Pyramid Healthcare INC.
Pyramid Healthcare INC. was paid $11.01M by Medicaid between Aug 2020 and Dec 2024, across 16 billing codes. Its largest line is H0015, Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education — 62% of everything it billed.
ALLENTOWN, PA 18104
Next to other Substance Use Disorder Rehabilitation Clinic/Center providers in Pennsylvania
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 | |
|---|---|---|---|
| 2020 | 9,767 | $403K | |
| 2021 | 32,316 | $1.97M | |
| 2022 | 31,198 | $3.28M | |
| 2023 | 22,934 | $2.68M | |
| 2024incomplete | 20,412 | $2.69M |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| H0015 | Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education | 62% | 62,933 | 10,749 | $6.78M |
| H0035 | Mental health partial hospitalization, treatment, less than 24 hours | 11% | 6,408 | 809 | $1.16M |
| H2035 | Alcohol and/or other drug treatment program, per hour | 7.0% | 4,953 | 632 | $770K |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 5.8% | 11,545 | 6,718 | $634K |
| 90792 | Psychiatric diagnostic evaluation with medical services | 4.1% | 3,733 | 3,477 | $453K |
| 90853 | Group psychotherapy (other than of a multiple-family group) | 3.4% | 7,386 | 3,588 | $374K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 3.1% | 9,179 | 6,696 | $340K |
| H0047 | Alcohol and/or other drug abuse services, not otherwise specified | 2.2% | 4,828 | 2,166 | $245K |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | 1.3% | 1,462 | 1,242 | $144K |
| 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% | 673 | 584 | $44K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 485 | 446 | $25K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | <1% | 893 | 676 | $21K |
4 more codes
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 |
|---|---|---|
| Pyramid Health Care INC. | Wilkinsburg, PA | $128.75M |
| Pyramid Healthcare | Belleville, PA | $87.33M |
| Pyramid Healthcare, INC. | Newport News, VA | $40.65M |
| Pyramid Walden LLC | Charlotte Hall, MD | $27.53M |
| October Road INC. | Asheville, NC | $24.64M |
| Pyramid Health Care INC. | Duncansville, PA | $23.92M |
| Mountaineer Behavioral Health | Kearneysville, WV | $20.46M |
| Pyramid Walden, LLC | Joppa, MD | $16.70M |
| Pyramid Healthcare INC. | Altoona, PA | $14.30M |
| Pyramid Healthcare INC. | Altoona, PA | $13.25M |
| October Road, INC. | Mars Hill, NC | $10.82M |
| Pyramid Healthcare INC. | East Stroudsburg, PA | $10.38M |
| Pyramid Healthcare INC. | Langhorne, PA | $8.62M |
| Pyrmaid Healthcare INC. | York, PA | $8.19M |
| Pyramid Healthcare INC | Gibsonia, PA | $8.17M |
| Pyramid Healthcare, INC. | Radford, VA | $7.68M |
| Pyramid Walden, LLC | California, MD | $4.79M |
| Pyramid Healthcare INC. | Quakertown, PA | $4.16M |
| October Road, INC. | Asheville, NC | $3.63M |
| Pyramid Healthcare INC. | Tyrone, PA | $3.47M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.