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NPI 1437261211 · Gering, NE · Federally Qualified Health Center (FQHC)
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Community Action Partnership Of Western Nebraska is a federally qualified health center (fqhc) provider located in Gering, Nebraska. This profile covers 0 Medicare and 72 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Community Action Partnership Of Western Nebraska |
| Address | 975 Crescent Drive |
| City | Gering |
| State | NE |
| ZIP | 69341 |
| Taxonomy | Federally Qualified Health Center (FQHC) |
| NPI Enumerated | August 31, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $11.4M |
| Medicare | $0 |
This entity operates as a Federally Qualified Health Center (FQHC) and its Medicaid billing mix reflects that role: a single bundled clinic encounter code T1015 drives the largest share of revenue with 37.3K claims and $6.8M revenue (59.7% of the provider's Medicaid revenue), and the dedicated FQHC visit code G0467 also appears on the top list with 6.1K claims and $226.4K revenue. The dominance of per-visit bundled codes suggests the organization is structured around routine, high-volume primary care and wraparound services typical of FQHC operations rather than specialty procedural lines.
Revenue concentration is high: the precomputed top-3 Medicaid codes account for 82.0% of this provider's total Medicaid revenue, indicating financial dependence on a very small set of service lines. T1015 alone contributes $6.8M of the $11.4M total Medicaid revenue, which underscores that changes to reimbursement or utilization for that code would materially affect the provider's revenue base.
This provider is effectively a single-payer Medicaid operation: there is no Medicare billing on file while lifetime Medicaid revenue is $11.4M. The absence of Medicare activity means payer risk is concentrated in state Medicaid policy and enrollment trends rather than split across Medicare/Medicaid.
On competitive standing within Nebraska, T1015 ranks #4 of 44 providers (93th percentile) and is flagged as notably above typical state volume, indicating this FQHC is a major statewide provider for the clinic/encounter bundle. Other high-volume services consistent with primary care—99214 (9.4K claims, $1.3M, 11.2%) and 99213 (13.1K claims, $1.3M, 11.2%)—rank in the 94th and 93th percentiles respectively but are described as typical for that code, implying strong but not anomalous primary care E/M activity relative to peers.
Behavioral health is a meaningful secondary service line: high-duration psychotherapy 90837 has 5.7K claims and $673.5K revenue (5.9% of Medicaid revenue) and ranks #18 of 511 providers (97th percentile), described as notably above typical state volume. Shorter psychotherapy 90834 also appears on the list with 5.6K claims and $581.1K revenue (5.1%), together signaling integrated mental health services at scale within the FQHC model.
Oral health services are part of the care mix but represent a smaller share of revenue: D1110 (adult prophylaxis) and several diagnostic/dental evaluation codes (D0120, D0140, D0150) appear in the top codes with modest revenue shares. Several dental codes rank well above peers (D1110 ranks #17 of 308, D0140 ranks #8 of 159) which suggests a comparatively active dental program even if dental revenue is a minority of the total Medicaid dollars.
The provider shows particular code-level outlier signals that imply strategic emphasis areas: beyond T1015 being notably above typical state volume, G0467 ranks #1 of 17 (100th percentile; notably above typical), and D0140 and D1110 are noted as notably above typical. These designations point to operational strengths in FQHC‑style visits and preventive dental care relative to in-state peers.
This organization has long tenure in the NPI registry (NPI enumerated 2006-08-31 (~20 years ago)), which supports an interpretation of stable, established service delivery in the region. That longevity combined with concentrated Medicaid volume suggests statewide market position and operational continuity, but also a revenue profile sensitive to Medicaid policy and to utilization trends for a small set of high-impact codes.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
72 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 37,300 | $180 | $6.8M |
| 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… | 9,360 | $140 | $1.3M |
| 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… | 13,090 | $100 | $1.3M |
| 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… | 5,660 | $120 | $673.5K |
| 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… | 5,640 | $100 | $581.1K |
| G0467 | Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which… | 6,120 | $40 | $226.4K |
| 90791 | In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. | 640 | $100 | $66.9K |
| 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… | 740 | $90 | $63.3K |
| D1206 | Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients | 8,690 | $10 | $52.1K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 2,850 | $20 | $51.2K |
Showing 1–10 of 72
How this provider's Medicaid billing volume and revenue compare to other Nebraska providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Nebraska median
72 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 4 | 40 | 1,930 | $230 | $2.3M |
| 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… | 48 | 700 | 660 | $70 | $305.1K |
| 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… | 39 | 600 | 610 | $70 | $251.4K |
| 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… | 35 | 510 | 450 | $100 | $168.1K |
| 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… | 18 | 510 | 440 | $140 | $155.7K |
| 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… | 18 | 90 | 70 | $200 | $120.4K |
| D1351 | Sealant - per tooth | 116 | 130 | 460 | $30 | $84.7K |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 133 | 130 | 1,410 | $10 | $69.2K |
| D2392 | Post 2 surface resin‑based composite | 58 | 140 | 270 | $80 | $66.8K |
| D1206 | Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients | 20 | 320 | 460 | $20 | $62.2K |
Showing 1–10 of 72
Other providers in the same ZIP code as Community Action Partnership Of Western Nebraska, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Susan Martinez | NE | Mental Health Counselor | $27.9K | $226.8K |
| Monument Physical Therapy, LLC | NE | Physical Therapist | $0 | $249.3K |
| Michael Moravec | NE | Physical Therapist | $143.7K | $0 |
| Meghan Roper | NE | Physical Therapist | $139.5K | $0 |
| Western Sleep Medicine, LLC | NE | Sleep Disorder Diagnostic Clinic/Center | $105.2K | $0 |
| Jodene Burkhart | NE | Nurse Practitioner | $81.2K | $1.1K |
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