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

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

Missoula County Public Schools (NPI 1306995071)

Field	Value
Entity Type	Organization
Organization	Missoula County Public Schools
Address	Missoula County Public Schools 215 South Sixth West
City	Missoula
State	MT
ZIP	59801
Taxonomy	Local Education Agency (LEA)
NPI Enumerated	January 10, 2007

Payer Source	Total Paid
Medicaid	$16.3M
Medicare	$0

Key Findings

This entity has no Medicare billing on file and is effectively a single-payer Medicaid provider with lifetime Medicaid revenue of $16.3M, so analyses and payer negotiations should be Medicaid-focused rather than dual-payer. The absence of Medicare activity means national Medicare benchmarks are not applicable for this profile.

Revenue is extremely concentrated: the top 3 Medicaid codes account for 98.0% of the provider’s Medicaid revenue, with H0036 alone contributing $15M (92.1% of total Medicaid revenue). This concentration indicates that a single service line drives nearly all of the financial activity reported.

H0036 (Community psychiatric supportive treatment, face-to-face, per 15 minutes) dominates operations by volume and dollars (168.8K claims and $15M revenue), signaling a large-scale, unitized behavioral health program likely delivered in a school-based or community setting where 15-minute units are billed repeatedly. The code’s description and the claim structure suggest staffing, scheduling, and billing workflows optimized for short, frequent encounters.

Competitive standing for H0036 is outsized: the provider ranks #2 of 90 providers in-state (99th percentile; extreme outlier, far above typical state volume for this code), indicating it is a dominant statewide provider for community psychiatric supportive treatment. In contrast, other top codes show more typical positioning: T1019 ranks #19 of 38 providers in-state (51th percentile; typical, unremarkable volume) and 92507 ranks #18 of 147 providers in-state (88th percentile; typical, unremarkable volume).

Other Medicaid services reflect school-based therapy and supportive care: T1019 (personal care services) generated $514.6K (3.2% of Medicaid revenue) and 92507 (speech/language evaluation and treatment) generated $450.6K (2.8% of Medicaid revenue), showing supplemental personal care and speech therapy programs complementing the behavioral health focus. Lower-paid group and therapeutic codes such as 92508 (12.7K claims, $139.4K) and 97150 (2.3K claims, $18.3K) further indicate use of group-based therapy models and high claim counts with modest per-claim reimbursement.

The sheer claim volume for H0036 (168.8K claims) implies substantial operational scale and a billing model centered on frequent 15-minute units; this has implications for staffing capacity, claims processing resources, and contract pricing strategies with managed care plans. Analysts should consider utilization management and capacity planning when modeling cost or access impacts tied to this provider.

Given the provider’s long tenure—NPI enumerated 2007-01-10 (~19 years ago)—the Medicaid billing patterns, especially the heavy reliance on H0036, reflect a sustained service model rather than a transient program. That longevity supports interpreting the H0036 concentration as an embedded operational focus rather than a short-term anomaly.

Medicaid: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	168,790	$90	$15M
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	6,280	$80	$514.5K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	12,520	$40	$450.6K
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.	5,590	$30	$167.6K
92508	The provider treats a group of two or more individuals with communication and hearing difficulties by directly interacting with them. He assesses the patients with impairment in their ability to make…	12,670	$10	$139.4K
97150	In this procedure, the provider supervises and directs therapeutic procedures like exercise therapy for a group of patients.	2,280	$10	$18.3K
T2003	Non-emergency transportation; encounter/trip	230	$20	$3.4K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	20	$110	$1.8K
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…	150	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Montana Distribution

Missoula County Public Schools — 1 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. Montana median

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	19	40	6,240	$130	$14.6M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	2	90	5,740	$80	$1.6M
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	18	150	2,760	$40	$224.3K
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.	33	200	1,110	$60	$207.2K
T2003	Non-emergency transportation; encounter/trip	38	40	2,180	$30	$78K
92508	The provider treats a group of two or more individuals with communication and hearing difficulties by directly interacting with them. He assesses the patients with impairment in their ability to make…	5	50	3,530	$10	$61.6K
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…	142	230	300	$30	$38.1K
97150	In this procedure, the provider supervises and directs therapeutic procedures like exercise therapy for a group of patients.	2	20	550	$10	$9.4K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	18	30	30	$100	$8.2K

Nearby Providers

Other providers in the same ZIP code as Missoula County Public Schools, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Western Montana Mental Health Center	MT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$87.8M
Opportunity Resources Inc	MT	Developmentally Disabled Services Day Training Agency	$0	$48.5M
Missoula Developmental Service Corp	MT	Non-emergency Medical Transport (VAN)	$0	$33.6M
Express Personnel Services	MT	Nursing Care Agency	$0	$20.4M
3 Rivers Mental Health Solutions LLC	MT	Community/Behavioral Health Agency	$0	$16.7M
Meadowlark Home Care LLC	MT	Home Health Agency	$0	$12.9M
Client Dedicated Services, Inc	MT	Home Health Agency	$0	$10.6M
Children's Dentistry Of The Rockies	MT	Pediatric Dentistry	$0	$10.1M
Missoula Pediatric Dentistry PC	MT	Pediatric Dentistry	$0	$9.3M
Missoula Oral Surgery	MT	Oral and Maxillofacial Surgery Clinic/Center	$0	$8M

Missoula County Public Schools — Billing Profile & Reimbursement Data

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Missoula County Public Schools — 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