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NPI 1336222504 · Ada, OK · Psychiatry Physician
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Robert Morton is a psychiatry physician provider located in Ada, Oklahoma. This profile covers 16 Medicare and 17 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Robert Morton |
| Address | 1000 Rolling Hills Ln |
| City | Ada |
| State | OK |
| ZIP | 74820 |
| Taxonomy | Psychiatry Physician |
| NPI Enumerated | October 23, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $2.2M |
| Medicare | $1.3M |
Provider-level payer mix is heavily weighted to Medicaid: Total Medicare revenue is $1.3M while Total Medicaid revenue is $2.2M, so Medicaid represents the larger share of billed revenue on file. This is not a single-payer practice — both payers are active — but scale and volumes are materially greater on the Medicaid side.
Medicare revenue is highly concentrated: the precomputed top 3 Medicare codes by revenue account for 88.8% of this provider's total Medicare revenue, driven primarily by 99232 ($585.6K, 43.4%) and 99213 ($511.2K, 37.9%) with 99233 contributing $100.5K (7.5%). These top codes are all E/M services for inpatient follow-ups and office visits, indicating the Medicare book is dominated by evaluation-and-management encounters.
Medicaid revenue is also concentrated: the precomputed top 3 Medicaid codes by revenue account for 80.3% of this provider's total Medicaid revenue, with 99213 alone producing $1.1M (50.7%) and 99232 and 99214 contributing $406.3K (18.0%) and $258.7K (11.5%) respectively. That concentration shows Medicaid revenue is overwhelmingly generated by high-volume outpatient and inpatient E/M visits rather than a broad mix of ancillary procedures.
Competitive standing on Medicare for the top codes is unusually strong: 99232 ranks #7 of 177383 providers nationally and 99213 ranks #8 of 457151 providers nationally (both 100th percentile; labeled extreme outlier), while 99233 sits at the 99th percentile (rank #1189 of 128818; extreme outlier). In plain terms, this provider bills far more Medicare E/M volume for these codes than typical peers nationally, marking them as a national outlier for those services.
Competitive standing in-state on Medicaid mirrors Medicare for core codes: 99213 ranks #25 of 1746 providers in-state (99th percentile; extreme outlier) and 99232 ranks #5 of 279 providers in-state (99th percentile; extreme outlier), while 99214 is at the 85th percentile (rank #261 of 1680; typical). This pattern indicates the provider is a major Medicaid participant locally for routine and inpatient follow-up psychiatric E/M services but more typical for higher-level office codes.
Operational profile implied by the code mix: dominant codes are 99213, 99232, 99233 and 99214, which are evaluation-and-management services covering established office visits, and initial and subsequent inpatient/observation care. The presence of multiple nursing facility codes (e.g., 99308, 99306) and discharge-day management codes (99239/99238) suggests the practice spans outpatient, inpatient follow-up, and some long-term care visits rather than being limited to outpatient-only psychiatry.
Volume-driven Medicaid revenue with lower per-claim payments: Medicaid claim volumes for core codes are very large (e.g., 99213 has 35.7K claims and $1.1M revenue at $32 avg paid/claim; 99232 has 29K claims and $406.3K revenue at $14 avg paid/claim), whereas comparable Medicare entries show much smaller claim counts but higher avg paid/claim (Medicare 99213: 9K claims at $57 avg paid/claim; Medicare 99232: 9.8K claims at $60 avg paid/claim). These figures indicate the provider’s Medicaid revenue is driven primarily by high encounter volume despite lower per-claim payments.
Tenure and concentration risk: the provider has an enumerated NPI since 2006-10-23 (~20 years ago), indicating long-standing operations. However, both payers show strong revenue concentration into the top 3 codes (88.8% Medicare, 80.3% Medicaid), which implies revenue sensitivity to changes in utilization or reimbursement for a narrow set of E/M services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
16 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 9,760 | $60 | $585.6K |
| 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… | 8,970 | $60 | $511.2K |
| 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… | 1,230 | $80 | $100.5K |
| 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… | 360 | $130 | $46.1K |
| 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… | 430 | $80 | $35.6K |
| 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… | 450 | $40 | $16.7K |
| 99212 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,… | 460 | $30 | $15.6K |
| 99222 | The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 90 | $90 | $8.8K |
| 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… | 100 | $70 | $7.5K |
| 99205 | The provider sees a new 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 provider… | 60 | $130 | $7.4K |
Showing 1–10 of 16
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 16 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
16 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 99309 | 251 | 270 | 170 | $70 | $42.7K |
| 99308 | 139 | 270 | 180 | $50 | $26.5K |
| 99233 | 11 | 1,260 | 120 | $90 | $19.1K |
| 99214 | 3,153 | 5,560 | 130 | $70 | $18.4K |
| 99232 | 1 | 1,770 | 90 | $60 | $14K |
| 99306 | 104 | 130 | 60 | $130 | $12.3K |
| 99223 | 30 | 1,550 | 50 | $130 | $9.6K |
| 99213 | 1 | 5,450 | 80 | $50 | $8.7K |
| 99239 | 3 | 690 | 80 | $90 | $8.5K |
| 99205 | 130 | 620 | 30 | $140 | $5.8K |
Showing 1–10 of 16
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
17 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 35,690 | $30 | $1.1M |
| 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… | 29,020 | $10 | $406.3K |
| 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… | 4,620 | $60 | $258.7K |
| 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… | 6,120 | $20 | $128.5K |
| 99205 | The provider sees a new 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 provider… | 620 | $140 | $88K |
| 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… | 1,310 | $60 | $79.6K |
| 99308 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider… | 1,780 | $30 | $48K |
| 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… | 1,240 | $30 | $32.2K |
| 99212 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,… | 1,010 | $20 | $20.1K |
| 99309 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider… | 410 | $40 | $15.2K |
Showing 1–10 of 17
How this provider's Medicaid billing volume and revenue compare to other Oklahoma providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Oklahoma median
17 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99212 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,… | 98 | 530 | 140 | $450 | $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… | 261 | 1,680 | 820 | $90 | $307K |
| 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… | 25 | 1,750 | 870 | $70 | $254.4K |
| 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… | 19 | 190 | 480 | $70 | $218.8K |
| 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… | 5 | 280 | 840 | $50 | $179.5K |
| 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… | 30 | 200 | 110 | $140 | $105.8K |
| 99222 | The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 53 | 120 | 90 | $130 | $92.8K |
| 99238 | The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the… | 69 | 160 | 130 | $90 | $84.6K |
| 99309 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider… | 56 | 130 | 330 | $20 | $67.2K |
| 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… | 21 | 100 | 200 | $30 | $55.6K |
Showing 1–10 of 17
Other providers in the same ZIP code as Robert Morton, ranked by combined Medicare and Medicaid revenue.
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