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

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

Bonneville School Dist #93 (NPI 1538150081)

Field	Value
Entity Type	Organization
Organization	Bonneville School Dist #93
Address	3549 N Ammon Rd
City	Idaho Falls
State	ID
ZIP	83401
Taxonomy	Local Education Agency (LEA)
NPI Enumerated	November 3, 2005

Payer Source	Total Paid
Medicaid	$27.5M
Medicare	$0

Key Findings

This entity is effectively a Medicaid-focused provider: there is no Medicare billing on file and total Medicaid revenue is $27.5M, indicating a single-payer footprint concentrated on Medicaid-funded services rather than fee-for-service Medicare. The absence of Medicare activity suggests its operations are oriented toward populations and programs covered under state Medicaid rather than the Medicare beneficiary population.

Revenue is highly concentrated in a very small set of service lines: the precomputed top 3 Medicaid codes account for 75.6% of the provider’s total Medicaid revenue, so most of the $27.5M is driven by a handful of behavioral-health and assessment codes. That concentration implies financial sensitivity to rate, utilization, or policy changes affecting those specific codes.

Clinical mix and service line implications point to school-based behavioral health and therapy operations: H0004 (behavioral health counseling and therapy) and H2014 (skills training and development) together represent the largest shares ($10.8M and $5.9M respectively) and are delivered in high volumes, while 96152 and other assessment/therapy codes (e.g., speech and occupational therapy codes such as 92507, 92508, 97110) indicate integrated counseling, skills-building, testing, and therapy services consistent with an LEA providing in-school behavioral health, speech/language, and therapy supports.

Competitive standing in-state is strong on several high-revenue codes. The provider ranks #6 of 157 for H0004 at the 97th percentile and #3 of 56 for H2014 at the 96th percentile, which together indicate it is a leading statewide provider for those behavioral-health service lines and operates at substantially higher volumes than most peers. 96152 also ranks highly (#4 of 73, 96th percentile), showing similar leadership in testing/assessment activity.

Some high-volume codes are explicitly flagged as “notably above typical state volume,” creating clear statistical outliers for service intensity: H0004 and H2014 are both characterized that way, and several therapy/evaluation codes (92507, 92508, 97530) are also described as notably above typical state volume. These descriptors support describing the provider as an outlier in delivery volume for school-based behavioral health, speech services, and therapy relative to most in-state peers.

While several additional therapy and testing codes show activity, many are in more typical ranges: codes such as H2017, T1019, and multiple psychological testing codes (96130, 96131, 96136, 96137) are described as having typical or unremarkable volume and sit lower in their statewide ranking percentiles. This pattern indicates the provider’s dominance is concentrated in a few core codes rather than across all related service lines.

Operational tenure is long-standing: the NPI was enumerated on 2005-11-03 (~21 years ago), which supports interpreting current utilization patterns as the product of an established program rather than a newly created service line. This longevity may reflect sustained contracts or arrangements within the school district and Medicaid program.

Service mix suggests reliance on time-based, per-15-minute modalities: many top revenue codes (H0004, H2014, H2017, 97530, T1019) are billed per 15-minute units, indicating workflows organized around frequent, short-duration therapy and counseling sessions consistent with school-based delivery models and individualized education or treatment plans.

Medicaid: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0004	Behavioral health counseling and therapy, per 15 minutes	55,850	$190	$10.8M
H2014	Skills training and development, per 15 minutes	53,060	$110	$5.9M
96152	N/A	27,570	$150	$4.1M
H2017	Psychosocial rehabilitation services, per 15 minutes	10,100	$220	$2.2M
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.	23,960	$60	$1.5M
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…	28,880	$40	$1.2M
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…	34,330	$30	$892.6K
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…	40,380	$10	$282.6K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	3,480	$50	$180.7K
90832	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…	2,500	$60	$147.4K

Showing 1–10 of 20

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Idaho Distribution

Bonneville School Dist #93 — 7 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. Idaho median

20 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…	27	100	11,400	$80	$2M
H0004	Behavioral health counseling and therapy, per 15 minutes	6	160	4,020	$140	$1.6M
H2017	Psychosocial rehabilitation services, per 15 minutes	24	140	2,000	$110	$633.3K
H2014	Skills training and development, per 15 minutes	3	60	2,500	$60	$613.3K
96152	N/A	4	70	2,270	$80	$608.8K
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.	15	280	1,480	$70	$389.4K
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…	9	210	3,020	$50	$389K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	60	230	1,390	$40	$134.8K
T1001	Nursing assessment / evaluation	14	50	260	$60	$77K
96131	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	7	20	110	$190	$63.7K

Showing 1–10 of 20

Nearby Providers

Other providers in the same ZIP code as Bonneville School Dist #93, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Idaho Falls School District 91	ID	Local Education Agency (LEA)	$0	$11.2M
Affiliates Inc.	ID	Developmentally Disabled Services Day Training Agency	$0	$9.9M
Transitions, Inc.	ID	Developmentally Disabled Services Day Training Agency	$0	$7.8M
Innovative Health Care Concepts, Inc	ID	Case Manager/Care Coordinator	$0	$5.7M
Stewards Of Recovery	ID	Community/Behavioral Health Agency	$0	$5.1M
Joshua D. Smith Foundation	ID	Developmentally Disabled Services Day Training Agency	$0	$4.1M
See Opportunities And Achieve Results	ID	Case Management Agency	$0	$3.8M
Porter Eyecare PLLC	ID	Optometrist	$0	$3.1M
Denture Clinic Inc	ID	Dental Laboratory	$0	$3M
Childrens Supportive Services Incorporated	ID	Social Worker	$0	$3M

Bonneville School Dist #93 — Billing Profile & Reimbursement Data

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Bonneville School Dist #93 — 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