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.

Yankton Ph (NPI 1376051813)

Field	Value
Entity Type	Organization
Organization	Yankton Ph
Address	300 E 6th St
City	Yankton
State	SD
ZIP	57078
Taxonomy	Assisted Living Facility (Mental Illness)
NPI Enumerated	January 18, 2018

Payer Source	Total Paid
Medicaid	$4.1M
Medicare	$0

Key Findings

This provider reports no Medicare billing on file and has $4.1M in lifetime Medicaid revenue, making its financial footprint effectively single-payer Medicaid rather than a dual-payer mix. The absence of Medicare activity suggests the entity is not participating in fee-for-service Medicare markets or is not billing Medicare-covered services.

Revenue for this provider is highly concentrated: the precomputed top 3 Medicaid codes account for 100.0% of its total Medicaid revenue, and the single listed code T2031 represents the entirety of reported Medicaid revenue. This concentration indicates the provider’s Medicaid business is driven almost exclusively by a narrow set of residential care payments.

The dominant code, T2031 (Assisted living; waiver, per diem), and the provider taxonomy (Assisted Living Facility (Mental Illness)) together indicate this operation is oriented toward Medicaid waiver-funded assisted living services for behavioral health populations. The per-diem nature of T2031 implies revenue is tied to occupancy and daily residential care rather than discrete clinical procedures or episodic outpatient visits.

Claims and unit-payment profile show 3.3K claims with a $1254 avg paid/claim for T2031, which together produce the $4.1M revenue figure. The relatively high average paid per claim is consistent with per-diem reimbursement for residential waiver services and explains how a modest claim count can generate multi-million-dollar revenue.

In-state competitive standing for T2031 is strong: the provider ranks #2 of 43 providers in-state and sits in the 98th percentile, and the code’s performance is described as notably above typical state volume. This rank signals the provider is a major participant in the state’s assisted-living waiver market and likely draws a substantial share of the regional demand for this service.

The operational and financial profile implies concentration risk: because 100.0% of Medicaid revenue is tied to T2031 and there is no Medicare diversification, reimbursement policy changes, occupancy shifts, or waiver eligibility adjustments for per-diem assisted living could materially affect revenue. Analysts should flag sensitivity to Medicaid rate-setting and state waiver program changes.

Tenure data show the NPI was enumerated on 2018-01-18 (~8 years ago), indicating the provider has been active in the Medicaid billing environment for several years. This duration supports the observed accumulation of $4.1M in Medicaid revenue and the development of a stable position in the state waiver market.

Taken together, the data portray a specialist assisted-living facility focused on Medicaid waiver per-diem services for mental illness: it is a high-volume, in-state leader for T2031 with concentrated revenue exposure and limited participation outside the Medicaid assisted-living payment stream.

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
T2031	Assisted living; waiver, per diem	3,270	$1,250	$4.1M

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

Yankton Ph — 1 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
T2031	Assisted living; waiver, per diem	2	40	340	$1,090	$1.1M

Nearby Providers

Other providers in the same ZIP code as Yankton Ph, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ability Building Services, Inc.	SD	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$39.2M
Lewis & Clark Behavioral Health Services, Inc.	SD	Community/Behavioral Health Agency	$0	$24M
Yankton Medical Clinic PC	SD	Internal Medicine Physician	$0	$6.3M
Cedar Vilage Assisted Living Center	SD	Assisted Living Facility (Mental Illness)	$0	$2.4M
Heartland Psychological Services	SD	Psychiatry Physician	$0	$1.3M
Avera At Home	SD	Home Health Agency	$0	$1M
Sacred Heart Health Services	SD	Rural Acute Care Hospital	$0	$942.8K
Mary Lee Villanueva	SD	Hematology & Oncology Physician	$788.7K	$0
Sacred Heart Health Services	SD	Emergency Care Clinic/Center	$0	$766.6K
Kore Cares In Home Services, LLC	SD	In Home Supportive Care Agency	$0	$700.6K

Yankton Ph — Billing Profile & Reimbursement Data

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Yankton Ph — 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