Agency
Pathway Living Center, INC.
Pathway Living Center, INC. was paid $6.20M by Medicaid between Jan 2018 and Aug 2024, across 3 billing codes. Its largest line is H2016, community support for mental illness or disability, billed per day — 97% of everything it billed.
33Billing provider infoPATHWAY LIVING CENTER, INC.
CLINTON, IA 52732
CLINTON, IA 52732
33aNPI1528272689assigned 05/09/2007
33bProvider typeCommunity/Behavioral Health Agency
28Total paid$6.20M
24GClaims68,671
24DCodes billed3
24AFirst – last monthJan 2018 – Aug 2024
Compared with peers
Next to other Community/Behavioral Health Agency providers in Iowa
Rank by total paid#43 of 134
Median peer was paid$2.44M
This provider vs. median2.5×
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.
Single-Code Concentration97% of spending on code H2016 with only 3 total codes billed. Highly concentrated billing profile.
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 | 11,716 | $950K | |
| 2019 | 13,024 | $1.02M | |
| 2020 | 9,303 | $844K | |
| 2021 | 9,229 | $815K | |
| 2022 | 9,885 | $907K | |
| 2023 | 9,415 | $900K | |
| 2024incomplete | 6,099 | $756K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| H2016 | Community support for mental illness or disability, billed per dayComprehensive community support services, per diem | 97% | 62,059 | 4,529 | $6.02M |
| T2021 | Day program for adults with developmental disabilities, per 15 minutesDay habilitation, waiver; per 15 minutes | 2.7% | 6,408 | 1,694 | $167K |
| T2020 | Day habilitation, waiver; per diem | <1% | 204 | 143 | $12K |
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 officialPETERSON, MELISSA (EXECUTIVE DIRECTOR)