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

Why is the Medicaid comparison limited to North 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. North 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.

Heartview Foundation (NPI 1417000233)

Field	Value
Entity Type	Organization
Organization	Heartview Foundation
Address	101 E Broadway Ave
City	Bismarck
State	ND
ZIP	58501
Taxonomy	Substance Use Disorder Rehabilitation Clinic/Center
NPI Enumerated	January 18, 2007

Payer Source	Total Paid
Medicaid	$13.6M
Medicare	$0

Key Findings

HEARTVIEW FOUNDATION reports no Medicare billing on file and is effectively a Medicaid-focused provider with $13.6M in lifetime Medicaid revenue. This makes its commercial/other-payer exposure unclear from Medicare data and positions the organization as a single-payer (Medicaid) revenue operation in available records.

Revenue is highly concentrated in a small set of Medicaid service lines: H2036 ($3.7M, 27.1%), S0201 ($2.2M, 16.1%), and H0020 ($1.3M, 9.5%) together account for 52.7% of the provider’s total Medicaid revenue. Those three codes are the primary revenue drivers and indicate the bulk of billing depends on per-diem treatment and medication-dispensing services.

The code mix (H2036, S0201, H0020, H2010) indicates a service model centered on substance use disorder treatment that combines per-diem residential/ambulatory programs, structured day/partial hospitalization, and medication-assisted treatment. High volume lines such as H0020 (129K claims) and H2010 (82.1K claims) point to routine, repeated medication administration and medication management as core operational activities.

HEARTVIEW is a state leader for several group and intensive outpatient service lines: H0015 ranks #1 of 11 providers in-state (100th percentile) and is described as notably above typical state volume for this code, and H0005 ranks #1 of 8 providers (100th percentile) also notably above typical state volume. These standings suggest above-typical capacity or market share for group-based and intensive outpatient substance use services within North Dakota.

The provider also shows dominance in onsite testing services: 80305 (presumptive drug test) ranks #1 of 15 providers in-state (100th percentile; notably above typical state volume for this code) and 82075 (breath alcohol analysis) ranks #1 of 4 providers in-state (100th percentile; typical, unremarkable volume for this code). This pattern signals integrated clinical and laboratory workflows that support frequent toxicology screening and alcohol monitoring in their treatment programs.

HEARTVIEW sustains substantial outpatient medical and psychotherapy activity alongside addiction services, with 99213 generating $595.8K (4.4% of Medicaid revenue) and ranking #25 of 206 providers in-state (88th percentile), while psychotherapy codes such as 90853 ($294.5K, 2.2%, rank #6 of 22, 76th percentile) and 90832 ($251.5K, 1.8%, rank #3 of 29, 93th percentile) show meaningful behavioral health visit volumes. These figures indicate an integrated model that pairs medical evaluation and counseling services with substance use treatment.

Several high-volume codes are ranked at or above typical peer levels for the state: S0201 ranks #2 of 7 (83th percentile; typical, unremarkable volume for this code) and H0020 ranks #2 of 5 (75th percentile; typical, unremarkable volume for this code), indicating consistent but not dominant statewide positions in partial hospitalization and methadone administration. Conversely, codes where HEARTVIEW is at the 100th percentile—such as H0015 and 80305—represent clear outperformance relative to state peers in those specific services.

The provider has an established presence in the market based on tenure: NPI enumerated 2007-01-18 (~19 years ago), which suggests long-term operation and likely institutional experience delivering substance use disorder services in the Bismarck, ND area. That longevity combined with concentrated Medicaid revenue implies strategic dependence on maintaining Medicaid relationships and state program referrals.

Medicaid: Complete Services Breakdown

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

28 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2036	Alcohol and/or other drug treatment program, per diem	6,160	$600	$3.7M
S0201	Partial hospitalization services, less than 24 hours, per diem	5,550	$400	$2.2M
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	129,040	$10	$1.3M
H0016	Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting)	16,420	$70	$1.2M
S9475	Ambulatory setting substance abuse treatment or detoxification services, per diem	2,230	$410	$917.9K
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…	3,310	$220	$731.1K
H2010	Comprehensive medication services, per 15 minutes	82,060	$10	$656.5K
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…	5,730	$100	$595.8K
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…	2,560	$160	$417K
82075	The lab analyst performs the technical lab test to analyze the quantitative amount of alcohol in a patient’s breath and correlates the measurement to blood alcohol content.	6,900	$40	$303.6K

Showing 1–10 of 28

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Dakota Distribution

Heartview Foundation — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Dakota

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

28 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2036	Alcohol and/or other drug treatment program, per diem	4	10	3,070	$470	$2.2M
S9480	Intensive outpatient psychiatric services, per diem	2	10	840	$530	$2.1M
S0201	Partial hospitalization services, less than 24 hours, per diem	2	10	2,240	$540	$1.9M
H0016	Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting)	3	10	9,500	$90	$1.4M
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	2	10	88,890	$10	$988.7K
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…	25	210	360	$100	$498.2K
S9475	Ambulatory setting substance abuse treatment or detoxification services, per diem	2	10	240	$460	$492.4K
H2010	Comprehensive medication services, per 15 minutes	2	10	73,500	$10	$459K
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…	29	170	300	$100	$415.8K
H2035	Alcohol and/or other drug treatment program, per hour	14	20	590	$90	$206.4K

Showing 1–10 of 28

Related Providers

Other providers that share a Tax Identification Number (TIN) with Heartview Foundation, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Heartview Foundation Cando	ND	Substance Use Disorder Rehabilitation Clinic/Center	$0	$3M
Heartview Foundation	ND	Substance Use Disorder Rehabilitation Clinic/Center	$0	$2.3M
Heartview Foundation Dickinson	ND	Substance Use Disorder Rehabilitation Clinic/Center	$0	$677.5K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Enable, Inc.	ND	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$40.8M
Sanford Bismarck	ND	General Acute Care Hospital	$0	$12.5M
Bismarck Public Schools Early Intervention	ND	Early Intervention Provider Agency	$0	$12M
West Central Behavioral Health Clinic	ND	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$6.2M
D. Michael Goebel D.d.s., PC	ND	Pediatric Dentistry	$0	$5.8M
Poppy's Promise LLC	ND	Community/Behavioral Health Agency	$0	$5.6M
Sanford Bismarck	ND	Clinical Medical Laboratory	$726.9K	$4.3M
St. Alexius Medical Center	ND	Specialist	$0	$3.6M
Lasting Love Homecare	ND	In Home Supportive Care Agency	$0	$3.6M
St. Alexius Medical Center	ND	General Acute Care Hospital	$0	$3.5M

Heartview Foundation — Billing Profile & Reimbursement Data

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Heartview Foundation — 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