Prairie Ridge Integrated Behavioral Healthcare

Prairie Ridge Integrated Behavioral Healthcare was paid $24.22M by Medicaid between Jan 2018 and Dec 2024, across 30 billing codes. Its largest line is H0018, Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem — 34% of everything it billed.

33Billing provider infoPRAIRIE RIDGE INTEGRATED BEHAVIORAL HEALTHCARE
MASON CITY, IA 50401

33aNPI1952443632assigned 02/12/2007

33bProvider typeAddiction (Substance Use Disorder) Counselor

28Total paid$24.22M

24GClaims260,652

24DCodes billed30

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

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

Rank by total paid#1 of 37

Median peer was paid$124K

This provider vs. median196×

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	28,798	$2.52M
2019	31,030	$2.92M
2020	34,821	$2.79M
2021	40,680	$3.43M
2022	43,984	$3.61M
2023	48,271	$4.77M
2024incomplete	33,068	$4.19M

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	34%	46,848	3,488	$8.29M
99490	Ccm add 20min	22%	34,175	30,742	$5.35M
90834	Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient	15%	40,281	23,321	$3.62M
90853	Group psychotherapy (other than of a multiple-family group)	10%	46,334	10,371	$2.54M
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	4.3%	17,480	14,582	$1.05M
H0040	Assertive community treatment program, per diem	3.5%	14,945	777	$842K
90791	Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation	3.0%	6,351	6,128	$738K
90792	Psychiatric diagnostic evaluation with medical services	2.5%	3,327	3,111	$613K
Q3014	Telehealth originating site facility fee	1.1%	14,602	12,870	$273K
90832	Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient	1.0%	5,390	4,226	$245K
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%	5,351	4,333	$222K
99204	Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	<1%	1,241	1,151	$160K

18 more codes

99215	Doctor's office visit, returning patient (complex)	<1%	1,250	$136K
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	<1%	607	$56K
90837	Psychotherapy session, about an hour	<1%	518	$49K
99205	Prolong outpt/office vis	<1%	109	$20K
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	<1%	1,664	$5K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	113	$4K
99203	Doctor's office visit, new patient (routine)	<1%	52	$4K
T1016	Case management, each 15 minutes	<1%	430	$2K
90847	Family psychotherapy with the patient present, 50 minutes	<1%	16	$1K
99308	Subsequent nursing facility care, per day, straightforward	<1%	39	$258.08
99439		<1%	2,204	$199.09
G0506	Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)	<1%	2,765	$57.34
H0038	Self-help/peer services, per 15 minutes	<1%	5,221	$25.02
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	0%	2,238	$0.00
G9008	Coordinated care fee, physician coordinated care oversight services	0%	5,730	$0.00
G2065	Comprehensive care management for a single high-risk disease services, e.g. principal care management, at least 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month with the following elements: one complex chronic condition lasting at least 3 months, which is the focus of the care plan, the condition is of sufficient severity to place patient at risk of hospitalization or have been cause of a recent hospitalization, the condition requires development or revision of disease-specific care plan, the condition requires frequent adjustments in the medication regimen, and/or the management of the condition is unusually complex due to comorbidities	0%	318	$0.00
G2058	Chronic care management services, each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (list separately in addition to code for primary procedure). (do not report g2058 for care management services of less than 20 minutes additional to the first 20 minutes of chronic care management services during a calendar month). (use g2058 in conjunction with 99490). (do not report 99490, g2058 in the same calendar month as 99487, 99489, 99491)).	0%	343	$0.00
99426		0%	710	$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 officialHANSEN, JAY (EXECUTIVE DIRECTOR)