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

Why is the Medicaid comparison limited to South Dakota 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. South Dakota (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.

Lutheran Social Services Of Sd (NPI 1356527402)

Field	Value
Entity Type	Organization
Organization	Lutheran Social Services Of Sd
Address	2519 Windmill Dr
City	Spearfish
State	SD
ZIP	57783
Taxonomy	Psychiatric Residential Treatment Facility
NPI Enumerated	January 18, 2008

Payer Source	Total Paid
Medicaid	$16.9M
Medicare	$0

Key Findings

This provider is listed under the Psychiatric Residential Treatment Facility taxonomy and its top Medicaid billing code is T2048, which is described as behavioral health long-term residential care with room and board and a per-diem basis; that code’s description indicates the organization operates as a residential, non-acute behavioral health facility where stays are typically longer than 30 days. The predominance of a per-diem, room-and-board code implies revenue tied to bed capacity, occupancy rates, and length of stay rather than discrete outpatient encounters.

Medicaid revenue is highly concentrated: the precomputed top three Medicaid codes account for 100.0% of this provider’s total Medicaid revenue, and the single listed code T2048 represents $16.9M in Medicaid revenue (2.8K claims at $5947 avg paid/claim), i.e., the entire reported Medicaid topline. This concentration means virtually all Medicaid receipts derive from long-term residential per-diem billing rather than a mix of services.

Payer mix is effectively single-payer: there is no Medicare billing on file and total Medicare revenue is reported as none, while Medicaid revenue totals $16.9M. In practical terms the provider appears to be a Medicaid-dependent residential behavioral health operator rather than a mixed Medicare/Medicaid facility.

Competitive standing within the state is modest for the dominant code: T2048 ranks #5 of 8 providers in-state (43th percentile), and the dataset labels its volume as typical and unremarkable for this code. This rank suggests the provider is a mid‑tier participant in South Dakota’s market for long-term residential behavioral health rather than a dominant statewide provider.

The provider’s NPI was enumerated on 2008-01-18 (~18 years ago), indicating an established operating history. That tenure is consistent with operating a licensed residential program that requires sustained administrative and clinical infrastructure to manage long-stay populations.

Operational and financial implications flow from the per-diem model and the reported averages: $5947 avg paid/claim on 2.8K claims means Medicaid cashflow is driven by sustained occupancy and average daily rates. This creates sensitivity to changes in Medicaid policy, per-diem reimbursement, utilization management, and referral patterns; a modest drop in occupancy or per-diem rates could materially affect revenue given the concentration in a single code/payer.

The concentration of 100.0% of Medicaid revenue into T2048 makes the provider exposed to payer-specific and service-line risk but also positions it as a specialized residential behavioral health provider that could be attractive for targeted Medicaid contracting or capacity planning. Given the mid-range state ranking, the organization may have room to grow market share locally but would be vulnerable if state Medicaid reimbursement policies or utilization controls for long-term residential care change.

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
T2048	Behavioral health; long-term care residential (non-acute care in a residential treatment program where stay is typically longer than 30 days), with room and board, per diem	2,850	$5,950	$16.9M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Dakota Distribution

Lutheran Social Services Of Sd — 0 of 1 code billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. South Dakota median

1 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2048	Behavioral health; long-term care residential (non-acute care in a residential treatment program where stay is typically longer than 30 days), with room and board, per diem	5	10	3,270	$1,840	$23.2M

Nearby Providers

Other providers in the same ZIP code as Lutheran Social Services Of Sd, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northern Hills Training Center, Inc.	SD	Developmentally Disabled Services Day Training Agency	$0	$39.3M
A.w. Holdings, LLC	SD	Case Manager/Care Coordinator	$0	$3.7M
Edgewood Spearfish Senior Living LLC	SD	Assisted Living Facility (Behavioral Disturbances)	$0	$2.3M
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$2M
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$1.8M
Spearfish Emergency Ambulance Service	SD	Land Ambulance	$540.7K	$302.3K
West River Transit Authority, Inc.	SD	Bus	$0	$788.1K
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$745.7K
Spearfish Collaborative Care LLC	SD	Assisted Living Facility	$0	$657.7K
Black Hills Psychology, LLC	SD	Clinical Psychologist	$0	$601.6K

Lutheran Social Services Of Sd — Billing Profile & Reimbursement Data

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Lutheran Social Services Of Sd — 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