Coastal Medical Associates

Coastal Medical Associates was paid $9.95M by Medicaid between Jan 2018 and Dec 2024, across 53 billing codes. Its largest line is 99285, emergency room visit (most serious) — 55% of everything it billed.

33Billing provider infoCOASTAL MEDICAL ASSOCIATES
WEYMOUTH, MA 02190

33aNPI1932175684assigned 02/23/2006

33bProvider typeAddiction (Substance Use Disorder) Counselor

28Total paid$9.95M

24GClaims174,882

24DCodes billed53

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Addiction (Substance Use Disorder) Counselor providers in Massachusetts

Rank by total paid#4 of 118

Median peer was paid$56K

This provider vs. median178×

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	17,195	$899K
2019	20,631	$1.03M
2020	19,525	$1.11M
2021	23,740	$1.31M
2022	23,404	$1.36M
2023	38,990	$2.29M
2024incomplete	31,397	$1.96M

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99285	Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life	55%	67,180	66,519	$5.45M
99284	Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity	15%	25,692	25,505	$1.50M
99232	Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity	5.6%	24,353	11,398	$555K
99233	Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m	5.4%	16,147	8,044	$542K
99223	Prolong inpt eval add15 m	5.0%	6,524	6,399	$501K
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	2.8%	4,043	3,563	$276K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	2.2%	6,233	5,230	$222K
99239	Hospital discharge day management, more than 30 minutes	2.1%	5,495	5,412	$207K
99222	Initial hospital care, per day, moderate complexity	1.5%	2,639	2,601	$149K
76816	Ultrasound, pregnant uterus, real time with image documentation, follow-up	1.1%	3,280	3,105	$106K
76819	Fetal biophysical profile; without non-stress testing	<1%	2,634	2,126	$77K
99291	Critical care, evaluation and management of the critically ill patient, first 30-74 minutes	<1%	840	692	$71K

41 more codes

11042	Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm	<1%	2,540	$51K
76811	Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed	<1%	512	$37K
90791	Psychiatric diagnostic evaluation	<1%	321	$36K
99283	Emergency room visit (moderate)	<1%	889	$28K
99238	Hospital discharge day management, 30 minutes or less	<1%	569	$19K
90832	Psychotherapy session, about 30 minutes	<1%	464	$19K
90792	Psychiatric diagnostic evaluation with medical services	<1%	345	$18K
76813		<1%	311	$14K
99454		<1%	438	$12K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	585	$9K
90837	Psychotherapy session, about an hour	<1%	58	$7K
99221		<1%	198	$7K
99220		<1%	91	$5K
01967	Neuraxial labor analgesia/anesthesia for planned vaginal delivery	<1%	19	$4K
99231	Subsequent hospital care, per day, straightforward or low complexity	<1%	274	$4K
99217		<1%	131	$4K
97597		<1%	330	$4K
99204	Doctor's office visit, new patient (more involved)	<1%	53	$4K
76942		<1%	147	$3K
59025	Fetal non-stress test	<1%	53	$2K
00731		<1%	29	$1K
01810		<1%	22	$1K
99453		<1%	160	$1K
76705	Ultrasound, abdominal, real time with image documentation; limited	<1%	52	$890.71
90834	Psychotherapy session, about 45 minutes	<1%	12	$833.75
99203	Doctor's office visit, new patient (routine)	<1%	13	$632.46
62323		<1%	33	$623.00
90853	Group psychotherapy (other than of a multiple-family group)	<1%	20	$614.20
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	<1%	60	$532.95
76817	Ultrasound, pregnant uterus, real time with image documentation, transvaginal	<1%	16	$474.72
99219		<1%	13	$466.12
99215	Doctor's office visit, returning patient (complex)	<1%	14	$246.36
93308		<1%	12	$179.82
94060		<1%	14	$88.86
94726		<1%	15	$85.14
99447		<1%	13	$81.28
94729		<1%	15	$63.18
96127		<1%	88	$61.62
G8950	Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented	0%	12	$0.00
G8952	Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given	0%	12	$0.00
G9744	Patient not eligible due to active diagnosis of hypertension	0%	869	$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 officialCAPUTO, MARIANNE (PROVIDER ENROLLMENT SUPERVISOR)