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

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

Presbyterian Hospitality House (NPI 1275754012)

Field	Value
Entity Type	Organization
Organization	Presbyterian Hospitality House
Address	7609 Chena Hot Springs Rd
City	Fairbanks
State	AK
ZIP	99712
Taxonomy	Emotionally Disturbed Childrens' Residential Treatment Facility
NPI Enumerated	May 1, 2007

Payer Source	Total Paid
Medicaid	$25.1M
Medicare	$0

Key Findings

This provider is effectively single-payer: there is no Medicare billing on file while Medicaid revenue totals $25.1M. The absence of Medicare receipts indicates the organization’s operations and revenue are concentrated on Medicaid-funded behavioral health services rather than dual Medicare/Medicaid care models.

Revenue is highly concentrated in a small number of Medicaid codes: the top three codes together account for 74.1% of the provider’s total Medicaid revenue. The single largest line is H2020 at $9.2M (36.5% of Medicaid revenue), followed by H0018 at $4.8M (19.2%) and H2021 at $4.6M (18.5%), which together drive the bulk of financial performance.

The code mix points to a residential and intensive behavioral health operating model: H2020 (Therapeutic behavioral services, per diem), H0018 (short-term residential, per diem without room and board), and H2021 (community-based wrap-around, per 15 minutes) are the top revenue sources. High per‑diem and per‑15‑minute utilization suggests ongoing residential placements and intensive community-based care rather than one-off outpatient encounters.

Competitive standing varies by service line within the state. The provider ranks #1 of 6 for H2020 (100th percentile) indicating a local leadership position on that therapeutic behavioral per‑diem line, ranks #7 of 76 for H2021 (92th percentile) showing a strong statewide presence in wrap‑around services, but is more modest on short‑term residential H0018 where it ranks #7 of 11 (40th percentile).

Operational intensity is reflected in claims volumes for top lines: H2020 has 33.2K claims, H0018 has 20.4K claims, and H2021 has 13.6K claims. These high claim counts for per‑diem and per‑15‑minute codes are consistent with continuous residential care and frequent, time‑based community interventions rather than episodic outpatient visits.

While residential and wrap‑around services dominate, traditional psychotherapy and group/family therapy codes contribute but remain secondary revenue sources. For example, 90837 accounts for $770K (3.1% of Medicaid revenue) and 90853 accounts for $552.2K (2.2%), indicating that individual and group psychotherapy are provided but are not the primary revenue drivers.

Some payment patterns show higher-than-average paid per claim for lower-volume services: H0038 (self‑help/peer services) averages $486 paid/claim and generates $544.3K in revenue from 1.1K claims, demonstrating selective use of higher‑paid ancillary services. Overall, many of the listed codes are described in the file as "typical, unremarkable volume," including the top codes, so the provider’s mix appears consistent with established, expected utilization for a residential behavioral health program rather than anomalous billing patterns.

The provider has an established presence in Medicaid markets with long tenure: the NPI was enumerated on 2007-05-01 (~19 years ago). Combined with the concentrated Medicaid revenue profile, this tenure suggests a long-standing, Medicaid-oriented residential behavioral health operation rather than a newly entered service line.

Medicaid: Complete Services Breakdown

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2020	Therapeutic behavioral services, per diem	33,200	$280	$9.2M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	20,430	$240	$4.8M
H2021	Community-based wrap-around services, per 15 minutes	13,600	$340	$4.6M
T2033	Residential care, not otherwise specified (nos), waiver; per diem	6,630	$330	$2.2M
H2019	Therapeutic behavioral services, per 15 minutes	5,940	$280	$1.7M
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…	6,530	$120	$770K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	6,280	$90	$552.2K
H0038	Self‑help/peer services, per 15 minutes	1,120	$490	$544.3K
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.	1,550	$100	$161.6K
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…	2,080	$80	$155.8K

Showing 1–10 of 16

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Alaska Distribution

Presbyterian Hospitality House — 1 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alaska

Full comparison — all codes billed, vs. Alaska median

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	7	10	23,880	$260	$8.4M
H2020	Therapeutic behavioral services, per diem	1	10	17,020	$280	$4.7M
T2033	Residential care, not otherwise specified (nos), waiver; per diem	5	10	7,460	$490	$3.4M
H2019	Therapeutic behavioral services, per 15 minutes	16	40	3,660	$250	$3.1M
H2021	Community-based wrap-around services, per 15 minutes	7	80	1,070	$330	$1.3M
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…	22	150	1,020	$200	$620.5K
T1016	Case management, each 15 minutes	46	90	1,620	$150	$606.4K
H0038	Self‑help/peer services, per 15 minutes	7	10	1,120	$200	$442.1K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	12	60	1,070	$80	$392.9K
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…	49	90	370	$180	$361K

Showing 1–10 of 16

Nearby Providers

Other providers in the same ZIP code as Presbyterian Hospitality House, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Shangri'la Ranch	AK	Developmentally Disabled Services Day Training Agency	$0	$10.9M

Presbyterian Hospitality House — Billing Profile & Reimbursement Data

Sign up for Presbyterian Hospitality House — Billing Profile & Reimbursement Data policy alerts

Presbyterian Hospitality House — Billing Profile & Reimbursement Data

Sign up for Presbyterian Hospitality House — 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