Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Montana for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Montana only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Montana (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

West Mont (NPI 1043421902)

Field	Value
Entity Type	Organization
Organization	West Mont
Address	2708 Bozeman Ave
City	Helena
State	MT
ZIP	59601
Taxonomy	Adult Care Home Facility
NPI Enumerated	May 24, 2007

Payer Source	Total Paid
Medicaid	$34.7M
Medicare	$0

Key Findings

WEST MONT is effectively a single-payer Medicaid provider: there is no Medicare billing on file, and its lifetime Medicaid revenue is $34.7M, indicating that Medicaid funds drive nearly all of its reimbursed activity. This profile suggests payers should treat it as a Medicaid-focused operation rather than a mixed Medicare/Medicaid facility.

Revenue is highly concentrated in a very small set of codes: the precomputed top 3 Medicaid codes account for 94.2% of the provider’s total Medicaid revenue. Those three codes are T2017 at $23.9M (68.9%), T2021 at $6.1M (17.7%), and S5100 at $2.6M (7.5%), so programmatic shifts affecting these codes would materially change the provider’s topline.

The code mix points to a residential and day habilitation business model: T2017 (habilitative residential waiver), T2021 (day habilitation, waiver), and S5100 (adult day care services) together drive the bulk of revenue, which is consistent with an Adult Care Home Facility offering waiver-funded residential habilitation plus day services. This pattern implies operations centered on long-term residential supports and daytime habilitation programming rather than episodic medical care.

Despite the “typical, unremarkable volume” label attached in the source, WEST MONT is a major in-state provider for residential habilitation: it ranks #3 of 21 providers statewide for T2017 and sits in the 90th percentile for that code. That high state rank for the single largest revenue driver ($23.9M) signals substantial market share in residential habilitation within Montana.

For day habilitation and adult day services the competitive picture is mixed: T2021 is $6.1M and ranks #8 of 45 (84th percentile), indicating above-typical statewide activity but not dominance, while S5100 is $2.6M and ranks #3 of 5 (50th percentile), reflecting modest participation among a small set of providers. Together these positions suggest strength in day habilitation relative to many peers but only moderate presence in the narrower adult day service market.

Non-emergency transportation is a notable operational component by encounter volume even though it accounts for a small share of revenue: T2002 shows 2.2K claims for $256.9K (0.7% of revenue) and T2003 shows 5.9K claims for $206.3K (0.6% of revenue). T2003 ranks #3 of 39 in-state and is labeled as notably above typical state volume, suggesting WEST MONT supplies a high number of transportation encounters that support its residential/day programs despite limited revenue per claim.

The provider’s NPI was enumerated on 2007-05-24 (~19 years ago), indicating long tenure and an established operating history in the state; combined with $34.7M in lifetime Medicaid revenue, this tenure supports the view of a stable, established Medicaid waiver services provider.

Concentration risk is material: with 94.2% of Medicaid revenue coming from three waiver- and day-service codes, WEST MONT’s financial performance is highly sensitive to Medicaid payment rate changes, waiver policy adjustments, or shifts in referral patterns for T2017, T2021, and S5100. The absence of Medicare billing further limits revenue diversification and increases exposure to state Medicaid program dynamics.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2017	Habilitation, residential, waiver; 15 minutes	4,380	$5,450	$23.9M
T2021	Day habilitation, waiver; per 15 minutes	4,970	$1,240	$6.1M
S5100	Day care services, adult; per 15 minutes	1,530	$1,710	$2.6M
T2032	Residential care, not otherwise specified (nos), waiver; per month	1,150	$870	$1M
H2025	Ongoing support to maintain employment, per 15 minutes	940	$590	$555.9K
T2002	Non-emergency transportation; per diem	2,180	$120	$256.9K
T2003	Non-emergency transportation; encounter/trip	5,890	$40	$206.3K

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Montana providers billing the same CPT/HCPCS codes.

Claims Volume vs. Montana Distribution

West Mont — 0 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. Montana median

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2017	Habilitation, residential, waiver; 15 minutes	3	20	2,530	$4,970	$13.2M
T2021	Day habilitation, waiver; per 15 minutes	8	50	1,630	$1,010	$2.6M
S5100	Day care services, adult; per 15 minutes	3	10	1,530	$440	$2M
T2032	Residential care, not otherwise specified (nos), waiver; per month	10	20	1,120	$830	$1M
H2025	Ongoing support to maintain employment, per 15 minutes	8	20	940	$590	$609.8K
T2002	Non-emergency transportation; per diem	7	30	1,440	$110	$141.5K
T2003	Non-emergency transportation; encounter/trip	3	40	2,180	$30	$78K

Related Providers

Other providers that share a Tax Identification Number (TIN) with West Mont, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Benefis Hospitals Inc	MT	Multi-Specialty Clinic/Center	$0	$38.2M
Union Associated Physicians Clinic, LLC	IN	Family Medicine Physician	$0	$31.1M
Benefis Hospitals, Inc.	MT	Air Ambulance	$0	$5.2M
Benefis Hospitals, Inc.	MT	General Acute Care Hospital	$0	$3.5M
Syed Akbar	IL	Diagnostic Radiology Physician	$280.8K	$223.7K
Michele Degregorio	MI	Cardiovascular Disease Physician	$436.4K	$0
David Reisman	NH	Hematology & Oncology Physician	$366.8K	$0
James Haug	CO	Diagnostic Radiology Physician	$326.9K	$0
Noman Malik	GA	Diagnostic Radiology Physician	$326.1K	$0
Scott Pargot	MT	Otolaryngology Physician	$57.3K	$263.5K

Nearby Providers

Other providers in the same ZIP code as West Mont, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Intermountain Deaconess Home	MT	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$11.9M
County Of Lewis & Clark Lewis & Clark County School District #1	MT	Local Education Agency (LEA)	$0	$10.8M
Pediatric Dentistry PC	MT	Pediatric Dentistry	$0	$9.9M
Montana Children's Home & Hospital	MT	General Acute Care Hospital	$0	$8.7M
Region Iv Family Outreach, Inc	MT	Case Manager/Care Coordinator	$0	$7.3M
Lewis And Clark Emergency Physicians P C	MT	Emergency Medicine Physician	$0	$6.6M
Montana Independent Living Project	MT	In Home Supportive Care Agency	$0	$6M
St. Peter's Health	MT	Family Medicine Physician	$0	$5.2M
Edgewood Helena Senior Living LLC	MT	Assisted Living Facility	$0	$4.7M
Montana Surgery Center	MT	Ambulatory Surgical Clinic/Center	$0	$4.6M

West Mont — Billing Profile & Reimbursement Data

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West Mont — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References