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

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

Rediscover (NPI 1376085100)

Field	Value
Entity Type	Organization
Organization	Rediscover
Address	1555 Ne Rice Rd
City	Lees Summit
State	MO
ZIP	64086
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	November 10, 2016

Payer Source	Total Paid
Medicaid	$213.9M
Medicare	$0

Key Findings

REDISCOVER is effectively a Medicaid-focused community behavioral health agency: it reports no Medicare billing on file and $213.9M in lifetime Medicaid revenue, indicating Medicaid is the sole material payer in the available data. The provider’s NPI was enumerated on 2016-11-10 (~10 years ago), so this profile reflects roughly a decade-long Medicaid presence concentrated in Missouri.

Revenue is extremely concentrated in a single line: T1040 (Medicaid certified community behavioral health clinic services, per diem) generates $213.3M and accounts for 99.7% of the provider’s total Medicaid revenue, and the top three Medicaid codes combined are precomputed to account for 100.0% of Medicaid revenue. That concentration shows the organization’s financial model is dominated by per‑diem CCBHC reimbursement rather than fee-for-service line-item payments.

Operationally, the code mix supports a broad community behavioral health model: T1040 per-diem services are the primary revenue engine, while 90834 (psychotherapy, $209.2K) and 99214 (established patient E/M, $287.3K) appear as much smaller fee-for-service activity. The presence of psychiatric evaluation codes (90791, 90792) and psychotherapy codes suggests the provider delivers both diagnostic and ongoing outpatient therapeutic services, consistent with a CCBHC or community behavioral health agency.

Despite very high claim counts on several non-revenue line items, many common behavioral health CPT/HPCPCS codes report $0 avg paid/claim (for example H0036, H2017, H0037, H2010 and others), which indicates that payments are likely being captured in the T1040 per‑diem line rather than as separate reimbursable units in the claims-level payment fields. Several high-volume support and rehabilitation codes therefore contribute operational activity without showing discrete Medicaid dollars in the available paid-claim fields.

Competitive standing is mixed by code: for the dominant T1040 line REDISCOVER ranks #4 of 31 in-state (90th percentile; labeled "typical, unremarkable volume"), which places it as a meaningful but not dominant statewide provider of CCBHC per-diem services. By contrast, for some fee-for-service lines the provider is an outlier — 99214 ranks #14 of 3166 (100th percentile; "extreme outlier") and 90834 ranks #3 of 1059 (100th percentile; "notably above typical"), indicating unusually high volume of E/M and psychotherapy claims relative to large numbers of in-state peers even though those lines represent a small share of revenue.

The two small fee-for-service revenue contributors (99214 at $287.3K and 90834 at $209.2K, each ~0.1% of total Medicaid revenue) are operationally notable because their state percentile ranks are very high. These high-volume, low-dollar E/M and psychotherapy claim profiles suggest substantial outpatient encounter activity that is either low-paid in Medicaid rates or is being documented in addition to per-diem billing.

Several specialty support codes show state-level prominence despite $0 recorded paid amounts — for example H2010 (comprehensive medication services) ranks #2 of 23 (95th percentile; "notably above typical") and T1017 (targeted case management) ranks #1 of 6 (100th percentile; "notably above typical"). This pattern points to significant programmatic activity in medication management and case management embedded within the organization’s CCBHC-like service package even where discrete paid-line revenue is not reflected.

For payers and network planners, the profile signals a single-payer dependency risk and operational scale tied to the CCBHC per-diem model: any contract or rate change affecting T1040-level reimbursement would materially impact the provider’s financials given that T1040 constitutes 99.7% of reported Medicaid revenues and the top three codes together make up 100.0% of Medicaid revenue. Analysts should treat REDISCOVER as a Medicaid-centric CCBHC-style operator with high documented encounter volumes across psychotherapy, E/M, and ancillary behavioral health services.

Medicaid: Complete Services Breakdown

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

34 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1040	Medicaid certified community behavioral health clinic services, per diem	738,150	$290	$213.3M
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…	71,840	$1	$287.3K
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…	34,870	$10	$209.2K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	2,140	$20	$40.7K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	1,740	$10	$17.4K
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…	1,450	$10	$14.5K
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,…	2,840	$1	$8.5K
99204	The provider sees a new 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 provider…	400	$10	$2.8K
99215	The provider sees an established 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…	130	$10	$1.6K
90839	In this service, the provider performs psychotherapy for a crisis situation when the patient is in a life–threatening state and needs immediate attention. The treatment session typically lasts…	60	$10	$750

Showing 1–10 of 34

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Missouri Distribution

Rediscover — 3 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. Missouri median

34 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1040	Medicaid certified community behavioral health clinic services, per diem	4	30	198,100	$260	$125.7M
H0037	Community psychiatric supportive treatment program, per diem	4	20	56,420	$120	$11.7M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	5	20	214,040	$20	$10.8M
H2036	Alcohol and/or other drug treatment program, per diem	9	10	17,770	$200	$7.4M
H0031	Mental health assessment, by non-physician	7	10	130	$620	$4.7M
H2015	Comprehensive community support services, per 15 minutes	5	20	4,550	$50	$2.5M
H2017	Psychosocial rehabilitation services, per 15 minutes	5	20	40,460	$20	$2M
H2012	Behavioral health day treatment, per hour	10	10	33,050	$30	$1.9M
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	4	10	1,150	$160	$1.4M
H0001	Alcohol and/or drug assessment	4	10	380	$280	$1.1M

Showing 1–10 of 34

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Mercy-community Choice Pediatrics	MO	Pediatrics Physician	$0	$9M
Kc Pain Asc, LLC	MO	Ambulatory Surgical Clinic/Center	$2.5M	$12.5K
Saint Luke's Surgicenter - Lee's Summit	MO	Ambulatory Surgical Clinic/Center	$2.3M	$0
David Fieleke	MO	Dermatology Physician	$823.2K	$0
Sarah Foster	MO	Family Nurse Practitioner	$675.5K	$0
Kevin Skelsey	MO	Ophthalmology Physician	$479.1K	$0
Zhineng Yang	MO	Hematology & Oncology Physician	$413.4K	$6.9K
Gary Mcewen	MO	Dermatology Physician	$379.6K	$0
Michael Hellman	MO	Orthopaedic Surgery Physician	$313K	$0
Wesley Frevert	MO	Sports Medicine (Orthopaedic Surgery) Physician	$232.3K	$0

Rediscover — Billing Profile & Reimbursement Data

Sign up for Rediscover — Billing Profile & Reimbursement Data policy alerts

Rediscover — Billing Profile & Reimbursement Data

Sign up for Rediscover — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References