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

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

Nystrom & Associates, Ltd (NPI 1396750188)

Field	Value
Entity Type	Organization
Organization	Nystrom & Associates, Ltd
Address	1900 Silver Lake Rd Nw
City	New Brighton
State	MN
ZIP	55112
Taxonomy	Clinical Social Worker
NPI Enumerated	July 30, 2006

Payer Source	Total Paid
Medicaid	$187.1M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-focused practice: there is no Medicare billing on file and lifetime Medicaid revenue is $187.1M, indicating the organization operates almost entirely within the Medicaid payer environment rather than across Medicare and Medicaid. The NPI was enumerated on 2006-07-30 (~20 years ago), so the provider has a long-standing presence in its market.

Revenue is highly concentrated in a small set of procedure lines: the top 3 Medicaid codes (90837, 99214, 90833) account for 67.7% of this provider’s total Medicaid revenue. In dollar terms those codes are 90837 $81.5M (44.1%), 99214 $28.8M (15.5%), and 90833 $14.9M (8.1%), signaling heavy dependence on psychotherapy and related evaluation & management services.

The code mix points to a high-volume psychotherapy and outpatient behavioral-health operation: large revenue and claims for 90837, 90833, 90834, and 90832 alongside major E&M codes such as 99214 and 99213 suggest the practice delivers long psychotherapy sessions and concurrent evaluation/management visits as a core service line. Additional Medicaid revenue from H2019 (therapeutic behavioral services), H2014 (skills training), and S0280/S0281 (medical home care coordination) indicates the provider also bills per-15-minute behavioral interventions and care coordination services.

This provider is a dominant statewide player for multiple high-revenue codes: 90837 (754.8K claims, $108 avg paid/claim, $81.5M) ranks #1 of 1143 providers in-state and is described as an extreme outlier, while 90833 (266.1K claims, $56 avg paid/claim, $14.9M) and several other codes (H2019, 90791, 90792, 96131, 96137, 90836) also rank #1 in-state and are labeled extreme outliers. 99214 (346.4K claims, $83 avg paid/claim, $28.8M) ranks #4 in-state but is still in the 100th percentile and called an extreme outlier, reinforcing that this provider operates at a scale far above typical in-state peers for its core services.

High claim volumes underline operational scale: 90837 has 754.8K claims and 99214 has 346.4K claims, while add-on and intensity codes such as 90785 appear in very large volume (203.7K claims, $13 avg paid/claim, $2.6M) which may reflect routine use of add-on psychotherapy intensity codes across many sessions. Several high-volume codes have relatively low average paid-per-claim (for example 90785 $13 avg paid/claim), suggesting reimbursement is driven by quantity of short or add-on billed units as well as by longer psychotherapy and E&M visits.

The provider demonstrates broader clinical capabilities beyond individual psychotherapy: notable revenue and top-in-state ranks for psychological testing codes (96131 $1.2M, ranks #1; 96137 $1.0M, ranks #1; 96130 $623.2K, ranks #2) and assessment codes (90791, 90792) indicate institutional capacity for standardized testing, diagnostic evaluation, and reporting in addition to therapy. This mix supports a service-line profile that includes diagnostic assessment, therapy, skills training, and care coordination rather than single-modality care.

While many codes show extreme outlier status, a subset of billed services is described as typical or unremarkable in-state: H2014 ($2.5M, ranks #25 of 185; 87th percentile), H0046 ($1.7M, ranks #13 of 214; 94th percentile), H0032 ($690.9K, ranks #19 of 226; 92th percentile) and 97530 ($496.9K, ranks #59 of 262; 78th percentile) are characterized as typical or only modestly above typical state volumes. This pattern indicates the provider’s dominance is concentrated in core psychotherapy, E&M, and testing lines while ancillary services perform at or near more typical state levels.

Given the long tenure (NPI enumerated 2006-07-30, ~20 years ago) combined with Medicaid-only revenue of $187.1M and repeated 100th-percentile ranks on primary codes, the provider appears to be an established, high-capacity regional behavioral health organization with sustained demand for psychotherapy, testing, and care coordination services in the state Medicaid market.

Medicaid: Complete Services Breakdown

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

45 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	754,820	$110	$81.5M
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…	346,410	$80	$28.8M
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	266,130	$60	$14.9M
H2019	Therapeutic behavioral services, per 15 minutes	91,670	$150	$14M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	67,070	$120	$7.8M
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…	94,310	$80	$7.2M
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…	66,320	$60	$3.8M
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	13,640	$230	$3.1M
S0280	Medical home program, comprehensive care coordination and planning, initial plan	9,670	$300	$2.9M
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…	23,280	$120	$2.8M

Showing 1–10 of 45

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Minnesota Distribution

Nystrom & Associates, Ltd — 19 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. Minnesota median

45 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2012	Behavioral health day treatment, per hour	23	40	6,530	$140	$3.7M
H2035	Alcohol and/or other drug treatment program, per hour	269	280	5,980	$120	$3M
H2014	Skills training and development, per 15 minutes	25	190	6,230	$120	$2.2M
H2017	Psychosocial rehabilitation services, per 15 minutes	213	230	6,320	$120	$2M
H2019	Therapeutic behavioral services, per 15 minutes	1	50	5,850	$110	$1.2M
T1013	Sign language or oral interpretive services, per 15 minutes	37	210	560	$60	$822.1K
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	1,180	1,150	$80	$605.7K
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…	21	1,200	1,030	$70	$549.7K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	1	1,140	1,010	$100	$543K
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.	59	260	890	$60	$405.3K

Showing 1–10 of 45

Related Providers

Other providers that share a Tax Identification Number (TIN) with Nystrom & Associates, Ltd, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nystrom & Associates, Ltd.	MN	Addiction (Substance Use Disorder) Counselor	$0	$32.9M
Nystrom & Associates, Ltd	MN	Mental Health Counselor	$0	$11.8M
Eric Johnson	MN	Psychiatry Physician	$122.9K	$0
Jonathan Uecker	MN	Psychiatry Physician	$60.3K	$0
Pamela Walls	ND	Psychiatric/Mental Health Clinical Nurse Specialist	$8.1K	$38.5K
Marie Sund	MN	Psychiatric/Mental Health Nurse Practitioner	$41.7K	$0
Sonya Schroeder	MN	Psychiatry Physician	$39.8K	$0
Nathan Hockert	MN	Medical Physician Assistant	$35.4K	$0
Andrew Mackey	MN	Clinical Social Worker	$35.2K	$0
Ian Skare	MN	Psychiatric/Mental Health Nurse Practitioner	$35K	$0

Nearby Providers

Other providers in the same ZIP code as Nystrom & Associates, Ltd, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Medtox Laboratories, Inc	MN	Clinical Medical Laboratory	$63.4K	$47.7M
Family Support Services Inc.	MN	Mental Health Counselor	$0	$45.9M
Tru Healthcare, Inc.	MN	In Home Supportive Care Agency	$0	$28.8M
Apple Tree Dental	MN	General Practice Dentistry	$0	$11.4M
Apple Tree Dental	MN	General Practice Dentistry	$0	$8.3M
Avalon Programs, LLC	MN	Substance Abuse Rehabilitation Facility	$0	$8.1M
Quest Diagnostics LLC Il	MN	Clinical Medical Laboratory	$0	$6.5M
Latitudes Treatment Center LLC	MN	Substance Abuse Rehabilitation Facility	$0	$5.5M
Minnesota Vascular Surgery Center	MN	Ambulatory Surgical Clinic/Center	$1.1M	$254.4K
Neil Shah	MN	Dermatology Physician	$545.4K	$0

Nystrom & Associates, Ltd — Billing Profile & Reimbursement Data

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Nystrom & Associates, Ltd — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References