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

Why is the Medicaid comparison limited to Minnesota 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. Minnesota (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.

Northstar Regional (NPI 1659764587)

Field	Value
Entity Type	Organization
Organization	Northstar Regional
Address	1045 Stoughton Ave
City	Chaska
State	MN
ZIP	55318
Taxonomy	Substance Use Disorder Rehabilitation Clinic/Center
NPI Enumerated	March 17, 2015

Payer Source	Total Paid
Medicaid	$56.3M
Medicare	$0

Key Findings

NORTHSTAR REGIONAL operates as a substance use disorder rehabilitation clinic with its billing dominated by program-level treatment codes. The provider reports heavy volume on H2036 (58.5K claims, $479 avg paid/claim, $28M revenue) and H2035 (171.5K claims, $128 avg paid/claim, $22M revenue), which are per‑diem and per‑hour alcohol/other drug treatment program measures respectively, and it also reports high psychotherapy volume under 90837 (24.5K claims, $94 avg paid/claim, $2.3M revenue). This mix indicates core operations centered on structured SUD treatment programs supplemented by individual psychotherapy and evaluation services.

Revenue is extremely concentrated in a small set of Medicaid codes: the precomputed top three Medicaid codes by revenue account for 92.8% of the provider’s total Medicaid revenue. Those three codes are H2036 ($28M, 49.7% of Medicaid revenue), H2035 ($22M, 39.0%), and 90837 ($2.3M, 4.1%), so most of the $56.3M lifetime Medicaid revenue depends on program-level treatment and a single psychotherapy code.

The provider is effectively single‑payer at present: there is no Medicare billing on file while Medicaid accounts for $56.3M in lifetime revenue. Because Medicare activity is absent, all utilization and competitive analysis should be interpreted within the Medicaid market context rather than across dual‑payer dynamics.

NORTHSTAR holds a dominant statewide position for H2036, ranking #1 of 122 providers in-state and described as an "extreme outlier, far above typical state volume for this code" (100th percentile). That ranking signals market leadership in per‑diem SUD program services and suggests substantially greater capacity or focus on that service compared with peers in Minnesota.

H2035 performance is also well above typical state activity: the provider ranks #5 of 276 providers in-state for H2035 (99th percentile; notably above typical state volume for this code), indicating major scale in per‑hour program delivery. By contrast, 90837 ranks #47 of 1143 providers (96th percentile) but is labeled as a "typical, unremarkable volume for this code," which implies that while psychotherapy contributes materially to revenue, it is a common service across many providers and thus less differentiating.

Beyond the top-three codes, the profile shows a comprehensive behavioral health service set that supports SUD treatment workflows: notable volumes and revenue appear for 90834 (17.1K claims, $63 avg, $1.1M; ranks #42 of 623, 93th percentile), H0038 (15.3K claims, $35 avg, $536.5K; ranks #10 of 128, 93th percentile), and 90791 (4.8K claims, $105 avg, $505.2K; ranks #28 of 496, 95th percentile). These codes reflect psychotherapy of various durations, self‑help/peer services, and psychiatric evaluation capacity that are consistent with integrated SUD program delivery.

The provider’s NPI tenure dates to 2015-03-17 (~11 years ago), indicating an established Medicaid presence. This longevity combined with outsized H2036 and H2035 volumes suggests operational stability in the state market but also creates exposure: because $56.3M in lifetime Medicaid revenue is highly concentrated in a few codes, changes to Medicaid coverage, reimbursement, or utilization management for H2036/H2035 would disproportionately affect overall revenue and utilization patterns.

Medicaid: Complete Services Breakdown

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2036	Alcohol and/or other drug treatment program, per diem	58,480	$480	$28M
H2035	Alcohol and/or other drug treatment program, per hour	171,510	$130	$22M
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…	24,530	$90	$2.3M
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…	17,060	$60	$1.1M
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…	7,350	$80	$595.7K
H0038	Self‑help/peer services, per 15 minutes	15,330	$40	$536.5K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	4,810	$110	$505.2K
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…	6,200	$60	$347.1K
99205	The provider sees a new 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 provider…	2,660	$130	$346.1K
H0001	Alcohol and/or drug assessment	2,820	$120	$343.7K

Showing 1–10 of 16

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Minnesota Distribution

Northstar Regional — 3 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. Minnesota median

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2036	Alcohol and/or other drug treatment program, per diem	1	120	2,540	$1,210	$5.7M
H2035	Alcohol and/or other drug treatment program, per hour	5	280	5,980	$120	$3M
T1016	Case management, each 15 minutes	212	240	1,870	$50	$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…	252	1,180	1,150	$80	$605.7K
H0038	Self‑help/peer services, per 15 minutes	10	130	1,640	$80	$599.5K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	30	100	510	$40	$560.8K
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…	309	1,200	1,030	$70	$549.7K
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…	47	1,140	1,010	$100	$543K
90839	In this service, the provider performs psychotherapy for a crisis situation when the patient is in a life–threatening state and needs immediate attention. The treatment session typically lasts…	9	10	410	$120	$539.7K
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…	42	620	560	$80	$361.9K

Showing 1–10 of 16

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northstar Regional	MN	Clinical Medical Laboratory	$22.6K	$2.7M
Alfonso Morales-utrilla	MN	Family Medicine Physician	$109.8K	$0

Nearby Providers

Other providers in the same ZIP code as Northstar Regional, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Chaska Independent School District 112	MN	Local Education Agency (LEA)	$0	$4.5M
Chaska Plaza Surgery Center, LLC	MN	Ambulatory Surgical Clinic/Center	$1M	$0
Bhatti Gi Surgery Center LLC	MN	Ambulatory Surgical Clinic/Center	$224K	$284.3K
Pain Centers Of Minnesota - Chaska, LLC	MN	Ambulatory Surgical Clinic/Center	$245.4K	$1.3K
Ahsan Bhatti	MN	Gastroenterology Physician	$195K	$0
Nima Adimi	MN	Interventional Pain Medicine Physician	$102.9K	$0
Purvi Gada	MN	Hematology & Oncology Physician	$96.1K	$0
Grand St Paul Cvs LLC	MN	Pharmacy	$74.2K	$0
Ching-ho Huang	MN	Gastroenterology Physician	$61.9K	$0
Jennifer Lewis	MN	Family Medicine Physician	$51.5K	$0

Northstar Regional — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References