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

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

Great Falls Public Schools (NPI 1396892782)

Field	Value
Entity Type	Organization
Organization	Great Falls Public Schools
Address	4040 Central Ave
City	Great Falls
State	MT
ZIP	59405
Taxonomy	Local Education Agency (LEA)
NPI Enumerated	January 5, 2007

Payer Source	Total Paid
Medicaid	$15M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and is effectively a single‑payer Medicaid billing entity, reporting total Medicaid revenue of $15M. The absence of Medicare claims indicates payer mix is overwhelmingly Medicaid-directed rather than split between Medicare and Medicaid.

Revenue is extremely concentrated: the precomputed top three Medicaid codes account for 98.0% of this provider’s Medicaid revenue. Those top three are H0036 ($13.8M, 92.2%), 92507 ($625.5K, 4.2%), and T1019 ($241.1K, 1.6%), which together represent nearly the entire reported $15M Medicaid book of business.

The code mix points to a school-based behavioral health and therapy operation consistent with the Local Education Agency taxonomy: H0036 (Community psychiatric supportive treatment, face-to-face, per 15 minutes) drives the portfolio and is complemented by speech/language codes (92507 and 92508) and personal care services (T1019). This combination suggests primary service lines are high-volume, per‑15‑minute behavioral health visits plus substantial speech‑language pathology and supportive care delivered in an educational setting.

Volume and unit‑payment patterns show a high-frequency, lower-dollar encounter model. H0036 has 141.2K claims at $98 avg paid/claim ($13.8M revenue), 92507 has 17.4K claims at $36 avg paid/claim ($625.5K revenue), and 92508 has 19.3K claims at $11 avg paid/claim ($212.6K revenue), indicating many short-duration billable units rather than a small number of high-fee procedures.

State competitive standing is dominant on key behavioral health and speech metrics: H0036 ranks #3 of 90 providers in-state (98th percentile; extreme outlier), 92507 ranks #12 of 147 (92th percentile; notably above typical), and 92508 ranks #2 of 50 (98th percentile; notably above typical). By contrast, T1019 ranks #15 of 38 (62th percentile; typical), so the provider is a clear market leader for community psychiatric supportive treatment and a leading provider for speech services, while its personal care service volumes are unremarkable.

The provider’s NPI was enumerated on 2007-01-05 (~19 years ago), indicating a long-tenured presence in the market and a sustained billing relationship with Medicaid over nearly two decades. That tenure supports the plausibility of the high cumulative Medicaid revenue and deep operational focus on school-based services.

The extreme concentration in H0036 constitutes a material operational risk: because H0036 alone represents $13.8M (92.2%) of Medicaid revenue, any changes to authorization rules, reimbursement rates, or eligibility for that modality would disproportionately affect overall revenue. Monitoring policy or rate changes for H0036 and related school-based behavioral health billing guidance should be a priority for payers and analysts evaluating this provider.

Medicaid: Complete Services Breakdown

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	141,210	$100	$13.8M
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	17,370	$40	$625.5K
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	8,040	$30	$241.1K
92508	The provider treats a group of two or more individuals with communication and hearing difficulties by directly interacting with them. He assesses the patients with impairment in their ability to make…	19,320	$10	$212.6K
H2027	Psychoeducational service, per 15 minutes	600	$90	$56.5K
T2003	Non-emergency transportation; encounter/trip	1,050	$10	$14.7K
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.	470	$30	$14K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	20	$90	$1.5K
96101	N/A	10	$50	$660
HOO36	N/A	20	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Montana Distribution

Great Falls Public Schools — 3 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. Montana median

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	15	40	6,240	$130	$14.6M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	3	90	5,740	$80	$1.6M
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	12	150	2,760	$40	$224.3K
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.	132	200	1,110	$60	$207.2K
T2003	Non-emergency transportation; encounter/trip	29	40	2,180	$30	$78K
92508	The provider treats a group of two or more individuals with communication and hearing difficulties by directly interacting with them. He assesses the patients with impairment in their ability to make…	2	50	3,530	$10	$61.6K
H2027	Psychoeducational service, per 15 minutes	1	10	140	$90	$21.4K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	16	30	30	$100	$8.2K
96101	N/A	7	10	40	$80	$6.1K
HOO36	N/A	1	10	20	$0	$0

Nearby Providers

Other providers in the same ZIP code as Great Falls Public Schools, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Benefis Hospitals Inc	MT	Multi-Specialty Clinic/Center	$0	$38.2M
Great Falls Pediatric Dentistry, LLC	MT	Pediatric Dentistry	$0	$14.9M
Benefis Community Care, Inc.	MT	Case Management Agency	$0	$13.2M
Great Falls Clinic LLC	MT	Multi-Specialty Clinic/Center	$0	$11.2M
Easterseals-goodwill Northern Rocky Mountain, Inc.	MT	Developmentally Disabled Services Day Training Agency	$0	$7.4M
Levi C Maltby Dmd P.C.	MT	Dentist	$0	$6M
Great Falls Emergency Services Inc	MT	Land Ambulance	$842.6K	$4.4M
Benefis Hospitals, Inc.	MT	Air Ambulance	$0	$5.2M
Easterseals Goodwill N. Rocky Mtn	MT	Developmentally Disabled Services Day Training Agency	$0	$3.7M
Benefis Hospitals, Inc.	MT	General Acute Care Hospital	$0	$3.5M

Great Falls Public Schools — Billing Profile & Reimbursement Data

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Great Falls Public Schools — 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