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

Why is the Medicaid comparison limited to Missouri 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. Missouri (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 Missouri (NPI 1578199238)

Field	Value
Entity Type	Organization
Organization	State Of Missouri
Address	1706 E Elm St
City	Jefferson City
State	MO
ZIP	65101
Taxonomy	Rehabilitation Psychologist
NPI Enumerated	March 13, 2020

Payer Source	Total Paid
Medicaid	$91.5M
Medicare	$0

Key Findings

This entity is effectively single‑payer at the federal level: there is no Medicare billing on file while Medicaid revenue totals $91.5M, and the NPI has been enumerated since 2020-03-13 (~6 years ago), indicating roughly six years of recorded activity under this taxonomy. The absence of Medicare activity concentrates the provider’s exposure and growth opportunities in the Medicaid market rather than across traditional dual‑payer channels.

Revenue is highly concentrated in a few programmatic behavioral‑health codes: the top three Medicaid codes account for 82.4% of total Medicaid revenue, led by H0036 at $42.3M (46.2% of Medicaid revenue), H0037 at $20.5M (22.4%), and H2012 at $12.6M (13.8%). This three‑code concentration underscores that most of the provider’s Medicaid receipts derive from community psychiatric supportive treatment (H0036/H0037) and behavioral health day treatment (H2012).

The code mix points to a large community and programmatic behavioral‑health operation rather than a small outpatient psychology practice. Dominant codes H0036 (community psychiatric supportive treatment, per 15 minutes), H0037 (community psychiatric supportive treatment program, per diem), and H2012 (behavioral health day treatment, per hour) — together with line items such as H0031, H0040, H2017, and H0038 — indicate day programs, per‑diem program services, care coordination, and peer/support services form the core service lines.

Competitive standing for the top revenue drivers is modest within Missouri: H0036 ranks #9 of 23 providers in‑state (64th percentile; typical, unremarkable volume for this code), H0037 ranks #6 of 18 (71th percentile; typical, unremarkable volume for this code), and H2012 ranks #7 of 14 (54th percentile; typical, unremarkable volume for this code). Those ranks indicate a sizable presence but not a dominant statewide position for these programmatic services.

Certain non‑program codes show notable deviations from peer volumes: 99214 appears as an outlier with 16.9K claims and $1.7M revenue and is described as notably above typical state volume for this code (98th percentile). High utilization of 99214 suggests the organization also bills a large volume of standard established E/M encounters compared with peers, which could reflect integrated outpatient evaluation workflows or routine medical visits embedded in behavioral programs.

Assessment and intake throughput is relatively strong: H0031 (mental health assessment, by non‑physician) generated $6.6M from 9.3K claims and ranks #2 of 7 providers in‑state (83th percentile; typical, unremarkable volume for this code). This rank and revenue imply consistent referral/intake activity feeding the programmatic treatment lines rather than isolated, low‑volume assessments.

Operational scale is evident in claim volumes for program services: H0036 has 315.6K claims, H0037 has 71.6K claims, and H2012 has 34.4K claims, reflecting high throughput consistent with per‑15‑minute and per‑diem service delivery models. Outside the top three, a broad tail of codes (H0038, H2010, 90792, 99213, etc.) together account for the remaining Medicaid revenue, indicating some service diversification but with most dollars concentrated in the core programs.

From a risk and contracting perspective, the provider’s heavy reliance on Medicaid and on three programmatic codes (82.4% of Medicaid revenue) concentrates reimbursement risk: changes to Medicaid rates, per‑diem rules, or eligibility for H0036/H0037/H2012 could materially affect cash flow. Monitoring state policy, per‑unit rate adjustments, and utilization patterns for those dominant codes should be a priority for payer and provider analysts assessing financial and operational resilience.

Medicaid: Complete Services Breakdown

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

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	315,620	$130	$42.3M
H0037	Community psychiatric supportive treatment program, per diem	71,610	$290	$20.5M
H2012	Behavioral health day treatment, per hour	34,450	$370	$12.6M
H0031	Mental health assessment, by non-physician	9,280	$710	$6.6M
H0040	Assertive community treatment program, per diem	14,230	$190	$2.7M
H2017	Psychosocial rehabilitation services, per 15 minutes	23,180	$80	$1.9M
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…	16,920	$100	$1.7M
H0038	Self‑help/peer services, per 15 minutes	12,950	$130	$1.7M
H2010	Comprehensive medication services, per 15 minutes	14,580	$30	$495.7K
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…	1,520	$290	$435.3K

Showing 1–10 of 17

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Missouri Distribution

State Of Missouri — 1 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. Missouri median

17 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0037	Community psychiatric supportive treatment program, per diem	6	20	56,420	$120	$11.7M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	9	20	214,040	$20	$10.8M
H0031	Mental health assessment, by non-physician	2	10	130	$620	$4.7M
H2017	Psychosocial rehabilitation services, per 15 minutes	16	20	40,460	$20	$2M
H2012	Behavioral health day treatment, per hour	7	10	33,050	$30	$1.9M
H0040	Assertive community treatment program, per diem	7	10	20,740	$10	$572.6K
H2010	Comprehensive medication services, per 15 minutes	8	20	8,760	$10	$336.6K
H0038	Self‑help/peer services, per 15 minutes	10	40	2,510	$10	$272.7K
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	3,170	230	$70	$128.1K
H0002	Behavioral health screening to determine eligibility for admission to treatment program	20	20	8,600	$10	$125.5K

Showing 1–10 of 17

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
State Of Missouri	MO	Rehabilitation Psychologist	$0	$493.6M
State Of Missouri	MO	Addiction (Substance Use Disorder) Counselor	$0	$271.2M
State Of Missouri	MO	Local Education Agency (LEA)	$0	$39M
Cole County Residential Services, Inc	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$13.2M
Curators Of The University Of Missouri	MO	General Acute Care Hospital	$0	$12.1M
Central Connections, Inc	MO	Case Management Agency	$0	$8.6M
State Of Missouri	MO	Clinical Medical Laboratory	$0	$7.8M
Capital Region Medical Center	MO	Family Medicine Physician	$0	$4.4M
Community Health Ctr Of Central Missouri	MO	Federally Qualified Health Center (FQHC)	$0	$4.4M
Paige Hedgpath Od,pc	MO	Optometrist	$0	$3.6M

State Of Missouri — Billing Profile & Reimbursement Data

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State Of Missouri — 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