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

Why is the Medicaid comparison limited to New Mexico 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. New Mexico (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.

Presbyterian Medical Services (NPI 1588731582)

Field	Value
Entity Type	Organization
Organization	Presbyterian Medical Services
Address	2573 State Hwy 522
City	Questa
State	NM
ZIP	87556
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	November 29, 2006

Payer Source	Total Paid
Medicaid	$2.5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

34 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	5,560	$150	$816.6K
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…	3,660	$140	$501K
D0999	N/A	2,380	$190	$440.7K
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…	1,720	$180	$306.2K
90834	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…	460	$180	$82.3K
99442	N/A	400	$170	$68.7K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	380	$160	$60.9K
99441	N/A	290	$170	$50.6K
0011A	N/A	240	$170	$39.4K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	1,230	$30	$36.9K

Showing 1–10 of 34

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Mexico Distribution

Presbyterian Medical Services — 0 of 24 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Mexico

Full comparison — all codes billed, vs. New Mexico median

34 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2015	Comprehensive community support services, per 15 minutes	112	120	2,640	$150	$1.2M
D0999	N/A	41	80	2,250	$190	$987.3K
Q3014	Telehealth originating site facility fee	113	180	620	$160	$546.7K
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…	184	930	910	$80	$521.6K
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…	238	960	1,010	$90	$490K
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…	333	920	860	$120	$361.9K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	22	50	530	$90	$323.8K
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,…	318	380	220	$160	$273.9K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	94	100	2,650	$10	$265.6K
90834	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…	178	380	400	$80	$213.5K

Showing 1–10 of 34

Related Providers

Other providers that share a Tax Identification Number (TIN) with Presbyterian Medical Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$41.2M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$16.4M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$13.3M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$11M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$10.3M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$9.9M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$9.2M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$8.2M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$7.6M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$7.4M

Presbyterian Medical Services — Billing Profile & Reimbursement Data

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Presbyterian Medical Services — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Frequently Asked Questions

References