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

Why is the Medicaid comparison limited to South Dakota 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. South Dakota (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.

Roads Outpatient Treatment (NPI 1649311713)

Field	Value
Entity Type	Organization
Organization	Roads Outpatient Treatment
Address	520 Kansas City St
City	Rapid City
State	SD
ZIP	57701
Taxonomy	Case Management Agency
NPI Enumerated	February 9, 2007

Payer Source	Total Paid
Medicaid	$72K
Medicare	$0

Medicaid: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0005	Alcohol and/or drug services; group counseling by a clinician	120	$350	$41.7K
H0004	Behavioral health counseling and therapy, per 15 minutes	120	$260	$30.3K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Dakota Distribution

Roads Outpatient Treatment — 0 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. South Dakota median

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0005	Alcohol and/or drug services; group counseling by a clinician	17	20	520	$80	$128.2K
H0004	Behavioral health counseling and therapy, per 15 minutes	15	20	390	$90	$61.9K

Roads Outpatient Treatment — Billing Profile & Reimbursement Data

Sign up for Roads Outpatient Treatment — Billing Profile & Reimbursement Data policy alerts

Roads Outpatient Treatment — Billing Profile & Reimbursement Data

Sign up for Roads Outpatient Treatment — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Frequently Asked Questions

References