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

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

Preferred Family Healthcare (NPI 1124560248)

Field	Value
Entity Type	Organization
Organization	Preferred Family Healthcare
Address	900 E Laharpe St
City	Kirksville
State	MO
ZIP	63501
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	November 7, 2016

Payer Source	Total Paid
Medicaid	$134.5M
Medicare	$0

Key Findings

PREFERRED FAMILY HEALTHCARE is effectively a Medicaid-focused community behavioral health agency: there is no Medicare billing on file while total Medicaid revenue is $134.5M, indicating the organization’s operations and reimbursement footprint are concentrated entirely within Medicaid programs. The provider’s NPI was enumerated on 2016-11-07 (~10 years ago), so this Medicaid-dominant billing profile has been built over roughly a decade of enrollment.

Revenue is extremely concentrated in a single Medicaid per-diem behavioral health service: T1040 accounts for $133.9M of Medicaid revenue (99.5% of the provider’s total Medicaid revenue) across 592.3K claims at an average paid/claim of $226. This concentration shows the organization primarily bills for Medicaid certified community behavioral health clinic services on a per-diem basis rather than a broad mix of fee-for-service psychotherapy or E/M revenue.

Top non-per-diem psychotherapy and E/M codes together contribute only a sliver of revenue: 90834 ($206.7K), 90837 ($147.8K) and 90832 ($112K) are present but represent 0.2%–0.1% slices of total Medicaid revenue, indicating that individual psychotherapy sessions and standard E/M visits are ancillary to the provider’s dominant per-diem clinic model. The large claim counts for these codes (e.g., 29.5K claims for 90834) with low average paid/claim suggest these are high-volume, low-payment encounters compared with the T1040 per-diem revenue.

Competitive standing in-state for the T1040 per-diem is moderate: the provider ranks #7 of 31 in Missouri (80th percentile) for T1040 volume, which positions it as a typical to solid participant among certified community behavioral health clinic service providers rather than the statewide leader. For several psychotherapy codes (90834, 90837, 90832) the provider ranks at very high percentiles (100th, 98th, 99th respectively), meaning it bills substantially more of those specific services than most in-state peers even though those services contribute little to total revenue.

Service-line implications: the code mix (dominant T1040 per-diem plus numerous behavioral health H-codes and psychotherapy CPTs) is consistent with a multi-service community behavioral health operation that bills day programs, intensive outpatient services, and both individual and group psychotherapy. The presence of many H-codes with large claim counts but $0 reported average paid/claim (e.g., H0036, H0005, H2017) suggests substantial use of service codes that are either paid differently, bundled into per-diem payments, or reported separately for utilization tracking rather than driving direct fee-for-service revenue.

Payer mix and strategic inference: with no Medicare revenue reported and $134.5M in Medicaid revenue, the provider is functionally single-payer in terms of billed reimbursement; any strategic or network relationships are likely centered on Medicaid managed care and state behavioral health program contracting rather than Medicare fee-for-service arrangements. This profile bears on contract negotiations and risk arrangements where Medicaid is the primary revenue source.

Statistical outliers and high-volume exceptions are present: 90834 is characterized as “notably above typical” state volume (rank #5 of 1059, 100th percentile) and 90837 as an “extreme outlier” (rank #8 of 439, 98th percentile). Those high percentile ranks indicate unusually large volumes for specific psychotherapy services relative to most in-state providers, even though they remain small contributors to overall Medicaid revenue due to low paid/claim amounts.

Medicaid: Complete Services Breakdown

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

37 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1040	Medicaid certified community behavioral health clinic services, per diem	592,310	$230	$133.9M
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	29,520	$10	$206.7K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	12,310	$10	$147.8K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	18,670	$10	$112K
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…	13,890	$10	$97.2K
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…	15,600	$1	$31.2K
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…	1,280	$20	$30.8K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	2,400	$10	$21.6K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	1,250	$1	$2.5K
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…	440	$1	$1.8K

Showing 1–10 of 37

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Missouri Distribution

Preferred Family Healthcare — 6 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. Missouri median

37 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1040	Medicaid certified community behavioral health clinic services, per diem	7	30	198,100	$260	$125.7M
H0037	Community psychiatric supportive treatment program, per diem	18	20	56,420	$120	$11.7M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	11	20	214,040	$20	$10.8M
H2036	Alcohol and/or other drug treatment program, per diem	5	10	17,770	$200	$7.4M
H2015	Comprehensive community support services, per 15 minutes	3	20	4,550	$50	$2.5M
H2017	Psychosocial rehabilitation services, per 15 minutes	6	20	40,460	$20	$2M
H2012	Behavioral health day treatment, per hour	6	10	33,050	$30	$1.9M
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	2	10	1,150	$160	$1.4M
H0001	Alcohol and/or drug assessment	2	10	380	$280	$1.1M
H0004	Behavioral health counseling and therapy, per 15 minutes	4	40	3,680	$30	$978K

Showing 1–10 of 37

Nearby Providers

Other providers in the same ZIP code as Preferred Family Healthcare, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Chariton Valley Association, Inc.	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$27.2M
State Of Missouri	MO	Developmentally Disabled Services Day Training Agency	$0	$11.1M
Rural Advocates For Independent Living	MO	Community Based Hospice Care Agency	$0	$10.2M
Chariton Valley Association, Inc.	MO	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$9.1M
Adair County Sb40 Developmental Disability Board	MO	Case Management Agency	$0	$8.5M
Kirksville Missouri Hospital Company, LLC	MO	General Acute Care Hospital	$0	$8M
Northeast Missouri Area Agency On Aging	MO	Voluntary or Charitable Agency	$0	$6.5M
Ellendel Isl LLC	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$6.2M
Hannibal Regional Healthcare System, Inc	MO	Multi-Specialty Clinic/Center	$0	$4.5M
Northeast Missouri Health Council, Inc.	MO	Federally Qualified Health Center (FQHC)	$0	$3.5M

Preferred Family Healthcare — Billing Profile & Reimbursement Data

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Preferred Family Healthcare — 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

Nearby Providers

Frequently Asked Questions

References