Hospital
Pathways of Tennessee, INC.
Pathways of Tennessee, INC. was paid $3.30M by Medicaid between Jan 2018 and Nov 2024, across 24 billing codes. Its largest line is S0280, Medical home program, comprehensive care coordination and planning, initial plan — 56% of everything it billed.
33Billing provider infoPATHWAYS OF TENNESSEE, INC.
JACKSON, TN 38301
JACKSON, TN 38301
33aNPI1780789115assigned 09/13/2006
33bProvider typePsychiatric Hospital
28Total paid$3.30M
24GClaims75,199
24DCodes billed24
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Psychiatric Hospital providers in Tennessee
Rank by total paid#3 of 15
Median peer was paid$356K
This provider vs. median9.3×
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.
Entity ProliferationAuthorized official PRESCOTT, TINA controls 17+ related entities in our dataset. Read more
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 | 6,558 | $283K | |
| 2019 | 25,847 | $1.06M | |
| 2020 | 27,924 | $1.15M | |
| 2021 | 11,148 | $486K | |
| 2022 | 1,359 | $119K | |
| 2023 | 1,305 | $112K | |
| 2024incomplete | 1,058 | $93K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| S0280 | Medical home program, comprehensive care coordination and planning, initial plan | 56% | 16,305 | 10,666 | $1.86M |
| S9480 | Intensive outpatient psychiatric services, per diem | 24% | 8,966 | 1,500 | $805K |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 11% | 9,659 | 7,139 | $370K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 5.2% | 6,518 | 6,152 | $172K |
| 90791 | Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation | 1.3% | 683 | 623 | $42K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | <1% | 993 | 846 | $26K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 581 | 525 | $12K |
| 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 | <1% | 337 | 312 | $9K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | <1% | 184 | 182 | $6K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | <1% | 61 | 26 | $2K |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 37 | 37 | $1K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 13 | 13 | $163.80 |
12 more codes
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 28 | $20.00 |
| G9004 | Coordinated care fee, risk adjusted low, initial | 0% | 3,867 | $0.00 |
| G9010 | Coordinated care fee, risk adjusted maintenance, level 4 | 0% | 8,427 | $0.00 |
| S9485 | Crisis intervention mental health services, per diem | 0% | 1,405 | $0.00 |
| G9011 | Coordinated care fee, risk adjusted maintenance, level 5 | 0% | 1,517 | $0.00 |
| 3078F | 0% | 15 | $0.00 | |
| 80305 | 0% | 18 | $0.00 | |
| G9005 | Coordinated care fee, risk adjusted maintenance | 0% | 8,642 | $0.00 |
| G9007 | Coordinated care fee, scheduled team conference | 0% | 4,104 | $0.00 |
| G9006 | Coordinated care fee, home monitoring | 0% | 2,548 | $0.00 |
| 3008F | 0% | 278 | $0.00 | |
| 3074F | 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.
From NPPES
Who's on the registration
Authorized officialPRESCOTT, TINA (PRESIDENT AND CEO)
| Provider | Location | Paid |
|---|---|---|
| Jackson Madison County General Hospital | Jackson, TN | $46.51M |
| Pathways of Tennessee, INC. | Jackson, TN | $30.54M |
| 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 |
| 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.