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

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

Capstone Behavioral Health, Inc. (NPI 1154371748)

Key Findings

Field	Value
Entity Type	Organization
Organization	Capstone Behavioral Health, Inc.
Address	1941 S 42nd St
City	Omaha
State	NE
ZIP	68105
Taxonomy	Mental Health Counselor
NPI Enumerated	May 12, 2006

Payer Source	Total Paid
Medicaid	$5M
Medicare	$0

This provider is effectively single‑payer: total Medicaid revenue is $5M and there is no Medicare billing on file. The absence of Medicare activity combined with $5M of Medicaid receipts indicates the practice’s commercial footprint is concentrated in the Medicaid population rather than traditional Medicare beneficiaries.

Revenue is heavily concentrated in three psychotherapy codes: 90834, 90837, and 90832. Precomputed data show the top 3 Medicaid codes account for 79.4% of total Medicaid revenue, with 90834 contributing $2.2M (44.5%), 90837 $1.1M (22.7%), and 90832 $611.5K (12.2%), signaling a narrow set of high‑yield services driving the business.

The code mix and descriptions indicate a core operation built around individual outpatient psychotherapy across standard session lengths. High volumes of 90834 (38–52 minutes), 90837 (53+ minutes), and 90832 (16–37 minutes) show the practice primarily delivers individual psychotherapy, supported by substantial billing for initial psychiatric evaluations (90791) and a range of psychological testing codes (96130 series).

On competitive standing for psychotherapy, this provider is a high‑volume, above‑typical statewide performer. 90834 ranks #4 of 510 providers in‑state (99th percentile; extreme outlier) and 90832 ranks #2 of 128 (99th percentile; extreme outlier), while 90837 ranks #10 of 511 (98th percentile; notably above typical state volume), indicating dominant relative scale for individual psychotherapy in Nebraska.

The provider is also the leading in‑state reporter for psychiatric evaluations: 90791 generated $526.6K (10.5% of Medicaid revenue) and ranks #1 of 154 providers in‑state (100th percentile; extreme outlier). This suggests a substantial role in assessment and intake work that likely feeds the high psychotherapy volumes.

Psychological and neuropsychological testing represent a meaningful secondary service line but are a smaller share of revenue. Codes such as 96130 ($149.5K, 3.0%) and 96137 ($117.3K, 2.3%) rank in the mid‑to‑upper state percentiles (86th and 83rd respectively) and indicate in‑house testing capacity that supplements therapy and evaluation services without approaching the dominant scale of individual psychotherapy.

Certain service lines are limited or modest relative to individual psychotherapy: group therapy 90853 accounts for only $3.9K and ranks #35 of 46 providers in‑state (24th percentile), and substance assessment H0001 is $17.1K (0.3%) with a mid ranking. These low volumes suggest the practice focuses on individual treatment pathways rather than group programming or high volumes of SUD intake assessments.

The provider has a long tenure in the NPI registry (enumerated 2006-05-12, ~20 years ago), which combined with repeated high‑percentile rankings and concentrated Medicaid revenue suggests an established, specialized outpatient mental health operation with significant market share in Medicaid psychotherapy services within the state.

Medicaid: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	20,820	$110	$2.2M
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…	8,100	$140	$1.1M
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…	8,150	$80	$611.5K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	3,580	$150	$526.6K
96130	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	730	$200	$149.5K
96137	Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; each additional 30 minutes (List…	690	$170	$117.3K
96136	The provider, a physician or other qualified healthcare professional, administers two or more psychological or neuropsychological tests and scores them. Report this code for the first 30 minutes of…	690	$110	$78.7K
96131	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	520	$130	$68K
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…	610	$100	$59.9K
H0001	Alcohol and/or drug assessment	80	$220	$17.1K

Showing 1–10 of 13

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Nebraska Distribution

Capstone Behavioral Health, Inc. — 4 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nebraska

Full comparison — all codes billed, vs. Nebraska median

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	4	510	450	$100	$168.1K
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…	10	510	440	$140	$155.7K
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…	18	110	140	$100	$38.3K
96130	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	3	20	40	$150	$36.5K
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…	2	130	140	$60	$36.4K
96137	Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; each additional 30 minutes (List…	3	10	40	$150	$33.5K
H0001	Alcohol and/or drug assessment	6	10	80	$180	$32K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	35	50	260	$30	$30.5K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	1	150	40	$130	$26.8K
96131	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	2	10	30	$120	$18.7K

Showing 1–10 of 13

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Chidren's Dentistry Of South Omaha, LLC	NE	Pediatric Dentistry	$0	$8.6M
Heartland Family Service	NE	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$5.3M
Baart Community Healthcare	NE	Substance Use Disorder Rehabilitation Clinic/Center	$89.9K	$4.1M
Keegan Harkins	NE	Ophthalmology Physician	$3.5M	$0
Rai Care Centers Of Nebraska Ii, LLC	NE	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$2.7M
Douglas County Nebraska	NE	Psychiatric Hospital	$0	$2.4M
Psychological Healing Insights,pc	NE	Mental Health Counselor	$0	$947.2K
Sakrx, LLC	NE	Durable Medical Equipment & Medical Supplies	$15.4K	$689.1K
Align Care	NE	Dentist	$0	$617.8K
Buoyant Family Services Counseling And Consulting LLC	NE	Community/Behavioral Health Agency	$0	$580.6K

Capstone Behavioral Health, Inc. — Billing Profile & Reimbursement Data

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Capstone Behavioral Health, Inc. — 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