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

Why is the Medicaid comparison limited to South Dakota 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. South Dakota (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.

Abbott House, Inc. (NPI 1053526673)

Field	Value
Entity Type	Organization
Organization	Abbott House, Inc.
Address	909 Court Merrill St
City	Mitchell
State	SD
ZIP	57301
Taxonomy	Psychiatric Residential Treatment Facility
NPI Enumerated	May 14, 2007

Payer Source	Total Paid
Medicaid	$28.1M
Medicare	$0

Key Findings

ABBOTT HOUSE, INC. is effectively a Medicaid-focused Psychiatric Residential Treatment Facility: reported Total Medicare revenue is none (no Medicare billing on file) while Total Medicaid revenue is $28.1M, indicating near-exclusive reliance on Medicaid for billed services. This payer mix makes the facility a single-payer operation in practice rather than a mixed Medicare/Medicaid provider.

Revenue is highly concentrated in a single Medicaid service line: the precomputed top 3 Medicaid codes account for 100.0% of this provider's total Medicaid revenue, and the listed code T2048 alone is reported as $28.1M (100.0% of Medicaid revenue). That concentration means the organization’s financial profile is driven by a narrow set of covered behavioral-health residential services.

The dominant code, T2048, describes long-term residential behavioral health care with room and board, per diem. The presence of T2048 as the sole revenue driver aligns with an operating model built around extended non-acute residential stays (typically longer than 30 days) rather than short-term outpatient or crisis services, suggesting care delivery is focused on long-stay youth or adult psychiatric residential treatment.

Unit-level billing shows 3.7K claims for T2048 with an average paid per claim of $7601, which is consistent with per-diem plus room-and-board reimbursement that yields high per-claim payments. This claim and pricing pattern reinforces that revenue is driven by extended-length episodes rather than high-volume, low-unit-cost encounters.

Competitive standing within the state is modest: T2048 revenue ranks #4 of 8 providers in-state and sits at the 57th percentile, characterized in the source as typical, unremarkable volume for this code. That position indicates the provider is neither a market leader nor an outlier in South Dakota for long-term residential behavioral-health services, but occupies a mid-market slot among peers.

Operationally, the combination of long tenure and concentrated Medicaid exposure is notable: the NPI was enumerated 2007-05-14 (~19 years ago), showing established presence in the market, while dependence on a single Medicaid-heavy code mix leaves the provider sensitive to Medicaid rate changes, per-diem policy adjustments, or shifts in state behavioral-health contracting. Stakeholders should consider both the stability implied by longevity and the business risk from limited service diversification.

Medicaid: Complete Services Breakdown

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

1 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2048	Behavioral health; long-term care residential (non-acute care in a residential treatment program where stay is typically longer than 30 days), with room and board, per diem	3,700	$7,600	$28.1M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Dakota Distribution

Abbott House, Inc. — 0 of 1 code billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. South Dakota median

1 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2048	Behavioral health; long-term care residential (non-acute care in a residential treatment program where stay is typically longer than 30 days), with room and board, per diem	4	10	3,270	$1,840	$23.2M

Nearby Providers

Other providers in the same ZIP code as Abbott House, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lifequest	SD	Developmentally Disabled Services Day Training Agency	$0	$53.1M
Lifequest	SD	Case Manager/Care Coordinator	$0	$13.2M
Dakota Counseling Institute, Inc.	SD	Mental Health Counselor	$0	$9.7M
Dakota Solace Home Care	SD	In Home Supportive Care Agency	$0	$4.9M
Rural Health Care, Inc	SD	Federally Qualified Health Center (FQHC)	$0	$4.4M
Rosewood Court	SD	Assisted Living Facility	$0	$2.7M
Avera Queen Of Peace	SD	Critical Access Hospital	$0	$1.3M
Sanford Clinic	SD	Obstetrics & Gynecology Physician	$0	$1.2M
Dpt Inc	SD	Home Health Agency	$0	$835.1K
Avera Queen Of Peace	SD	Rural Acute Care Hospital	$0	$803.8K

Abbott House, Inc. — Billing Profile & Reimbursement Data

Sign up for Abbott House, Inc. — Billing Profile & Reimbursement Data policy alerts

Abbott House, Inc. — Billing Profile & Reimbursement Data

Sign up for Abbott House, Inc. — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References