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.

Lewis & Clark Behavioral Health Services, Inc. (NPI 1215918339)

Field	Value
Entity Type	Organization
Organization	Lewis & Clark Behavioral Health Services, Inc.
Address	3111 Shirley Bridge Ave
City	Yankton
State	SD
ZIP	57078
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	November 7, 2005

Payer Source	Total Paid
Medicaid	$24M
Medicare	$0

Key Findings

LEWIS & CLARK BEHAVIORAL HEALTH SERVICES, INC. is effectively a single-payer Medicaid billing entity with no Medicare revenue on file and $24M in lifetime Medicaid revenue; this indicates the organization’s operations and revenue generation are concentrated entirely within state Medicaid behavioral health programs rather than Medicare populations.

Revenue concentration is high: the precomputed top three Medicaid codes account for 83.5% of the provider’s total Medicaid revenue, signaling dependence on a small set of service lines for the bulk of income and operational throughput.

The dominant revenue driver is H2016 (Comprehensive community support services, per diem), producing $11.6M and representing 48.4% of Medicaid revenue; the provider ranks #1 of 11 in-state (100th percentile), making it the leading state provider for this per-diem community support service and suggesting substantial capacity or contractual emphasis on wraparound community supports.

H2021 (Community-based wrap-around services, per 15 minutes) and H0039 (Assertive community treatment, face-to-face, per 15 minutes) together contribute $4.4M (18.2%) and $4M (16.9%) respectively and, combined with H2016, form the top three codes that account for the 83.5% concentration; these codes indicate the organization is focused on intensive community-based behavioral health, care coordination, and outreach models rather than short office-based psychotherapy.

Several other codes show notable in-state standing that reinforce a community behavioral health orientation: H0019 long-term residential services (5.5% of Medicaid revenue) ranks #1 of 7 providers (100th percentile), H0004 behavioral health counseling (0.8%) ranks #2 of 18 (94th percentile), and H0001 alcohol/drug assessment (0.7%) ranks #1 of 16 (100th percentile). These rankings imply the provider holds leading positions for multiple residential and treatment assessment services in South Dakota.

Operationally, the claim counts for top codes are substantial (for example, 143.2K claims for H2016 and ~50K claims each for H2021 and H0039), indicating high-volume, ongoing service delivery rather than episodic or rare interventions; average paid/claim levels ($81 for H2016, $87 for H2021, $79 for H0039) suggest these are routine, time- or day-based Medicaid payments rather than high-fee procedures.

The provider’s NPI was enumerated on 2005-11-07 (~21 years ago), indicating long-tenured participation in Medicaid networks; this longevity combined with top-state rankings on multiple codes suggests established referral relationships, contracts, or programmatic roles in the state behavioral health system.

Competitive standing is mixed: for several high-volume, specialty behavioral health codes the provider is a top performer in-state (multiple #1 rankings and 100th percentiles), while for common outpatient psychotherapy and E/M codes (e.g., 90832, 99214) the provider’s ranks are high-percentile but not dominant, indicating focused specialty capacity with less emphasis on mainstream office-based medical visits.

Medicaid: Complete Services Breakdown

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

18 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2016	Comprehensive community support services, per diem	143,170	$80	$11.6M
H2021	Community-based wrap-around services, per 15 minutes	50,210	$90	$4.4M
H0039	Assertive community treatment, face-to-face, per 15 minutes	51,210	$80	$4M
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	4,960	$270	$1.3M
90863	The provider prescribes and reviews medications for pharmacological management after psychotherapy services at the same encounter.	8,740	$110	$969.9K
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…	5,750	$80	$431.4K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	1,470	$150	$219K
W0037	N/A	2,300	$80	$184K
H0004	Behavioral health counseling and therapy, per 15 minutes	2,120	$90	$179.9K
H0001	Alcohol and/or drug assessment	1,260	$140	$171.9K

Showing 1–10 of 18

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

Lewis & Clark Behavioral Health Services, Inc. — 3 of 18 codes 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

18 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	1	10	1,970	$1,550	$3.8M
H2016	Comprehensive community support services, per diem	1	10	29,180	$80	$3.6M
H2021	Community-based wrap-around services, per 15 minutes	5	10	47,600	$90	$3.5M
H0039	Assertive community treatment, face-to-face, per 15 minutes	2	10	45,430	$80	$3.3M
90863	The provider prescribes and reviews medications for pharmacological management after psychotherapy services at the same encounter.	3	10	5,650	$90	$550.2K
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…	214	340	1,010	$100	$511K
H2012	Behavioral health day treatment, per hour	4	10	1,150	$180	$324.5K
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…	23	260	860	$80	$222.6K
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…	9	70	200	$80	$176.7K
H0005	Alcohol and/or drug services; group counseling by a clinician	5	20	520	$80	$128.2K

Showing 1–10 of 18

Nearby Providers

Other providers in the same ZIP code as Lewis & Clark Behavioral Health Services, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ability Building Services, Inc.	SD	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$39.2M
Yankton Medical Clinic PC	SD	Internal Medicine Physician	$0	$6.3M
Yankton Ph	SD	Assisted Living Facility (Mental Illness)	$0	$4.1M
Cedar Vilage Assisted Living Center	SD	Assisted Living Facility (Mental Illness)	$0	$2.4M
Heartland Psychological Services	SD	Psychiatry Physician	$0	$1.3M
Avera At Home	SD	Home Health Agency	$0	$1M
Sacred Heart Health Services	SD	Rural Acute Care Hospital	$0	$942.8K
Mary Lee Villanueva	SD	Hematology & Oncology Physician	$788.7K	$0
Sacred Heart Health Services	SD	Emergency Care Clinic/Center	$0	$766.6K
Kore Cares In Home Services, LLC	SD	In Home Supportive Care Agency	$0	$700.6K

Lewis & Clark Behavioral Health Services, Inc. — Billing Profile & Reimbursement Data

Sign up for Lewis & Clark Behavioral Health Services, Inc. — Billing Profile & Reimbursement Data policy alerts

Lewis & Clark Behavioral Health Services, Inc. — Billing Profile & Reimbursement Data

Sign up for Lewis & Clark Behavioral Health Services, 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