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.

South Peninsula Behavioral Health Services Inc (NPI 1285640961)

Field	Value
Entity Type	Organization
Organization	South Peninsula Behavioral Health Services Inc
Address	3948 Ben Walters Ln
City	Homer
State	AK
ZIP	99603
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	August 1, 2006

Payer Source	Total Paid
Medicaid	$21.6M
Medicare	$0

Key Findings

This provider is effectively a single‑payer Medicaid operation: there is no Medicare billing on file and the provider reports $21.6M in lifetime Medicaid revenue, so Medicaid accounts for essentially all observed public-payer activity for this entity. Analysts should treat comparisons and financial exposure primarily through a Medicaid lens rather than a dual‑payer dynamic.

Revenue is highly concentrated in a small set of behavioral‑health service lines: the precomputed top 3 Medicaid codes (H2017, H2019, H2015) account for 69.9% of the provider’s total Medicaid revenue. Specifically, H2017 generated $7.6M (35.0%), H2019 generated $3.9M (18.1%), and H2015 generated $3.6M (16.8%), indicating that a few community‑behavioral services drive the majority of billing.

The code mix points to a community/behavioral health agency focused on intensive community‑based supports: H2017 (psychosocial rehabilitation), H2019 (therapeutic behavioral services), and H2015 (comprehensive community support) are the top revenue drivers, and the provider also reports substantial H0023 outreach ($1.8M, 8.5%). Together these codes describe an operation organized around repeated, time‑based direct support and outreach interventions rather than high volumes of primary medical E/M or specialty procedural care.

Competitive standing is mixed across codes: the provider ranks as a statewide leader on several mid‑to‑low‑revenue but service‑critical lines (for example, H2015 ranks #6 of 64 providers at the 92th percentile and H0023 ranks #2 of 41 providers at the 98th percentile, both described as "notably above typical" state volume). By contrast, its largest single code H2017 ($7.6M) ranks #4 of 11 providers at the 70th percentile and is characterized as "typical, unremarkable" volume for that code, so the organization is strong in some specialized community supports while more middling among peers for psychosocial rehab by revenue.

Psychotherapy and case‑management capacity appear substantial and operationally important: 90837 shows 17.4K claims and $1.3M revenue (6.1% of Medicaid revenue) at the 97th percentile ("notably above typical"), 90832 shows 8.4K claims and $311.7K (1.4%) and is flagged as an "extreme outlier" (97th percentile), and T1016 case management reports 18.3K claims and $1.1M (5.2%) at the 94th percentile ("notably above typical"). These volumes imply significant clinician/field staff time allocated to both long and short psychotherapy encounters and to case management.

The provider delivers a broad set of wraparound and medication support services beyond core rehab: H2021 wrap‑around services ($325.5K, 1.5%), H2010 comprehensive medication services ($357K, 1.7%, rank #2 of 18 at the 94th percentile), and T1007 substance‑abuse treatment planning ($392.5K, 1.8% at the 96th percentile) indicate a multi‑service community model that includes medication management and substance‑use treatment planning alongside psychosocial supports. This breadth suggests capability to manage complex behavioral health needs in community settings.

Telehealth and crisis intervention are present but not dominant: Q3014 telehealth originating site shows 1K claims and $27.8K (0.1%) at the 90th percentile, while S9484 crisis intervention reports 251 claims and $22.8K (0.1%) at the 42th percentile. These figures indicate telehealth and crisis response are part of the service mix but are much smaller revenue contributors compared with the time‑based community supports.

Tenure data show an established presence in the market: the NPI was enumerated on 2006-08-01 (~20 years ago), which supports interpreting these volumes as the output of a longstanding community behavioral health program rather than a short‑term entrant. Combined with the concentration on a small set of Medicaid service codes, that longevity heightens the importance of Medicaid policy and state reimbursement changes for the provider’s financial stability.

Medicaid: Complete Services Breakdown

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2017	Psychosocial rehabilitation services, per 15 minutes	20,010	$380	$7.6M
H2019	Therapeutic behavioral services, per 15 minutes	18,540	$210	$3.9M
H2015	Comprehensive community support services, per 15 minutes	27,000	$140	$3.6M
H0023	Alcohol and/or drug outreach	10,220	$180	$1.8M
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…	17,420	$80	$1.3M
T1016	Case management, each 15 minutes	18,300	$60	$1.1M
T1007	Alcohol and/or substance abuse services, treatment plan development and/or modification	3,270	$120	$392.5K
H2010	Comprehensive medication services, per 15 minutes	3,840	$90	$357K
H2021	Community-based wrap-around services, per 15 minutes	4,720	$70	$325.5K
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…	8,420	$40	$311.7K

Showing 1–10 of 22

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

South Peninsula Behavioral Health Services Inc — 4 of 22 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

22 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2017	Psychosocial rehabilitation services, per 15 minutes	4	10	2,750	$280	$3.3M
H2019	Therapeutic behavioral services, per 15 minutes	8	40	3,660	$250	$3.1M
H2015	Comprehensive community support services, per 15 minutes	6	60	4,510	$230	$1.8M
H2021	Community-based wrap-around services, per 15 minutes	20	80	1,070	$330	$1.3M
S9484	Crisis intervention mental health services, per hour	22	40	500	$580	$844.5K
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…	5	150	1,020	$200	$620.5K
T1016	Case management, each 15 minutes	6	90	1,620	$150	$606.4K
H0023	Alcohol and/or drug outreach	2	40	1,310	$180	$521.5K
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…	186	440	580	$170	$458.7K
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…	18	60	1,070	$80	$392.9K

Showing 1–10 of 22

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
South Peninsula Hospital, Inc	AK	Critical Access Hospital	$0	$30.1M
Seldovia Village Tribe	AK	Federally Qualified Health Center (FQHC)	$0	$10.1M
South Peninsula Behavioral Health Svcs Inc	AK	Respite Care	$0	$4.4M
South Peninsula Hospital, Inc.	AK	Critical Access Hospital	$0	$2.7M
Prodigy Medical, LLC	AK	Oxygen Equipment & Supplies (DME)	$0	$1.5M
James Bourne Dds PC	AK	Dentist	$0	$1.4M
Michael Connors	AK	Optometrist	$0	$1.4M
Homer Eyecare LLC	AK	Optometrist	$0	$1.2M
Homer Senior Citizens, Inc.	AK	Assisted Living Facility	$0	$1.2M
Zank Center, LLC	AK	Speech-Language Pathologist	$0	$1M

South Peninsula Behavioral Health Services Inc — Billing Profile & Reimbursement Data

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South Peninsula Behavioral Health Services 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

Nearby Providers

Frequently Asked Questions

References