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

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

Dirne Health Centers, Inc. (NPI 1255756730)

Field	Value
Entity Type	Organization
Organization	Dirne Health Centers, Inc.
Address	3700 W Seltice Way
City	Coeur D Alene
State	ID
ZIP	83814
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	February 20, 2014

Payer Source	Total Paid
Medicaid	$7.1M
Medicare	$0

Key Findings

Medicaid-dominant, single-payer profile: DIRNE HEALTH CENTERS reports no Medicare billing on file and $7.1M in lifetime Medicaid revenue, making its financial footprint effectively single-payer Medicaid. The absence of Medicare activity suggests the organization’s operations and revenue are concentrated within Medicaid managed or fee-for-service channels rather than Medicare populations.

Extreme revenue concentration in a single encounter code: Three Medicaid codes account for 99.8% of the provider’s Medicaid revenue, with T1015 alone generating $7M (98.5% of total Medicaid revenue) from 47.5K claims. This indicates the practice’s cash flow is overwhelmingly driven by bundled clinic/encounter payments rather than a diversified fee mix.

Service-line implications — primary care/FQHC model with behavioral-health services: The dominance of T1015 (Clinic visit/encounter, all-inclusive) is consistent with an FQHC operating a broad primary care or bundled encounter model, while presence of H0038 (9.9K claims, $59.5K) and H2017 (6K claims, $36K) shows substantive self-help/peer and psychosocial rehabilitation activity. Together these codes imply an FQHC-style clinic that integrates primary care encounters with behavioral health and peer-support services rather than billing large volumes of separately reimbursed specialty procedures.

Competitive standing for top codes within the state: For the revenue-driving T1015 code the provider ranks #8 of 143 in-state (95th percentile), placing it among higher-volume T1015 billers statewide even as the dataset labels the volume as "typical, unremarkable." H0038 ranks #17 of 114 (86th percentile) and H2017 ranks #40 of 135 (71th percentile), indicating moderate-to-strong positioning for peer and psychosocial services but not a statewide dominant share of those lines.

Claim versus paid-revenue mismatch for mental-health CPTs: Several psychotherapy and mental-health CPTs appear with non-trivial claim counts but minimal or $0 paid amounts — for example 90834 has 3.4K claims with $13.6K revenue ($4 avg paid/claim) and 90832 has 1.8K claims with $0 revenue. This pattern suggests many behavioral-health encounters are either being captured within the T1015 bundled encounter payment or are submitted but not resulting in separate Medicaid reimbursement.

Limited separately-billable FQHC mental-health visits: Specialty FQHC mental-health visit code G0470 appears only 23 times ($529 revenue; ranks #4 of 5 in-state, 25th percentile), and several other mental-health service codes (H0032, H0046, 90853, 90791) produce little to no Medicaid revenue despite appearing on claims. This reinforces that the clinic’s revenue model relies on bundled visit reimbursement rather than on high-volume, separately reimbursed mental-health procedure billing.

Established presence: The provider’s NPI was enumerated on 2014-02-20 (~12 years ago), indicating an established operational tenure in the market that aligns with sustained Medicaid billing patterns centered on FQHC encounter payments.

Medicaid: Complete Services Breakdown

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

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	47,530	$150	$7M
H0038	Self‑help/peer services, per 15 minutes	9,910	$10	$59.5K
H2017	Psychosocial rehabilitation services, per 15 minutes	5,990	$10	$36K
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…	3,410	$1	$13.6K
G0470	Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc…	20	$20	$530
H0032	Mental health service plan development by non-physician	60	$1	$110
3725F	The provider screens a patient with dementia for the presence of depression, which is a mental disorder characterized by sadness, guilt feelings, hopelessness, or irritability.	20	$0	$0
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	130	$0	$0
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…	1,820	$0	$0
90846	A provider meets with the patient’s family without the patient present to counsel the family on the psychological issues affecting the patient and the family.	110	$0	$0

Showing 1–10 of 17

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Idaho Distribution

Dirne Health Centers, Inc. — 1 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. Idaho median

17 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	8	140	5,470	$180	$2.6M
H2017	Psychosocial rehabilitation services, per 15 minutes	40	140	2,000	$110	$633.3K
H2014	Skills training and development, per 15 minutes	54	60	2,500	$60	$613.3K
H0038	Self‑help/peer services, per 15 minutes	17	110	1,730	$90	$436.4K
H0005	Alcohol and/or drug services; group counseling by a clinician	76	80	2,240	$50	$257.3K
T1017	Targeted case management, each 15 minutes	126	190	1,060	$60	$221.8K
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…	100	410	740	$60	$174.3K
H0046	Mental health services, not otherwise specified	16	30	500	$80	$92.4K
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…	60	150	210	$80	$52.7K
H0032	Mental health service plan development by non-physician	69	110	150	$70	$37.3K

Showing 1–10 of 17

Related Providers

Other providers that share a Tax Identification Number (TIN) with Dirne Health Centers, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dirne Health Centers, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$13.6M
Dirne Health Centers, Inc	ID	Federally Qualified Health Center (FQHC)	$0	$6.7M
Dirne Health Centers, Inc	ID	Federally Qualified Health Center (FQHC)	$0	$6.5M
Dirne Health Centers, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$6.3M
Dirne Health Centers, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$3M
Dirne Health Centers Inc	ID	Federally Qualified Health Center (FQHC)	$0	$870.1K
Dirne Health Centers, Inc	ID	Federally Qualified Health Center (FQHC)	$0	$789.6K
Dirne Health Centers Inc	ID	Federally Qualified Health Center (FQHC)	$0	$390.1K
Kerri Ruddell	WA	Family Nurse Practitioner	$63.1K	$0
Jill White	ID	Psychiatric/Mental Health Nurse Practitioner	$28.8K	$0

Nearby Providers

Other providers in the same ZIP code as Dirne Health Centers, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Res-care Washington, Inc	ID	In Home Supportive Care Agency	$0	$31.9M
Coeur D'alene Pediatrics PA	ID	Pediatrics Physician	$0	$11.6M
Coeur D'alene School District #271	ID	Local Education Agency (LEA)	$0	$9.8M
Ambitions Of Idaho, Inc	ID	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$7.6M
Kootenai Health, Inc.	ID	General Acute Care Hospital	$0	$7M
Family Support Services Of North Idaho	ID	Mental Health Counselor	$0	$6.9M
Kootenai Health, Inc.	ID	Psychiatry Physician	$0	$6.7M
Collaborative Behavior Solutions, LLC	ID	Community/Behavioral Health Agency	$0	$5.9M
Kootenai County Emergency Medical Services System	ID	Land Ambulance	$1.7M	$3.6M
Inspired By You, LLC	ID	Developmental Disabilities Clinic/Center	$0	$4.8M

Dirne Health Centers, Inc. — Billing Profile & Reimbursement Data

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Dirne Health Centers, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References