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Hospital Profile Psychiatric Hospital Voluntary non-profit - Private 25 Beds · urban Updated: 3/6/2026

Pathways of Tennessee, Inc

238 Summar Dr, Jackson, TN 38301 · 10 Priced Procedures

CMS Overall Rating No CMS Rating
Pillar 1 · The BaseRate™ CompositeHow 1.00× Fair BaseRate Works: Raw price averages unfairly penalize hospitals in high-wage cities or trauma centers treating sicker patients. We adjust for local CMS hospital wage levels and patient complexity first. A 1.00× score means right at the fair price average, 0.85× means 15% cheaper than fair market, and 1.30× means 30% above fair market.Good Deal · Below Fair Market
0.48×vs. Fair Market Price
Position vs. 1.00× Fair Price52% Below Fair Price 1.00× (center of the bar) is the U.S. fair price average after accounting for local hospital wages and patient complexity. Left of center (<1.00×) is below fair price; right of center (>1.00×) is above fair price.

Typical commercial prices here are 52% below the fair benchmark (0.48×) after accounting for local nurse/doctor wages and patient complexity.

Pillar 2 · VeriRate™ Data TrustHow VeriRate™ (0–100) Works: Hospitals are legally required to publish machine-readable price files, but some bury fake $0.01 numbers or omit cash discounts. VeriRate audits each file across 5 checks (hover any badge below to see what it tests).63/100 · Caution
63/100Self-Pay Cash Beats Insurance 0% of the Time
File Completeness51Provenance (File Completeness): Checks whether the hospital published a complete, up-to-date machine-readable price file with valid CPT and MS-DRG billing codes instead of leaving blanks.
Price Logic100Coherence (Price Logic): Checks whether the hospital’s numbers make basic sense — e.g., self-pay cash price is lower than gross list price, with no fake $0.01 or $999,999 placeholder numbers.
Peer Alignment72Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing28Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount50Cash Honesty (Real Cash Discount): Checks whether the hospital offers a genuine self-pay cash discount that beats or matches commercial insurance rates instead of billing full sticker price.
Pillar 3 · Clinical Quality & ER SpeedChecks whether higher hospital prices actually buy better clinical quality — combining CMS Star Ratings, hospital safety scores, and emergency room wait times.Regional Value Leader
CMS Star RatingNot RatedOfficial CMS Overall Hospital Quality Star Rating (1 to 5 stars) summarizing mortality, safety of care, readmissions, and patient experience.
Safety ScoreNot ScoredComposite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER WaitNo ER DataMedian minutes patients spent in the emergency department before leaving from the visit, as reported to CMS Timely and Effective Care.

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Behavioral Pricing FingerprintLow Shoppable & Low Captive Rates

Uniform Value Leader · Low-Cost Across Departments

Pathways of Tennessee, Inc maintains low, disciplined commercial pricing across both routine shoppable procedures (0.5× Medicare, p50 0.46× Fair BaseRate) and emergency/ancillary services (0.4× Medicare, p75 0.56× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.

#1 of 84 in TN · 1st State Percentile#42 of 3,385 in U.S. · 1st National Percentile
Advantage

Where They're Good (Patient & Payer Edge)

  • Elective shoppable care is priced 52% below peer Fair BaseRate (0.48×)
  • Self-pay cash beats commercial insurance on 0% of shoppable procedures (50/100 Cash Honesty)
  • CMS clinical safety score (54/100 safety score) with 72% patient recommendation
  • IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (51.4% AGB cap)
Watchout

Where You Can Get Burned (Markup Traps)

  • Even at low-cost facilities (0.48× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
  • Commercial insurance median sits at 0.46× Fair BaseRate (0.5× Medicare), so insured patients should always compare the self-pay cash price before paying.
  • Upper-quartile procedures (Q75 0.56×) jump +22% above the median procedure ratio (Q50 0.46×)
  • Consolidated metro market (HHI 7,991) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Front-Door ShoppableElective / Imaging
0.5× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER0.80× Divergence
0.4× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+22% Upper Tail
Q25 0.39× · Q50 0.46× · Q75 0.56×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.
Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×
Front-Door Shoppable CareFront-Door Shoppable
0.5× MedicareGood
Outpatient Surgery & ORBack-Door Captive
0.6× MedicareGood
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
0.5× MedicareGood
Back-Door Captive ER VisitsBack-Door Captive
0.7× MedicareGood
Inpatient Lab & PathologyBack-Door Captive
0.7× MedicareGood
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
1.1× MedicareGood
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
0% Cash Edge · 50/100Elevated
CMS Clinical Safety & Star ValueIntegrity & Outcomes
3 CMS · 54/100Elevated

Procedure Prices at Pathways of Tennessee, Inc

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 10 published procedures.

Sort:
Audit a Bill & 501(r) Cap ↓
Procedure & Billing Code This Hospital vs. Fair
Psychiatric evaluation (first visit)
CPT Code: 90791
 $104 0.6×
Family therapy session
CPT Code: 90847
 $84 0.5×
New patient office visit (30-44 min)
CPT Code: 99203
 $71 0.6×
Office visit, established patient (20-29 min)
CPT Code: 99213
 $53 0.6×
Office visit, established patient (30-39 min)
CPT Code: 99214
 $53 0.4×
Psychotherapy session (60 minutes)
CPT Code: 90837
 $75 0.4×
Psychotherapy session (45 minutes)
CPT Code: 90834
 $64 0.4×
Community mental health services
HCPCS Code: H0038
 $17 1.1×
Group therapy session
CPT Code: 90853
 $24 0.2×
Psychological testing evaluation
CPT Code: 96136
 $20 0.2×
Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 51.4%

Audit a Bill or Quote at Pathways of Tennessee, Inc (Zero PHI Required)

CMS CCN: 444010
CPT 90791
Fair BaseRate™ $185
Medicare Rate $181
Self-Pay Cash Request Quote
Insurer Median $104
Pre-filled with Pathways of Tennessee, Inc’s charged/list benchmark
Screened against 2026 HHS Federal Poverty Guidelines
2026 FPL: $15,650 + $5,500 per additional person
Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $77 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $77

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (51.4% of gross = $77).

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Pathways of Tennessee, Inc's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target Target: $185 Fair BaseRate

Negotiate Toward $185 Fair BaseRate ($181 Medicare)

Your entered amount is at or below the modeled Fair BaseRate benchmark ($185).

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.
IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold
Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier
Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported
26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (51.4% of gross charges)

Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑
CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Pathways of Tennessee, Inc. Prior administrative notices do not necessarily reflect current compliance status.

  • 2025-02-13·administrative_or_closure

    Closure Notice

    Recorded
  • 2024-12-26·cap_corrective_action

    CAP Request

    Recorded
  • 2024-09-13·cap_corrective_action

    CAP Request

    Recorded

Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Regional Quality & Price Benchmark Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Pathways of Tennessee, Inc.

Price Index: 0.46× regional baseline
Quality: 54/100 CMS composite
Median Household Income$58,189U.S. Census ACS
Local Uninsured Share10.2%Regional ACS estimate
200% FPL (1 Person)$31,920Common free-care ceiling
400% FPL (Family of 4)$128,600Common AGB cap ceiling
45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 63/100 · Caution CMS CCN 444010

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 444010) ↗ CMS HCRIS Cost Reports ↗
Published MRF FileCMS_45_CFR_180_FILING.json
Publication / Vintage3/6/2026
Validated Rate Rows118 (CMS v3.0.0)
File Integrity DigestVerified · CCN 444010

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

Submit MRF Update Correction Policy