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.

St Lukes Community Hospital (NPI 1548612096)

St Lukes Community Hospital is a rural health clinic/center provider located in Polson, Montana. This profile covers 0 Medicare and 29 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	St Lukes Community Hospital
Address	107 Ridgewater Dr, Ste A
City	Polson
State	MT
ZIP	59860
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	July 8, 2016

Payer Source	Total Paid
Medicaid	$403.3K
Medicare	$0

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

29 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	7,210	$30	$237.8K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	1,870	$30	$50.6K
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…	7,490	$10	$45K
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…	6,460	$10	$32.3K
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.	860	$20	$18.9K
G0283	Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care	1,430	$10	$10K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	490	$10	$3K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	130	$20	$2.8K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	70	$10	$870
97161	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	10	$60	$820

Showing 1–10 of 29

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

St Lukes Community Hospital — 0 of 13 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

29 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	59	530	580	$70	$224.6K
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.	114	200	1,110	$60	$207.2K
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…	66	520	730	$40	$196.4K
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…	716	1,200	750	$80	$143.2K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	31	70	420	$80	$111.7K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	27	70	310	$90	$107.1K
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…	40	160	250	$110	$85.9K
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…	22	160	1,050	$10	$45.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	21	80	130	$80	$43.2K
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…	129	170	310	$20	$38.7K

Showing 1–10 of 29

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Lukes Community Hospital	MT	Urgent Care Clinic/Center	$0	$1.2M
St Lukes Community Hospital	MT	Family Medicine Physician	$0	$824.3K
St Lukes Community Hospital	MT	Critical Access Hospital	$0	$714.7K
Patrick Mcdonnell	NM	Diagnostic Radiology Physician	$142.3K	$0
Valerie Stine	MT	Diagnostic Radiology Physician	$132.8K	$0
Kara Heuvelhorst	WI	Diagnostic Radiology Physician	$131.4K	$0
Michael Henson	MT	Diagnostic Radiology Physician	$129.7K	$0
William Benedetto	MT	Diagnostic Radiology Physician	$122.4K	$0
Andrew Ziegert	WI	Diagnostic Radiology Physician	$120.9K	$0
Kelly Kieper	NM	Diagnostic Radiology Physician	$117.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Polson Ambulance, Inc.	MT	Land Ambulance	$459.3K	$2.1M
Polson School District 23	MT	Local Education Agency (LEA)	$0	$1.6M
Providence St Joseph Medical Center	MT	Family Medicine Physician	$0	$1.1M
Montana Dental Group LLC	MT	General Practice Dentistry	$0	$1M
Michael Windauer	MT	General Practice Dentistry	$0	$673.1K
Kickin It Enterprises	MT	Clinical Social Worker	$0	$659.3K
Providence St Joseph Medical Center	MT	Critical Access Hospital	$0	$654.7K
Jeffrey Bird	MT	General Practice Dentistry	$0	$619.1K
Kalispell Regional Medical Center Inc	MT	Family Medicine Physician	$0	$418.9K
Shasta Baum-strait	MT	Mental Health Counselor	$0	$360.7K

St Lukes Community Hospital — Billing Profile & Reimbursement Data

Sign up for St Lukes Community Hospital — Billing Profile & Reimbursement Data policy alerts

St Lukes Community Hospital — Billing Profile & Reimbursement Data

Sign up for St Lukes Community Hospital — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References