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 Federated States of Micronesia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Federated States of Micronesia 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. Federated States of Micronesia (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.

Minnewaska Lutheran Home (NPI 1356343669)

Field	Value
Entity Type	Organization
Organization	Minnewaska Lutheran Home
Address	605 Main Street
City	Starbuck
State	FM (Federated States of Micronesia)
ZIP	56381
Taxonomy	Skilled Nursing Facility
NPI Enumerated	June 1, 2005
NPI Deactivated	October 18, 2023

Payer Source	Total Paid
Medicaid	$2.1K
Medicare	$0

Key Findings

MINNEWASKA LUTHERAN HOME is a Skilled Nursing Facility located in STARBUCK, FM with an NPI enumerated on 2005-06-01 (~21 years ago), indicating long-standing registration and potential operational continuity in the market. Its taxonomy and tenure are consistent with a facility that provides post-acute and long-term care services typical of SNFs.

This provider has no Medicare billing on file (none (no Medicare billing on file)) and reported $2.1K in lifetime Medicaid revenue, making its payer footprint effectively single-payer with Medicaid as the sole recorded payer. Analysts should treat comparisons to Medicare activity as not applicable for this entity.

Revenue is highly concentrated: the precomputed top-3 Medicaid codes account for 100.0% of the provider's total Medicaid revenue, and in fact a single code, 97530, represents the entirety of reported Medicaid revenue. The 97530 activity shows 72 claims at a $29 avg paid/claim for $2.1K revenue (100.0% of this provider's total Medicaid revenue).

The dominance of 97530 (therapeutic activities to improve functional performance, billed per 15 minutes) indicates the facility’s Medicaid-billed services are focused on hands-on rehabilitative therapy rather than a broader mix of medical or ancillary billings. This pattern aligns with a SNF that bills Medicaid primarily for therapy sessions provided to residents.

Competitive standing is limited to the available state reporting: the 97530 line ranks #1 of 1 providers in-state (0th percentile; no state peer volume comparison available), meaning this provider is the only in-state reporter for that code and cannot be meaningfully benchmarked against peers. The absolute revenue ($2.1K) suggests a small billing footprint despite the rank position.

Because the reported percentile and rank reflect a single in-state reporter (ranks #1 of 1 providers in-state (0th percentile; no state peer volume comparison available)), statistical assessment of whether 97530 utilization is unusually high or low is not possible from the available data. Analysts should note this limitation when drawing comparisons or flagging utilization outliers.

Operationally, the tiny Medicaid revenue base ($2.1K) concentrated entirely in therapy code 97530 (72 claims, $29 avg paid/claim) suggests either a very small Medicaid census, intermittent Medicaid billing activity, or selective billing for therapy services only. For network, utilization, or contracting analyses, treat this provider as a low-volume Medicaid therapy biller and consider supplementing with local market data or direct outreach to understand service scope.

Medicaid: Complete Services Breakdown

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

1 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	70	$30	$2.1K

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Federated States of Micronesia providers billing the same CPT/HCPCS codes. Note: "FM" is a Pacific island nation in free association with the United States — not one of the 50 states; claims coded under it are benchmarked here as their own state-equivalent group.

Claims Volume vs. Federated States of Micronesia Distribution

Minnewaska Lutheran Home — 0 of 1 code billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Federated States of Micronesia

Full comparison — all codes billed, vs. Federated States of Micronesia median

1 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	1	10	70	$30	$2.1K

Minnewaska Lutheran Home — Billing Profile & Reimbursement Data

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Minnewaska Lutheran Home — 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

Frequently Asked Questions

References