Pathways of Tennessee, INC.
Pathways of Tennessee, INC. was paid $30.54M by Medicaid between Jan 2018 and Dec 2024, across 43 billing codes. Its largest line is S0280, Medical home program, comprehensive care coordination and planning, initial plan — 54% of everything it billed.
JACKSON, TN 38301
Next to other Clinic/Center providers in Tennessee
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 105,102 | $4.55M | |
| 2019 | 70,064 | $3.12M | |
| 2020 | 80,778 | $3.60M | |
| 2021 | 98,085 | $4.01M | |
| 2022 | 110,541 | $5.12M | |
| 2023 | 121,158 | $5.75M | |
| 2024incomplete | 88,990 | $4.40M |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| S0280 | Medical home program, comprehensive care coordination and planning, initial plan | 54% | 136,260 | 89,532 | $16.56M |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | 14% | 59,898 | 34,396 | $4.18M |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 7.8% | 49,706 | 34,111 | $2.39M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 5.9% | 52,355 | 40,167 | $1.79M |
| 90791 | Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation | 5.1% | 17,859 | 13,296 | $1.54M |
| 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 | 5.0% | 34,753 | 25,307 | $1.54M |
| 90792 | Psychiatric diagnostic evaluation with medical services | 1.9% | 7,498 | 5,651 | $579K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | 1.7% | 14,649 | 10,428 | $512K |
| H2017 | Psychosocial rehabilitation, billed per 15 minutesPsychosocial rehabilitation services, per 15 minutes | 1.6% | 4,853 | 655 | $477K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | <1% | 5,176 | 4,059 | $215K |
| H0038 | Self-help/peer services, per 15 minutes | <1% | 3,656 | 1,249 | $178K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 5,136 | 3,884 | $168K |
31 more codes
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 2,577 | $79K |
| H0033 | Oral medication administration, direct observation | <1% | 528 | $61K |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 838 | $44K |
| 90847 | Family psychotherapy with the patient present, 50 minutes | <1% | 486 | $43K |
| 99223 | Prolong inpt eval add15 m | <1% | 415 | $42K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 1,002 | $38K |
| 90853 | Group psychotherapy (other than of a multiple-family group) | <1% | 1,269 | $37K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 1,337 | $29K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 8,155 | $19K |
| 99442 | <1% | 1,486 | $11K | |
| H0049 | Alcohol and/or drug screening | <1% | 1,086 | $5K |
| H0034 | Medication training and support, per 15 minutes | <1% | 344 | $4K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 65 | $2K |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 37 | $1K |
| 90836 | <1% | 43 | $1K | |
| 3008F | <1% | 9,490 | $1K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 456 | $862.53 |
| 90846 | Family psychotherapy without the patient present, 50 minutes | <1% | 12 | $689.44 |
| 99221 | <1% | 13 | $179.94 | |
| G9010 | Coordinated care fee, risk adjusted maintenance, level 4 | <1% | 64,043 | $176.89 |
| G9005 | Coordinated care fee, risk adjusted maintenance | <1% | 78,556 | $0.16 |
| G9007 | Coordinated care fee, scheduled team conference | <1% | 28,092 | $0.06 |
| G9004 | Coordinated care fee, risk adjusted low, initial | <1% | 37,094 | $0.05 |
| G9006 | Coordinated care fee, home monitoring | <1% | 17,934 | $0.03 |
| 3074F | 0% | 1,770 | $0.00 | |
| 3075F | 0% | 246 | $0.00 | |
| 3079F | 0% | 206 | $0.00 | |
| G9011 | Coordinated care fee, risk adjusted maintenance, level 5 | 0% | 14,301 | $0.00 |
| 3078F | 0% | 1,936 | $0.00 | |
| S9485 | Crisis intervention mental health services, per diem | 0% | 9,089 | $0.00 |
| 80305 | 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.
Who's on the registration
| Provider | Location | Paid |
|---|---|---|
| Jackson Madison County General Hospital | Jackson, TN | $46.51M |
| Dyersburg Health | Dyersburg, TN | $13.19M |
| Jackson-Madison County General Hospital | Jackson, TN | $12.97M |
| Jackson-Madison County General Hospital | Jackson, TN | $7.37M |
| WT Medical Associates | Dyersburg, TN | $5.52M |
| West Tennessee Healthcare Henry County | Paris, TN | $4.47M |
| Therapy & Learning Center INC | Jackson, TN | $4.19M |
| Martin Health | Martin, TN | $3.94M |
| Milan General Hospital, INC. | Milan, TN | $3.54M |
| Camden General Hospital, INC. | Camden, TN | $3.46M |
| Pathways of Tennessee, INC. | Jackson, TN | $3.30M |
| Bolivar General Hospital, INC. | Bolivar, TN | $2.36M |
| Martin Health | South Fulton, TN | $1.47M |
| Lift Therapy, INC. | Jackson, TN | $778K |
| Jackson-Madison County General Hospital | Jackson, TN | $449K |
| West Tennessee Healthcare Henry County | Paris, TN | $136K |
| Jackson-Madison County General Hospital | Jackson, TN | $108K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.