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.

Turnwell Mental Health Of Montana, PC (NPI 1265133292)

Turnwell Mental Health Of Montana, PC is a psychiatry physician provider located in Billings, Montana. This profile covers 0 Medicare and 10 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Turnwell Mental Health Of Montana, PC
Address	3737 Grand Ave Ste 6
City	Billings
State	MT
ZIP	59102
Taxonomy	Psychiatry Physician
NPI Enumerated	March 16, 2023

Payer Source	Total Paid
Medicaid	$438.4K
Medicare	$0

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	3,000	$120	$344.8K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	210	$160	$33.1K
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…	200	$100	$19.3K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	370	$50	$19.1K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	240	$50	$11.4K
G2212	Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary…	120	$60	$7.1K
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…	10	$120	$1.7K
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…	20	$50	$1.1K
J3490	Unclassified drugs	270	$1	$530
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	30	$10	$290

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

Turnwell Mental Health Of Montana, PC — 1 of 10 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

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	103	530	580	$70	$224.6K
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…	475	520	730	$40	$196.4K
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…	912	1,200	750	$80	$143.2K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	32	60	380	$70	$91.2K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	86	160	250	$110	$85.9K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	30	40	1,450	$1	$10.7K
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…	7	10	30	$80	$10.6K
J3490	Unclassified drugs	19	40	420	$1	$6.7K
G2212	Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary…	1	10	60	$80	$4.8K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	60	70	200	$10	$4.3K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Montana Psychiatry, PLLC	MT	Psychiatry Physician	$0	$1M
William Upshaw	FL	Psychiatry Physician	$310.3K	$0
Deborah Malters	MT	Psychiatry Physician	$29.7K	$0
Erin Amato	MT	Psychiatry Physician	$23.3K	$0
Desmond Fialkosky	MT	Physician Assistant	$16.5K	$0
Carly Kyte	MT	Physician Assistant	$15.9K	$0
Kaitlin Staebler	MT	Physician Assistant	$12.1K	$0
Jose Reyes	GA	Psychiatry Physician	$4.7K	$4.5K
Jorey Egeland	MT	Physician Assistant	$3K	$0
Hilary Nelson	MT	Physician Assistant	$470	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Youth Dynamics, Inc.	MT	Mental Illness Community Based Residential Treatment Facility	$0	$65.4M
New Day, Inc.	MT	Mental Illness Community Based Residential Treatment Facility	$0	$27.7M
Youth Dynamics, Inc.	MT	Professional Counselor	$0	$24.6M
Resource, Support, & Development, Inc.	MT	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$21.3M
Brittany Curl	MT	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$17.5M
Rimrock Pediatric Dentistry	MT	Pediatric Dentistry	$0	$15.2M
Bridges Of Montana	MT	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$12.7M
The Childrens Clinic Of Billings, PC	MT	Pediatrics Physician	$0	$10.9M
Community Option Resource Enterprises, Inc.	MT	Developmentally Disabled Services Day Training Agency	$0	$9.8M
Ryan K. Larsen Dmd & Associates	MT	Dental Anesthesiology	$0	$8.3M

Turnwell Mental Health Of Montana, PC — Billing Profile & Reimbursement Data

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Turnwell Mental Health Of Montana, PC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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