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

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

State Of Hawaii, Department Of Health (NPI 1306062690)

State Of Hawaii, Department Of Health is a community/behavioral health agency provider located in Honolulu, Hawaii. This profile covers 0 Medicare and 15 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	State Of Hawaii, Department Of Health
Address	1250 Punchbowl St
City	Honolulu
State	HI
ZIP	96813
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	April 17, 2007

Payer Source	Total Paid
Medicaid	$1.4M
Medicare	$0

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1017	Targeted case management, each 15 minutes	51,040	$20	$1.2M
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…	7,310	$20	$138.9K
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…	1,200	$20	$25.1K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	4,690	$10	$23.5K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	4,930	$1	$19.7K
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…	1,180	$20	$18.9K
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…	950	$10	$10.4K
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…	720	$10	$7.9K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	180	$40	$6.6K
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…	220	$10	$2.4K

Showing 1–10 of 15

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Hawaii Distribution

State Of Hawaii, Department Of Health — 2 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Hawaii

Full comparison — all codes billed, vs. Hawaii median

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1017	Targeted case management, each 15 minutes	1	10	25,910	$20	$596.5K
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…	25	70	370	$150	$457.3K
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…	467	710	650	$90	$274.1K
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…	52	690	650	$90	$235.4K
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…	68	80	320	$100	$119.2K
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	30	780	$40	$93.2K
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…	35	90	500	$30	$56.4K
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…	14	140	140	$90	$42.9K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	11	40	50	$90	$39.9K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	7	90	180	$10	$14.5K

Showing 1–10 of 15

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Queens Medical Center	HI	General Acute Care Hospital	$0	$200M
Straub Clinic & Hospital	HI	General Acute Care Hospital	$0	$45.6M
State Of Hawaii Dept. Of Health Adult Mental Health Division	HI	Community/Behavioral Health Agency	$0	$29.3M
Positive Behavior Supports Corporation	HI	Community/Behavioral Health Agency	$0	$26.4M
Easter Seals Hawaii	HI	Developmentally Disabled Services Day Training Agency	$0	$16.8M
The Emergency Group, Inc.	HI	Emergency Medicine Physician	$0	$15M
Hawaii Dental Group, Inc.	HI	General Practice Dentistry	$0	$12.4M
The Queen's Medical Center	HI	General Acute Care Hospital	$0	$10.3M
Hawaii Home Care Inc	HI	Nursing Care Agency	$0	$9.3M
Evergreen Adult Day Care	HI	Adult Day Care Clinic/Center	$0	$8.9M

State Of Hawaii, Department Of Health — Billing Profile & Reimbursement Data

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State Of Hawaii, Department Of Health — 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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