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

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

Wyoming Behavioral Institute (NPI 1295709822)

Key Findings

Field	Value
Entity Type	Organization
Organization	Wyoming Behavioral Institute
Address	2521 E 15th St
City	Casper
State	WY
ZIP	82609
Taxonomy	Psychiatric Hospital
NPI Enumerated	February 13, 2006

Payer Source	Total Paid
Medicaid	$2.7M
Medicare	$0

WYOMING BEHAVIORAL INSTITUTE is effectively a single‑payer provider in the claims on file: there is no Medicare billing on file while total Medicaid revenue is $2.7M. This concentration on Medicaid makes the facility dependent on state Medicaid reimbursement and limits revenue diversification from federal Medicare payments.

Revenue is highly concentrated in a small set of Medicaid services: the precomputed top 3 Medicaid codes by revenue account for 60.9% of this provider's total Medicaid revenue. Those top codes are 99233 ($847.3K, 31.9%), 97150 ($488.1K, 18.4%), and 90853 ($282.1K, 10.6%), indicating a narrow set of high‑impact billing lines.

The code mix points to a hybrid operation combining inpatient/observation E/M work and high‑volume group/therapeutic programming. High revenue and claims for inpatient E/M codes (for example 99233: 14.1K claims, $60 avg paid/claim, $847.3K revenue; and 99223: 2.4K claims, $113 avg paid/claim, $274.7K revenue) alongside large volumes for group therapy and supervised therapeutic procedures (97150: 54.2K claims, $9 avg paid/claim, $488.1K revenue; 90853: 14.1K claims, $20 avg paid/claim, $282.1K revenue) are consistent with a psychiatric hospital that emphasizes both inpatient care and group-based therapeutic services.

Statewide competitive standing is strong on several high‑revenue codes: 97150 ranks #1 of 5 providers in‑state (100th percentile) and 90853 ranks #1 of 9 providers in‑state (100th percentile), while 99223 ranks #1 of 6 providers in‑state (100th percentile). 99233 is also well above peers, ranking #2 of 10 providers in‑state (89th percentile), which together indicate the provider is a major in‑state participant for core psychiatric hospital services.

Multiple individual codes are flagged as statistical outliers compared with in‑state peers, which signals unusually high relative volumes for certain services. For example, 99232 is described as an "extreme outlier, far above typical state volume" and 90791 and 90785 are also labeled "extreme outlier," while 99233, 97150, and 90853 are described as "notably above typical" — these characterizations corroborate the provider's dominant state position on several lines of business.

The payer economics are driven by very different per‑claim payment profiles: high claim counts with low per‑claim averages characterize some dominant lines (97150: 54.2K claims at $9 avg paid/claim), while inpatient E/M services produce higher per‑claim payments but fewer claims (99223: $113 avg paid/claim; 99233: $60 avg paid/claim). This mix suggests operational scale in group/supervised therapies that is volume‑driven and inpatient E/M services that contribute outsized revenue per encounter.

WYOMING BEHAVIORAL INSTITUTE shows longstanding market presence, with its NPI enumerated on 2006-02-13 (~20 years ago). That tenure, coupled with repeated #1 statewide rankings across multiple behavioral health codes, implies an established referral and service footprint within Wyoming's Medicaid network.

The concentrated Medicaid revenue base and the provider’s dominant positions on several state‑level codes present both operational risk and negotiating leverage: the lack of Medicare billing means less diversification if Medicaid policy or rates change, but the provider’s #1 rankings and extreme outlier volumes on key behavioral health and inpatient codes could strengthen its position in Medicaid managed care contracting and utilization discussions.

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
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	14,120	$60	$847.3K
97150	In this procedure, the provider supervises and directs therapeutic procedures like exercise therapy for a group of patients.	54,230	$10	$488.1K
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…	14,110	$20	$282.1K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	2,430	$110	$274.7K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	7,290	$30	$196.9K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	6,340	$20	$107.8K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	800	$120	$96.8K
90838	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…	1,580	$60	$94.6K
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…	610	$100	$58.7K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	660	$80	$51K

Showing 1–10 of 22

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wyoming Distribution

Wyoming Behavioral Institute — 10 of 21 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wyoming

Full comparison — all codes billed, vs. Wyoming median

22 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	2	10	310	$80	$275.5K
H2019	Therapeutic behavioral services, per 15 minutes	112	170	840	$80	$192.2K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	37	40	1,590	$50	$181.4K
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…	7	20	530	$40	$129.4K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	1	10	3,690	$30	$100.6K
97150	In this procedure, the provider supervises and directs therapeutic procedures like exercise therapy for a group of patients.	1	10	220	$10	$99.2K
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…	49	140	350	$70	$81.5K
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…	131	220	400	$50	$79.3K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	1	10	350	$110	$66.7K
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…	1	10	480	$20	$41.5K

Showing 1–10 of 22

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Stephen Brown	WY	Child & Adolescent Psychiatry Physician	$0	$2.4M
Jennifer Frausto	WY	Psychiatric/Mental Health Nurse Practitioner	$40.6K	$306.5K
Teecee Hailey-fulfer	WY	Psychiatric/Mental Health Nurse Practitioner	$19.9K	$133.8K
Kelly Plessman	WY	Family Nurse Practitioner	$61.2K	$0
Harbans Hans	OK	Psychiatry Physician	$42.1K	$0
Jenny Lok	WY	Occupational Therapist	$17.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northwest Community Action Programs Of Wyoming, Inc.	WY	Developmentally Disabled Services Day Training Agency	$0	$25.8M
Community Health Center Of Central Wyoming, Inc.	WY	Federally Qualified Health Center (FQHC)	$0	$15.3M
Emg Casper Mw LLC	WY	Assisted Living Facility	$0	$5.9M
Casper Children's Center, LLC	WY	Pediatrics Physician	$0	$4M
John Purviance	WY	Radiation Oncology Physician	$2.5M	$0
2nd Street Dental, LLC	WY	Dental Clinic/Center	$0	$2.4M
Solutions Counseling Services LLC	WY	Community/Behavioral Health Agency	$0	$2.1M
Surfin Smiles LLC	WY	Pediatric Dentistry	$0	$2M
Elie Fahed	WY	Medical Oncology Physician	$1.9M	$0
Robert Peterson	WY	School Psychologist	$0	$1.9M

Wyoming Behavioral Institute — 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