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.

State Of Montana (NPI 1497765150)

Field	Value
Entity Type	Organization
Organization	State Of Montana
Address	525 E Mercury St
City	Butte
State	MT
ZIP	59701
Taxonomy	Substance Abuse Rehabilitation Facility
NPI Enumerated	August 8, 2006

Payer Source	Total Paid
Medicaid	$12.7M
Medicare	$0

Key Findings

This provider reports $12.7M in lifetime Medicaid revenue and has no Medicare billing on file, making its active commercial/Medicare footprint effectively nil and its operations functionally single-payer (Medicaid) in scale. Analysts should treat this entity as Medicaid-focused when assessing payer exposure and reimbursement trends.

Revenue is highly concentrated: the top three Medicaid codes (H0018, H0010, and 99326) together account for 99.6% of this provider's total Medicaid revenue, with H0018 alone generating $11.4M (90.1% of Medicaid revenue), H0010 $980.1K (7.7%), and 99326 $230.1K (1.8%). This concentration indicates that changes in reimbursement or utilization for these specific services would materially affect the provider's topline.

Code mix and service-line implications point to a residential substance-use disorder treatment model: H0018 (short-term residential behavioral health, per diem, without room and board) and H0010 (sub-acute detoxification, residential inpatient) together account for the overwhelming majority of revenue, signaling that the facility’s core business is residential addiction treatment and detox. The presence of 99344 (home/residence E/M visits, 60+ minutes) and 99326 (no description available) suggests ancillary evaluation & management services are billed alongside residential care, possibly for intensive clinical assessments or extended patient encounters.

Competitive standing on the largest code is modest within the state: H0018 is $11.4M and ranks #3 of 6 providers in-state (60th percentile; typical, unremarkable volume for this code), indicating the provider is neither the dominant statewide leader nor a low-volume outlier but a typical participant in short-term residential billing. Given H0018’s 90.1% share of the provider’s Medicaid revenue, this middling statewide rank still translates to a locally significant operational footprint.

H0010’s state position and interpretation: H0010 produced $980.1K (7.7% of Medicaid revenue) and ranks #2 of 2 providers in-state (0th percentile; typical, unremarkable volume for this code), which reflects a very small peer universe rather than unusually high or low utilization. For 99326 the data notes 1.8K claims and $230.1K revenue and shows rank #1 of 1 providers in-state (0th percentile; no state peer volume comparison available), implying unique or isolated billing for that code in the state—use caution when benchmarking 99326 because there is effectively no comparable state peer set.

Statistical standing language from the dataset aligns with routine volumes rather than extreme outliers: the dataset labels for these codes include "typical, unremarkable volume for this code" (H0018, H0010, 99344) and "no state peer volume comparison available" (99326), so the provider’s Medicaid activity looks concentrated but not anomalous versus the available in-state peers. There are no dataset labels indicating notably above-typical or extreme outlier behavior.

Tenure and operational stability: the NPI was enumerated on 2006-08-08 (~20 years ago), indicating a long-standing presence in the market that supports the observed specialization in residential substance-abuse services and suggests established referral and payor relationships within Medicaid. This longevity lowers the likelihood that observed patterns are temporary start-up artifacts.

Business risk and strategic implications: with 90.1% of Medicaid revenue coming from H0018, the provider is highly dependent on short-term residential behavioral health per-diem reimbursement; this concentration creates both operational focus and vulnerability to rate changes, utilization shifts, or policy updates affecting residential behavioral health and detox services. The absence of Medicare billing limits diversification of payer mix and may constrain comparisons to national Medicare-based benchmarks, making Medicaid rate and utilization trends the primary levers for revenue forecasting and competitive analysis.

Medicaid: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	4,300	$2,660	$11.4M
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	350	$2,840	$980.1K
99326	N/A	1,810	$130	$230.1K
99344	The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider spends at least…	370	$130	$46.8K

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

State Of Montana — 1 of 4 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

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	3	10	3,620	$460	$10.3M
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	2	10	2,590	$480	$1.2M
99326	N/A	1	10	1,810	$130	$230.4K
99344	The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider spends at least…	1	10	220	$110	$24.7K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Amber Dayhuff	MT	Psychiatric/Mental Health Nurse Practitioner	$0	$208.1K
Sandra Cox	CA	Psychiatry Physician	$94.9K	$0

Nearby Providers

Other providers in the same ZIP code as State Of Montana, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bsw, Inc.	MT	Developmentally Disabled Services Day Training Agency	$0	$20.4M
Benefis Community Care, Inc.	MT	Case Management Agency	$0	$14.6M
Scl Health Medical Group-butte LLC	MT	Family Medicine Physician	$0	$9.9M
Butte Public Schools	MT	Local Education Agency (LEA)	$0	$6.9M
Community, Counseling & Correctional Services, Inc.	MT	Substance Use Disorder Rehabilitation Clinic/Center	$0	$3.8M
Butte School District #1	MT	Mental Health Counselor	$0	$3.8M
Ryan Todorovich	MT	General Practice Dentistry	$0	$3.1M
Lindsey Todorovich	MT	General Practice Dentistry	$0	$2.9M
Silver Bow County Developmental Disabilities Council, Inc.	MT	Developmentally Disabled Services Day Training Agency	$0	$2.2M
Big Sky Senior Living	MT	Assisted Living Facility	$0	$2.1M

State Of Montana — Billing Profile & Reimbursement Data

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State Of Montana — 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