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

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

Hillcrest Family Services (NPI 1326096116)

Field	Value
Entity Type	Organization
Organization	Hillcrest Family Services
Address	2005 Asbury Rd
City	Dubuque
State	IA
ZIP	52001
Taxonomy	Child & Adolescent Psychiatry Physician
NPI Enumerated	May 4, 2006

Payer Source	Total Paid
Medicaid	$32.5M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-focused operation: there is no Medicare billing on file and the provider reports $32.5M in lifetime Medicaid revenue, indicating a single‑payer Medicaid revenue base rather than a mixed Medicare/Medicaid payer mix. The absence of Medicare activity simplifies payer analysis but concentrates reimbursement and utilization risk within Medicaid.

Revenue is highly concentrated in a few community‑based behavioral health service codes: the precomputed top three Medicaid codes account for 74.3% of this provider’s Medicaid revenue, led by H2016 ($18.2M, 56.0%), followed by 99490 ($3.5M, 10.6%) and H0040 ($2.5M, 7.7%). This concentration implies the organization’s financial performance is closely tied to reimbursement and utilization trends for these specific service lines.

The code mix (H2016, 99490, H0040) points to a service model built around comprehensive community supports, provider‑directed clinical staff care coordination, and assertive community treatment programs rather than procedure‑driven or inpatient care. Given the provider’s taxonomy as Child & Adolescent Psychiatry Physician, the dominant codes are consistent with an outpatient/community behavioral health provider delivering coordinated, longitudinal services and intensive community outreach.

Psychotherapy and psychiatric evaluation volumes are substantial and skew toward longer sessions: 90834 appears with $2M revenue (6.2%) and ranks #24 of 675 providers in-state (97th percentile; notably above typical state volume), while 90837 shows $1.8M revenue (5.5%) and ranks #9 of 610 providers in-state (99th percentile; extreme outlier). High-volume evaluation codes 90791 ($717.4K, 2.2%, 96th percentile) and 90792 ($333.3K, 1.0%, 88th percentile) further confirm heavy utilization of psychotherapy and diagnostic services, suggesting clinical intensity in outpatient encounters.

Competitive standing is mixed across the major Medicaid codes: the provider ranks #9 of 176 for H2016 (95th percentile), placing it among higher-volume statewide providers for comprehensive community supports, while 99490 ranks #19 of 57 (68th percentile) and H0040 ranks #7 of 12 (45th percentile), indicating more modest positions for care coordination and assertive community treatment within their respective peer groups. Analysts should treat the provider as a leading participant for H2016 specifically, but a mid‑to‑small player for the other two top revenue drivers.

The profile shows diversification across service settings and modalities beyond per‑diem community supports: Q3014 (telehealth originating site) appears with 11K claims and $186.7K revenue (0.6%) and ranks #10 of 75 in-state (88th percentile), and S9123 (nursing care in the home) reports 2.5K claims and $165.2K revenue (0.5%) and ranks #4 of 11 in-state (70th percentile). These data indicate meaningful telehealth utilization and some provision of home‑based nursing supports alongside clinic and community services, which may affect network placement and capitation considerations.

Several high-volume outpatient E/M codes also rank at or above the 95th percentile, for example 99214 ($1.1M revenue, 3.4%, 98th percentile) and 99215 ($217.6K revenue, 0.7%, 98th percentile), reinforcing that many encounters are substantive, time‑intensive outpatient visits. Combined with the psychotherapy outlier status, this pattern suggests both frequent and relatively high‑intensity ambulatory behavioral health contact with patients.

The provider has long tenure in the NPI registry (enumerated 2006-05-04, ~20 years ago), which supports a view of established operations and sustained Medicaid engagement over time; combined with the revenue concentration and high percentiles on several codes, this longevity increases the relevance of any trends seen in utilization and reimbursement for payers and competitors.

Medicaid: Complete Services Breakdown

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

38 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2016	Comprehensive community support services, per diem	145,660	$130	$18.2M
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	25,610	$140	$3.5M
H0040	Assertive community treatment program, per diem	45,240	$60	$2.5M
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…	32,790	$60	$2M
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…	19,210	$90	$1.8M
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…	25,940	$40	$1.1M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	6,900	$100	$717.4K
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…	16,040	$40	$561.3K
H2017	Psychosocial rehabilitation services, per 15 minutes	4,550	$110	$491.3K
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…	10,190	$30	$346.6K

Showing 1–10 of 38

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Iowa Distribution

Hillcrest Family Services — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Iowa

Full comparison — all codes billed, vs. Iowa median

38 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2016	Comprehensive community support services, per diem	9	180	10,790	$390	$15.2M
H0040	Assertive community treatment program, per diem	7	10	48,800	$60	$4.6M
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	19	60	16,120	$150	$3.8M
H2019	Therapeutic behavioral services, per 15 minutes	79	90	5,380	$100	$1.5M
H2017	Psychosocial rehabilitation services, per 15 minutes	5	20	3,280	$160	$960.3K
H0037	Community psychiatric supportive treatment program, per diem	26	30	1,050	$210	$800.8K
T2021	Day habilitation, waiver; per 15 minutes	63	100	2,780	$60	$386.9K
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…	24	680	670	$70	$343.5K
T1016	Case management, each 15 minutes	8	20	480	$150	$340.3K
S9123	Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)	4	10	880	$80	$329.2K

Showing 1–10 of 38

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hillcrest Family Services	IA	Social Worker	$0	$7.1M
Hillcrest Family Services	IA	Community/Behavioral Health Agency	$0	$1.1M
Adib Kassas	IA	Psychiatry Physician	$84.1K	$0
Natasha Lash	IA	Psychiatric/Mental Health Nurse Practitioner	$31.1K	$0
Deborah Bahe	IA	Psychiatric/Mental Health Nurse Practitioner	$13.9K	$0
Nicole Li	WI	Psychiatric/Mental Health Nurse Practitioner	$2.1K	$1.9K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hills And Dales Child Development Center	IA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$68.5M
Area Residential Care Inc.	IA	Intellectual Disabilities Intermediate Care Facility	$0	$32.8M
Crescent Community Health Center	IA	Federally Qualified Health Center (FQHC)	$0	$29.5M
Dubuque Community School District	IA	Local Education Agency (LEA)	$0	$26.6M
The Finley Hospital	IA	General Acute Care Hospital	$0	$14.1M
City Of Dubuque	IA	Land Ambulance	$690.9K	$8.9M
Mercy Medical Center-dubuque	IA	General Acute Care Hospital	$0	$5.2M
Hills And Dales Child Development Center	IA	Intellectual Disabilities Intermediate Care Facility	$0	$4.7M
Dubuque Internal Medicine PC	IA	Internal Medicine Physician	$0	$3.9M
The Finley Hospital	IA	Emergency Medicine Physician	$0	$3.9M

Hillcrest Family Services — Billing Profile & Reimbursement Data

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Hillcrest Family 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