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 Wisconsin for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Wisconsin 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. Wisconsin (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.

Rogers Memorial Hospital Incorporated (NPI 1053329581)

Key Findings

Field	Value
Entity Type	Organization
Organization	Rogers Memorial Hospital Incorporated
Address	34700 Valley Rd
City	Oconomowoc
State	WI
ZIP	53066
Taxonomy	Psychiatric Hospital
NPI Enumerated	August 3, 2006

Payer Source	Total Paid
Medicaid	$54.1M
Medicare	$0

ROGERS MEMORIAL HOSPITAL reports no Medicare billing on file and $54.1M in total Medicaid revenue, making its commercial/public payer footprint effectively single-payer at the Medicaid level for the data shown. The absence of Medicare activity means analysts should treat Medicaid performance as the primary indicator of the hospital’s service mix and scale.

Revenue is highly concentrated: the precomputed top-three Medicaid codes account for 93.9% of the provider’s total Medicaid revenue, with H2012 alone representing $49.2M (90.9% of Medicaid revenue). This extreme concentration signals that a single service line—behavioral health day treatment billed hourly—is the dominant revenue driver for the facility.

The code mix and code descriptions point to an operational focus on intensive behavioral health programming combined with inpatient psychiatric care. High-volume H2012 (behavioral health day treatment, per hour) paired with substantial hospital E/M codes (for example, 99232 at $735.5K and 99239 at $705.5K) suggest the entity runs a large day-treatment/partial hospitalization program alongside significant inpatient or observation psychiatric services.

Competitive standing in-state is dominant for the core day-treatment service: H2012 ranks #1 of 52 providers in Wisconsin at the 100th percentile and is labeled an extreme outlier, indicating this hospital operates at a scale for day-treatment that is far above typical state volume. Similarly, 90792 (psychiatric evaluation with medical services) ranks #2 of 168 at the 99th percentile and is also an extreme outlier, reinforcing a leadership position in diagnostic/initial psychiatric evaluations.

Inpatient and observation evaluation-and-management activity is also far above typical peer levels: 99232 ranks #4 of 242 (99th percentile, extreme outlier), 99239 ranks #2 of 117 (99th percentile, extreme outlier), and 99233 ranks #5 of 173 (98th percentile, notably above typical). These rank patterns indicate the hospital is a major provider of inpatient/observation psychiatric E/M services in the state, not just a modest participant.

Although the Medicaid portfolio is dominated by high-volume facility-level behavioral health billing, a range of other psychiatric and E/M codes are present, including outpatient visits (99214, 99215), consultations (99254, 99253), and family psychotherapy (90847). Several of these codes show above-typical statewide placement (for example, 99254 ranks #1 of 21 at the 100th percentile), indicating the hospital offers a full continuum of behavioral health services beyond day treatment alone.

There are programmatic or billing anomalies that merit attention: H0035 (mental health partial hospitalization, less than 24 hours) shows 503 claims but $0 revenue, and 99418 shows 23 claims with $0 revenue. These zero-dollar paid-claim lines could reflect non-covered entries, contractual zero-dollar passes, or reporting artifacts and should be reviewed before drawing conclusions about service availability or utilization.

The provider’s NPI was enumerated on 2006-08-03 (noted as ~20 years ago), indicating long-standing enrollment and operational tenure in the Medicare/Medicaid ecosystem. That tenure, combined with sustained high-volume Medicaid billing for behavioral health codes, suggests an established programmatic footprint in the state’s psychiatric services market.

Medicaid: Complete Services Breakdown

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

24 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2012	Behavioral health day treatment, per hour	400,130	$120	$49.2M
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	10,820	$80	$909K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	45,970	$20	$735.5K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	15,340	$50	$705.5K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	22,040	$30	$595.1K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	19,050	$30	$552.5K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	9,170	$40	$403.3K
99253	The provider sees a patient for an inpatient or observation consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	9,270	$30	$268.7K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	1,830	$90	$169.7K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	3,240	$40	$116.5K

Showing 1–10 of 24

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wisconsin Distribution

Rogers Memorial Hospital Incorporated — 9 of 22 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

24 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2012	Behavioral health day treatment, per hour	1	50	8,810	$110	$2.2M
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	66	1,630	270	$40	$205.3K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	405	1,760	250	$40	$173.2K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	37	350	210	$60	$95.8K
99253	The provider sees a patient for an inpatient or observation consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	2	10	160	$40	$94.4K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	5	170	240	$20	$68.9K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	2	170	110	$80	$62.4K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	4	240	420	$10	$58.8K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	61	140	340	$30	$49.2K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	8	70	260	$70	$46.2K

Showing 1–10 of 24

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Prader Willi Homes Of Oconomowoc LLC	WI	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$6.2M
Genesee Community Services, LLC	WI	Community/Behavioral Health Agency	$0	$5.4M
Aurora Health Care Southern Lakes, Inc.	WI	General Acute Care Hospital	$0	$4.5M
John Bitner	WI	Dentist	$0	$3.6M
Bethany Christian Services	WI	Substance Abuse Rehabilitation Facility	$0	$3.3M
Prohealth Oconomowoc Memorial Hospital, Inc.	WI	General Acute Care Hospital	$0	$2.3M
Oconomowoc Area School District	WI	Local Education Agency (LEA)	$0	$1.9M
Kpi,inc	WI	Home Health Agency	$0	$1.3M
Kimberly Ireland	WI	Ophthalmology Physician	$1M	$0
Western Lakes Fire District	WI	Land Ambulance	$426.3K	$395.5K

Rogers Memorial Hospital Incorporated — 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