Montefiore Medcial Center
Montefiore Medcial Center was paid $1.09M by Medicaid between Jan 2019 and Sep 2022, across 18 billing codes. Its largest line is S9123, Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used) — 40% of everything it billed.
BRONX, NY 10466
Next to other Clinic/Center providers in New York
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.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2019 | 2,941 | $527K | |
| 2020 | 472 | $86K | |
| 2022 | 5,995 | $474K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| S9123 | Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used) | 40% | 2,427 | 662 | $434K |
| S9131 | Physical therapy; in the home, per diem | 16% | 934 | 255 | $170K |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatment program) | 16% | 788 | 404 | $170K |
| H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | 12% | 3,874 | 532 | $131K |
| G0397 | Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes | 7.8% | 520 | 338 | $85K |
| G0396 | Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes | 5.5% | 483 | 294 | $60K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.3% | 109 | 83 | $14K |
| S9127 | Social work visit, in the home, per diem | <1% | 52 | 41 | $9K |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | <1% | 18 | 18 | $6K |
| 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% | 14 | 13 | $3K |
| 80053 | Comprehensive metabolic panel | <1% | 37 | 37 | $2K |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r | <1% | 15 | 15 | $1K |
6 more codes
| 80061 | Lipid panel | <1% | 24 | $337.00 |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 19 | $126.00 |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 56 | $101.44 |
| 81001 | <1% | 13 | $19.02 | |
| 83735 | <1% | 12 | $10.06 | |
| 87636 | Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B | 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.
Who's on the registration
| Provider | Location | Paid |
|---|---|---|
| Montefiore North Ambulatory Care Center INC | Bronx, NY | $569K |
| Gun Hill Mri PC | Bronx, NY | $302K |
| Montefiore Medical Center | Bronx, NY | $14K |
| Montefiore Medical Center | Bronx, NY | $0.00 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.