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.

Benefis Community Care, Inc. (NPI 1194746883)

Field	Value
Entity Type	Organization
Organization	Benefis Community Care, Inc.
Address	245 E Park St Lowr Level
City	Butte
State	MT
ZIP	59701
Taxonomy	Case Management Agency
NPI Enumerated	July 21, 2006

Payer Source	Total Paid
Medicaid	$14.6M
Medicare	$0

Key Findings

BENEFIS COMMUNITY CARE, INC. reports $14.6M in lifetime Medicaid revenue and has no Medicare billing on file, making it effectively a single-payer (Medicaid) operation in the available dataset. This concentration means analyses of this entity should focus on Medicaid program rules and reimbursement dynamics rather than Medicare trends.

Revenue is highly concentrated in a very small set of codes: T2022 accounts for 87.1% of the provider's Medicaid revenue and H0032 accounts for 12.9%, with the precomputed top 3 codes together accounting for 100.0% of Medicaid revenue. This indicates that virtually all observed Medicaid income flows through care coordination and mental-health planning services.

The code mix points to a service model centered on ongoing care coordination and behavioral health planning: T2022 is billed as "Case management, per month" and H0032 is billed as "Mental health service plan development by non-physician." Together these codes imply enrollment-based, recurring case management and non-physician clinical planning rather than procedure-driven or facility-based care.

Operational volume under T2022 is substantial in claim count and consistent with a monthly enrollment model: 40.2K claims at an average paid amount of $317 per claim produced $12.8M in revenue for that code. By contrast, H0032 shows 5.3K claims at an average paid amount of $359 per claim for $1.9M, reflecting a lower-frequency but higher-paid-per-claim planning activity.

Competitive standing within Montana is mixed: the provider ranks #1 of 11 in-state for T2022 (100th percentile; labeled "typical, unremarkable volume for this code"), indicating it is the largest biller for monthly case management among peers but not an anomalous outlier in utilization intensity. For H0032 the provider ranks #2 of 8 in-state (86th percentile; labeled "typical, unremarkable volume for this code"), signaling a strong but not dominant position in non-physician mental health plan development.

The provider has an established enrollment history, with its NPI enumerated on 2006-07-21 (~20 years ago), which suggests long-term participation in Medicaid-managed care or state behavioral health programs and likely institutional knowledge of program billing. This tenure supports the high cumulative Medicaid revenue and sustained monthly billing patterns.

Despite leading in T2022 revenue statewide, neither top code is flagged as an extreme statistical outlier in the supplied labels—both are described as "typical, unremarkable volume for this code." In practical terms, the provider’s leading rank for T2022 reflects scale among peers rather than an unusual billing profile relative to the peer distribution.

The extreme dependence on T2022 for 87.1% of Medicaid revenue creates a concentration risk: changes to Medicaid case management eligibility, enrollment, or reimbursement rates could materially affect the provider’s revenue base. Coupled with the absence of Medicare revenue, this makes the organization particularly sensitive to Medicaid policy and rate-setting decisions affecting monthly case management and associated behavioral health planning services.

Medicaid: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2022	Case management, per month	40,230	$320	$12.8M
H0032	Mental health service plan development by non-physician	5,260	$360	$1.9M

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

Benefis Community Care, Inc. — 1 of 2 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

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2022	Case management, per month	1	10	1,510	$320	$5M
H0032	Mental health service plan development by non-physician	2	10	1,920	$360	$1.4M

Nearby Providers

Other providers in the same ZIP code as Benefis Community Care, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bsw, Inc.	MT	Developmentally Disabled Services Day Training Agency	$0	$20.4M
State Of Montana	MT	Substance Abuse Rehabilitation Facility	$0	$12.7M
Scl Health Medical Group-butte LLC	MT	Family Medicine Physician	$0	$9.9M
Butte Public Schools	MT	Local Education Agency (LEA)	$0	$6.9M
Community, Counseling & Correctional Services, Inc.	MT	Substance Use Disorder Rehabilitation Clinic/Center	$0	$3.8M
Butte School District #1	MT	Mental Health Counselor	$0	$3.8M
Ryan Todorovich	MT	General Practice Dentistry	$0	$3.1M
Lindsey Todorovich	MT	General Practice Dentistry	$0	$2.9M
Silver Bow County Developmental Disabilities Council, Inc.	MT	Developmentally Disabled Services Day Training Agency	$0	$2.2M
Big Sky Senior Living	MT	Assisted Living Facility	$0	$2.1M

Benefis Community Care, Inc. — Billing Profile & Reimbursement Data

Sign up for Benefis Community Care, Inc. — Billing Profile & Reimbursement Data policy alerts

Benefis Community Care, Inc. — Billing Profile & Reimbursement Data

Sign up for Benefis Community Care, 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