50M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| H2015 | Community support for mental illness or disability, per 15 minutesComprehensive community support services, per 15 minutes | 19% | 85,198 | 17,343 | $17.30M |
| T1017 | Case management, billed per 15 minutesTargeted case management, each 15 minutes | 15% | 42,161 | 27,355 | $13.09M |
| H0039 | Assertive community treatment, face-to-face, per 15 minutes | 11% | 57,413 | 5,555 | $9.54M |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | 7.7% | 27,234 | 16,330 | $6.88M |
| T1016 | Case management, each 15 minutes | 6.6% | 28,323 | 19,045 | $5.92M |
| H2030 | Mental health clubhouse services, per 15 minutes | 3.8% | 10,951 | 1,989 | $3.39M |
| 97153 | Applied behavior analysis (autism therapy), per 15 minutesAdaptive behavior treatment by protocol, administered by technician, each 15 minutes | 3.4% | 6,436 | 895 | $3.04M |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 3.0% | 13,891 | 10,560 | $2.70M |
| H2000 | Comprehensive multidisciplinary evaluation | 2.8% | 820 | 642 | $2.53M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 2.8% | 11,495 | 11,365 | $2.52M |
| 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 | 2.6% | 6,939 | 6,756 | $2.27M |
| H0032 | Mental health service plan development by non-physician | 2.5% | 15,505 | 12,607 | $2.25M |
30 more codes
| H2011 | Crisis intervention service, per 15 minutes | 2.5% | 5,590 | $2.19M |
| T1023 | Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter | 2.4% | 2,753 | $2.15M |
| H0036 | Community psychiatric support and treatment, per 15 minutes | 2.3% | 8,748 | $2.06M |
| 90791 | Psychiatric diagnostic evaluation | 1.9% | 4,945 | $1.66M |
| H0023 | Behavioral health outreach service (planned approach to reach a targeted population) | 1.7% | 8,207 | $1.53M |
| H0031 | Mental health assessment, by non-physician | 1.5% | 2,244 | $1.34M |
| 90792 | Psychiatric diagnostic evaluation with medical services | 1.2% | 1,056 | $1.11M |
| 90832 | Psychotherapy session, about 30 minutes | 1.0% | 7,662 | $896K |
| H0002 | Behavioral health screening to determine eligibility for admission to treatment program | <1% | 2,140 | $683K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 6,074 | $681K |
| H0038 | Self-help/peer services, per 15 minutes | <1% | 2,790 | $427K |
| 90847 | Family psychotherapy with the patient present, 50 minutes | <1% | 2,017 | $417K |
| S5111 | Home care training, family; per session | <1% | 1,955 | $337K |
| 0365T | <1% | 2,091 | $325K | |
| 90853 | Group psychotherapy (other than of a multiple-family group) | <1% | 1,361 | $319K |
| 97151 | <1% | 217 | $257K | |
| 90846 | Family psychotherapy without the patient present, 50 minutes | <1% | 1,110 | $246K |
| 97155 | Adaptive behavior treatment with protocol modification, administered by physician, each 15 minutes | <1% | 800 | $193K |
| S0280 | Medical home program, comprehensive care coordination and planning, initial plan | <1% | 1,012 | $175K |
| H2019 | Therapeutic behavioral services, billed per 15 minutes | <1% | 833 | $144K |
| H2022 | Community-based wrap-around services, per diem | <1% | 143 | $140K |
| 0364T | <1% | 2,108 | $114K | |
| T1999 | Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" | <1% | 3,808 | $105K |
| H2021 | Community-based wrap-around services, per 15 minutes | <1% | 686 | $62K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 307 | $52K |
| Q3014 | Telehealth originating site facility fee | <1% | 2,031 | $29K |
| H2014 | Skills training and development, per 15 minutes | <1% | 414 | $19K |
| 0369T | <1% | 150 | $18K | |
| 97156 | <1% | 95 | $12K | |
| 0368T | <1% | 187 | $11K |
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 officialNELSON, LAURA (CREDENTIALING COORDINATOR)