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

Why is the Medicaid comparison limited to New Mexico 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. New Mexico (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.

Southwest Psychiatry PLLC (NPI 1427616259)

Southwest Psychiatry PLLC is a psychiatric/mental health nurse practitioner provider located in Santa Teresa, New Mexico. This profile covers 0 Medicare and 12 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Southwest Psychiatry PLLC
Address	5805 Mcnutt Rd
City	Santa Teresa
State	NM
ZIP	88008
Taxonomy	Psychiatric/Mental Health Nurse Practitioner
NPI Enumerated	June 5, 2019

Payer Source	Total Paid
Medicaid	$1.6M
Medicare	$0

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	7,030	$120	$808.7K
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…	5,020	$60	$321.3K
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…	2,310	$80	$189.2K
99205	The provider sees a new 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 provider…	680	$180	$122.4K
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…	880	$110	$92.9K
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…	490	$130	$62K
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…	140	$130	$18K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	50	$130	$6.2K
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…	20	$180	$3.6K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	20	$100	$2.1K

Showing 1–10 of 12

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Mexico Distribution

Southwest Psychiatry PLLC — 0 of 11 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Mexico

Full comparison — all codes billed, vs. New Mexico median

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	471	930	910	$80	$521.6K
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…	140	960	1,010	$90	$490K
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…	548	920	860	$120	$361.9K
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…	79	380	400	$80	$213.5K
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…	19	110	630	$60	$175.1K
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…	181	320	220	$110	$146.2K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	165	180	300	$100	$134.2K
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…	320	380	150	$130	$132.8K
90846	A provider meets with the patient’s family without the patient present to counsel the family on the psychological issues affecting the patient and the family.	63	70	180	$100	$121.1K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	209	340	80	$130	$69.4K

Showing 1–10 of 12

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
At-home Personal Care Services LLC.	NM	Home Health Agency	$0	$88.1M
Sbh El Paso, LLC	NM	Psychiatric Hospital	$0	$42.3M
Amanecer Community Counseling Center	NM	Community/Behavioral Health Agency	$0	$22.1M
Direct Healthcare South Inc	NM	Home Health Agency	$0	$9M
Nm Family Services LLC	NM	Physical Therapist	$0	$8M
Buen Salud Inc	NM	Community/Behavioral Health Agency	$0	$4.2M
Thrive Wellness And Rehab, P.L.L.C	NM	Physical Therapist	$0	$4.1M
Rio Valle Behavioral Health Centre	NM	Psychiatry Physician	$0	$2.7M
Santa Teresa Family Medical Center	NM	Clinic/Center	$0	$2M
Doctors Of Santa Teresa PC	NM	Family Medicine Physician	$0	$1.8M

Southwest Psychiatry PLLC — Billing Profile & Reimbursement Data

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Southwest Psychiatry PLLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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References