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.

Youth Homes (NPI 1205055878)

Field	Value
Entity Type	Organization
Organization	Youth Homes
Address	550 N California St
City	Missoula
State	MT
ZIP	59802
Taxonomy	Emotionally Disturbed Childrens' Residential Treatment Facility
NPI Enumerated	April 24, 2007

Payer Source	Total Paid
Medicaid	$9.7M
Medicare	$0

Key Findings

YOUTH HOMES in MISSOULA, MT bills almost exclusively to Medicaid and its code mix is consistent with a residential foster-care and child behavioral health operation: the per‑diem foster care code S5145 (Foster care, therapeutic, child; per diem) is the dominant service line, supplemented by psychotherapy (90837) and therapeutic behavioral services (H2019/H2020). This pattern aligns with its taxonomy as an Emotionally Disturbed Childrens' Residential Treatment Facility.

Revenue is highly concentrated: total Medicaid revenue is $9.7M and the top three Medicaid codes account for 98.5% of that total. In particular, S5145 alone represents $9M (92.9% of the provider's Medicaid revenue), signaling extreme reliance on a single per‑diem reimbursement stream.

This provider has no Medicare billing on file, so it is effectively a single‑payer (Medicaid) operation at scale rather than a mixed Medicare/Medicaid provider. That absence of Medicare revenue underscores Medicaid policy and reimbursement changes as primary drivers of financial risk and opportunity.

Despite S5145 driving the bulk of this provider's revenue, YOUTH HOMES is not a dominant statewide provider of that specific code: it ranks #6 of 8 providers in‑state and sits at the 29th percentile, a position described in the source data as "typical, unremarkable volume for this code." In other words, the provider’s internal revenue dependence on S5145 is high even though its in‑state market share for that service is modest.

For non‑per‑diem services, the provider shows modest participation: 90837 (psychotherapy) generated $312K (3.2% of Medicaid revenue), with 3.4K claims and a rank of #172 of 1203 providers in‑state (86th percentile) and labeled "typical, unremarkable volume." H2019 (therapeutic behavioral services, per 15 minutes) produced $226.2K (2.3% of revenue), with 1.2K claims and a rank of #23 of 36 (37th percentile), also characterized as typical. These standings indicate participation in billable therapeutic services but not clear market leadership.

Operationally, the average paid amounts reflect the service model: S5145 has a high average paid/claim of $2736 across 3.3K claims, consistent with per‑diem residential placements and likely multi‑day stays, while 90837’s $91 avg paid/claim and H2019’s $196 avg paid/claim reflect lower‑unit psychotherapy and time‑based behavioral services provided alongside residential care. This mix implies revenue driven by bed‑based placement economics together with billed clinical minutes.

Established tenure: the provider’s NPI was enumerated on 2007-04-24 (~19 years ago), indicating long‑standing operations in the local market. That longevity supports operational experience in Medicaid billing and residential child behavioral health, though it has not translated into dominance in the specific per‑diem foster care code within Montana.

Strategic and risk implications follow from the billing profile: with $9.7M in Medicaid revenue concentrated 98.5% in the top three codes and no Medicare activity, YOUTH HOMES has limited payer diversification and high exposure to Medicaid policy, rate changes, and utilization management for S5145. Any payer or policy shift affecting per‑diem foster care reimbursement or enrollment could disproportionately affect the provider’s financial performance.

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5145	Foster care, therapeutic, child; per diem	3,290	$2,740	$9M
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…	3,430	$90	$312K
H2019	Therapeutic behavioral services, per 15 minutes	1,150	$200	$226.2K
H2020	Therapeutic behavioral services, per diem	310	$460	$143.8K
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…	50	$70	$3.7K

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

Youth Homes — 0 of 5 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

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5145	Foster care, therapeutic, child; per diem	6	10	10,460	$230	$12.3M
H2020	Therapeutic behavioral services, per diem	10	10	1,970	$120	$1.7M
H2019	Therapeutic behavioral services, per 15 minutes	23	40	3,280	$50	$759.9K
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…	172	1,200	750	$80	$143.2K
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…	40	50	240	$60	$42.5K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Youth Homes, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Youth Homes	MT	Community/Behavioral Health Agency	$0	$972.2K

Nearby Providers

Other providers in the same ZIP code as Youth Homes, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Consumer Direct District Of Columbia	MT	In Home Supportive Care Agency	$0	$393.2M
Western Montana Clinic PC	MT	Multi-Specialty Clinic/Center	$0	$8.7M
Providence Health & Services Mt	MT	Emergency Medicine Physician	$0	$8.2M
Providence Health & Services Mt	MT	Family Medicine Physician	$0	$5.7M
Providence Surgery Center	MT	Ambulatory Surgical Clinic/Center	$1.6M	$3.5M
Partnership For Children	MT	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$4.7M
Gary Wingfield	MT	Assisted Living Facility	$0	$4.7M
Providence Health & Services Mt	MT	General Acute Care Hospital	$0	$2.4M
Western Montana Clinic PC	MT	Clinical Medical Laboratory	$668.9K	$1.7M
Melody Nelsen	MT	Rheumatology Physician	$2M	$0

Youth Homes — Billing Profile & Reimbursement Data

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Youth Homes — 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