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.

Benefis Community Care, Inc. (NPI 1548530025)

Field	Value
Entity Type	Organization
Organization	Benefis Community Care, Inc.
Address	1411 9th St So
City	Great Falls
State	MT
ZIP	59405
Taxonomy	Case Management Agency
NPI Enumerated	December 30, 2011

Payer Source	Total Paid
Medicaid	$13.2M
Medicare	$0

Key Findings

BENEFIS COMMUNITY CARE, INC. is effectively a Medicaid-focused case management agency: it has no Medicare billing on file and $13.2M in lifetime Medicaid revenue, indicating the organization’s operations and revenue stream are concentrated in Medicaid services rather than Medicare. Its NPI was enumerated on 2011-12-30, so the provider has been in the registry for about 15 years, supporting a sustained presence in the state market.

Revenue concentration is extremely high: the top three Medicaid codes account for 100.0% of the provider’s total Medicaid revenue, with a single code, T2022, alone representing $12.5M or 94.9% of Medicaid revenue. This indicates the business model is dominated by monthly case management services rather than a broad mix of billable procedures.

The dominant code T2022 (Case management, per month) accounted for 39.9K claims at an average paid amount of $314 and generated $12.5M in revenue. In-state competitive positioning for T2022 is substantial: the provider ranks #2 of 11 in Montana and sits at the 90th percentile, suggesting it is one of the leading suppliers of monthly case management in the state but not the statewide single dominant supplier.

Secondary service lines are minor by comparison: H0032 (Mental health service plan development by non-physician) produced $640.2K (4.8% of Medicaid revenue) across 1.8K claims at $347 average paid, ranking #5 of 8 providers (43rd percentile). This placement indicates the provider participates in behavioral health planning services but at a moderate, unremarkable level relative to peers.

Other billed items are negligible in revenue share: T2003 (Non-emergency transportation; encounter/trip) and T1016 (Case management, each 15 minutes) together account for under 1% of Medicaid revenue ($35.8K and $2.6K respectively) and rank low in-state (T2003 at #33 of 39, 16th percentile; T1016 at #50 of 53, 6th percentile). These volumes imply transportation and 15-minute incremental case management units are operationally present but not material to the provider’s financial profile.

Given the absence of Medicare revenue, the payer mix is effectively single-payer (Medicaid) for this provider; analysts should treat Medicaid program policy and rate changes as primary drivers of financial risk and growth opportunity. The concentration in a single code (T2022) amplifies sensitivity to reimbursement or eligibility changes tied to monthly case management policies.

The provider’s in-state competitive standing is mixed: it is a leading participant for monthly case management (top decile for T2022) but only a middling or modest participant on related services like mental health plan development and transportation. This pattern suggests scale and specialization in recurring case management enrollment rather than breadth across ancillary service lines.

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
T2022	Case management, per month	39,900	$310	$12.5M
H0032	Mental health service plan development by non-physician	1,850	$350	$640.2K
T2003	Non-emergency transportation; encounter/trip	850	$40	$35.8K
T1016	Case management, each 15 minutes	40	$70	$2.6K

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

Benefis Community Care, Inc. — 0 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
T2022	Case management, per month	2	10	1,510	$320	$5M
H0032	Mental health service plan development by non-physician	5	10	1,920	$360	$1.4M
T1016	Case management, each 15 minutes	50	50	2,720	$50	$1.4M
T2003	Non-emergency transportation; encounter/trip	33	40	2,180	$30	$78K

Nearby Providers

Other providers in the same ZIP code as Benefis Community Care, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Benefis Hospitals Inc	MT	Multi-Specialty Clinic/Center	$0	$38.2M
Great Falls Public Schools	MT	Local Education Agency (LEA)	$0	$15M
Great Falls Pediatric Dentistry, LLC	MT	Pediatric Dentistry	$0	$14.9M
Great Falls Clinic LLC	MT	Multi-Specialty Clinic/Center	$0	$11.2M
Easterseals-goodwill Northern Rocky Mountain, Inc.	MT	Developmentally Disabled Services Day Training Agency	$0	$7.4M
Levi C Maltby Dmd P.C.	MT	Dentist	$0	$6M
Great Falls Emergency Services Inc	MT	Land Ambulance	$842.6K	$4.4M
Benefis Hospitals, Inc.	MT	Air Ambulance	$0	$5.2M
Easterseals Goodwill N. Rocky Mtn	MT	Developmentally Disabled Services Day Training Agency	$0	$3.7M
Benefis Hospitals, Inc.	MT	General Acute Care Hospital	$0	$3.5M

Benefis Community Care, Inc. — Billing Profile & Reimbursement Data

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Benefis Community Care, Inc. — 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