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

Why is the Medicaid comparison limited to New Mexico 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. New Mexico (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 Medical Services (NPI 1285646455)

Field	Value
Entity Type	Organization
Organization	Presbyterian Medical Services
Address	1001 W Broadway Ste D&e
City	Farmington
State	NM
ZIP	87401
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	August 13, 2006

Payer Source	Total Paid
Medicaid	$41.2M
Medicare	$0

Key Findings

PRESBYTERIAN MEDICAL SERVICES is effectively a Medicaid-focused provider with no Medicare billing on file and $41.2M in lifetime Medicaid revenue, indicating the organization operates at meaningful scale inside the Medicaid program rather than across both Medicare and Medicaid. Its taxonomy as a Federally Qualified Health Center (FQHC) aligns with the Medicaid-dominant revenue mix and the presence of FQHC-specific billing in the data.

Revenue concentration is high: the precomputed top‑3 Medicaid codes by revenue account for 52.7% of this provider's total Medicaid revenue, driven by 90853 ($7.9M, 19.6%), 99213 ($7.4M, 18.3%), and 99214 ($6M, 14.8%). This concentration signals that a small set of services — group psychotherapy and established outpatient E/M visits — generate the majority of Medicaid revenue for this entity.

The code mix points to a strong behavioral-health and outpatient primary care operation. 90853 (45.6K claims, $174 avg paid/claim, $7.9M revenue) is the single largest revenue code and is labeled an extreme outlier in the state (ranks #2 of 193, 99th percentile), while psychotherapy and psychiatric evaluation codes such as 90834, 90832, 90837 and 90791 also appear with substantial volumes, supporting a service-line focus on mental health care.

PRESBYTERIAN MEDICAL SERVICES is a high-volume Medicaid provider for common outpatient E/M services: 99213 (50.8K claims, $7.4M revenue) and 99214 (40.9K claims, $6M revenue) both rank in the 98th percentile statewide (#17 of 932 and #21 of 963 respectively), which positions the organization as a major primary-care/E/M participant within New Mexico Medicaid. These ranks indicate the provider is well above typical state volume for routine outpatient visits.

The organization shows distinctive strengths in FQHC-oriented billing: G0467 (13K claims, $376.2K revenue) ranks #2 of 100 in-state (99th percentile), confirming that FQHC visit billing is an important identifiable component of its Medicaid footprint even if G0467 represents a modest share (0.9%) of total Medicaid revenue. This alignment between taxonomy and billing suggests operations consistent with community health center models.

Telehealth and community-support services are present but secondary to behavioral health and E/M work: Q3014 (5K claims, $322.4K, 0.8% of revenue) ranks #33 of 179 (82nd percentile), while H2015 (26.4K claims, $4.5M, 11.1%) and H2017 (13.9K claims, $2.4M, 6.0%) reflect ongoing use of community support and psychosocial rehabilitation in the service mix. These lines provide revenue diversification beyond the top psychotherapy and E/M codes but do not exceed the top-3 concentration.

Several codes are statistical outliers within the state Medicaid market, reinforcing the behavioral-health orientation: 90853 is an extreme outlier (99th percentile, #2 of 193) and 90791 also appears as an extreme outlier (4.6K claims, $786.6K, 1.9% of revenue; ranks #4 of 339, 99th percentile). These outlier labels indicate volume well above typical state peers for psychiatric group therapy and psychiatric evaluation.

The provider has sustained presence and scale in Medicaid over time, having an NPI enumerated on 2006-08-13 (~20 years ago) and processing very large claim counts for key codes (for example 50.8K claims for 99213, 45.6K claims for 90853, and 40.9K claims for 99214). That tenure combined with high-volume rankings suggests an established regional operator whose financial performance in Medicaid is heavily dependent on behavioral health and outpatient E/M services.

Medicaid: Complete Services Breakdown

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

98 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	45,590	$170	$7.9M
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…	50,770	$150	$7.4M
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…	40,930	$150	$6M
H2015	Comprehensive community support services, per 15 minutes	26,390	$170	$4.5M
D0999	N/A	14,080	$200	$2.8M
H2017	Psychosocial rehabilitation services, per 15 minutes	13,880	$180	$2.4M
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…	11,880	$180	$2.1M
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…	9,160	$170	$1.6M
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…	7,640	$170	$1.3M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	4,630	$170	$786.6K

Showing 1–10 of 98

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Mexico Distribution

Presbyterian Medical Services — 6 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Mexico

Full comparison — all codes billed, vs. New Mexico median

98 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2033	Multisystemic therapy for juveniles, per 15 minutes	7	10	4,640	$370	$4.3M
H2015	Comprehensive community support services, per 15 minutes	10	120	2,640	$150	$1.2M
H2017	Psychosocial rehabilitation services, per 15 minutes	6	30	3,760	$140	$1.1M
D0999	N/A	8	80	2,250	$190	$987.3K
Q3014	Telehealth originating site facility fee	33	180	620	$160	$546.7K
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…	17	930	910	$80	$521.6K
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…	21	960	1,010	$90	$490K
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…	93	920	860	$120	$361.9K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	26	50	530	$90	$323.8K
D0190	N/A	2	10	460	$660	$301.5K

Showing 1–10 of 98

Related Providers

Other providers that share a Tax Identification Number (TIN) with Presbyterian Medical Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$16.4M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$13.3M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$11M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$10.3M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$9.9M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$9.2M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$8.2M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$7.6M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$7.4M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$5.6M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
San Juan Regional Medical Center, Inc.	NM	General Acute Care Hospital	$0	$141.5M
Basin Coordinated Healthcare,inc	NM	Personal Care Attendant	$0	$79.7M
Links Ii Inc	NM	In Home Supportive Care Agency	$0	$38.9M
Generations Personal Care, Inc	NM	Personal Care Attendant	$0	$33.9M
Southwestern Private Services, Inc.	NM	Home Health Agency	$0	$30.4M
San Juan Regional Medical Center Inc	NM	Emergency Medicine Physician	$0	$23.8M
San Juan Center For Independence	NM	Home Health Agency	$0	$22.5M
Cottonwood Clinical Services, Inc.	NM	Community/Behavioral Health Agency	$0	$18.1M
San Juan Regional Medical Center Inc	NM	Pediatrics Physician	$0	$15.7M
Better Together Home And Community Services, LLC	NM	Child Intellectual and/or Developmental Disabilities Respite Care	$0	$14.5M

Presbyterian Medical Services — Billing Profile & Reimbursement Data

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Presbyterian Medical Services — 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