Clinic
Escalera Health, LLC
Escalera Health, LLC was paid $316K by Medicaid between Apr 2019 and May 2023, across 18 billing codes. Its largest line is 90837, psychotherapy session, about an hour — 22% of everything it billed.
33Billing provider infoESCALERA HEALTH, LLC
TUCSON, AZ 85712
TUCSON, AZ 85712
33aNPI1962982397assigned 08/15/2018
33bProvider typeClinic/Center
28Total paid$316K
24GClaims8,308
24DCodes billed18
24AFirst – last monthApr 2019 – May 2023
Compared with peers
Next to other Clinic/Center providers in Arizona
Rank by total paid#36 of 89
Median peer was paid$216K
This provider vs. median1.5×
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 | |
|---|---|---|---|
| 2019 | 817 | $37K | |
| 2020 | 1,418 | $58K | |
| 2021 | 573 | $23K | |
| 2022 | 1,025 | $78K | |
| 2023 | 4,475 | $120K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | 22% | 428 | 200 | $71K |
| 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 | 18% | 1,053 | 897 | $58K |
| H2017 | Psychosocial rehabilitation, billed per 15 minutesPsychosocial rehabilitation services, per 15 minutes | 17% | 3,339 | 218 | $55K |
| H0031 | Mental health assessment, by non-physician | 6.9% | 394 | 379 | $22K |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 6.9% | 1,152 | 429 | $22K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 5.0% | 199 | 180 | $16K |
| 99222 | Initial hospital care, per day, moderate complexity | 4.8% | 169 | 162 | $15K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 4.5% | 402 | 354 | $14K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | 4.0% | 328 | 306 | $13K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 3.6% | 351 | 90 | $11K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 2.0% | 113 | 109 | $6K |
| 99223 | Prolong inpt eval add15 m | 1.8% | 38 | 37 | $6K |
6 more codes
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 84 | $2K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 68 | $2K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 33 | $1K |
| 99205 | Prolong outpt/office vis | <1% | 13 | $1K |
| 99000 | <1% | 127 | $525.13 | |
| T1016 | Case management, each 15 minutes | <1% | 17 | $188.88 |
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 officialHUDSON, EDWARD (CHIEF FINANCIAL OFFICER)
| Provider | Location | Paid |
|---|---|---|
| Escalera Health LLC | Tucson, AZ | $4.97M |
| Sunbelt Medical Group LLC | Tucson, AZ | $425K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.