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.

Human Service Agency (NPI 1720074644)

Field	Value
Entity Type	Organization
Organization	Human Service Agency
Address	123 19th St Ne
City	Watertown
State	SD
ZIP	57201
Taxonomy	Addiction (Substance Use Disorder) Counselor
NPI Enumerated	September 26, 2005

Payer Source	Total Paid
Medicaid	$39M
Medicare	$0

Key Findings

This provider is effectively a single‑payer Medicaid operation: there is no Medicare billing on file and the provider reports $39M in lifetime Medicaid revenue. That concentration means Medicaid policy, waiver program rates, and state contracting will dominate its financial performance and payer negotiations.

Revenue is highly concentrated in a small set of waiver-related codes: the precomputed top 3 Medicaid codes by revenue account for 80.8% of this provider's total Medicaid revenue, with T2016 alone representing 61.0% ($23.8M). Such concentration implies the provider’s financial health is tightly tied to the reimbursement and utilization of a few per‑diem habilitation services.

The claims mix points to a business model built around waiver habilitation and community support services rather than traditional office-based medical care. High-revenue codes T2016 and T2020 combined with H2016 and S0281 indicate a focus on residential habilitation, day habilitation, comprehensive community support, and care coordination, while the presence of psychotherapy and medication‑management codes (e.g., 90832, 90863, 90791) shows integrated behavioral health and SUD counseling within those waiver services.

On in‑state competitive standing, the provider is a solid but not dominant participant for its largest waiver codes: T2016 ranks #7 of 21 (70th percentile) and is characterized as typical/unremarkable volume, T2020 ranks #12 of 20 (42th percentile) and H2016 ranks #5 of 11 (60th percentile). Those ranks suggest meaningful scale in the state market but stop short of top-tier dominance for the key revenue drivers.

Several specific service lines are statistical outliers in the state, indicating pockets of specialty volume: 90832 and 90791 both rank #4 in their peer groups and are in the 96th percentile (notably above typical state volume), and T2035 ranks #1 of 6 (100th percentile, notably above typical). These elevated percentiles point to unusually high activity in psychotherapy/psychiatric evaluation and in supplying/maintaining assistive technology utilities relative to most in‑state peers.

The provider offers complementary wrap‑around and care‑coordination services at variable scale: S0281 generates $2.4M (6.1% of Medicaid revenue) and ranks #6 of 21 (75th percentile), while H2021 contributes $948K (2.4%) but ranks near the bottom of its peer set (#10 of 11, 10th percentile). This mix suggests robust care coordination capacity alongside some lower‑volume community‑based wrap‑around offerings.

Given the high dependence on Medicaid waiver per‑diem billing, changes to waiver program eligibility, per‑diem rates, or utilization management could materially affect revenue streams; the combination of $39M in Medicaid revenue with no Medicare exposure magnifies this policy and payer concentration risk. Payers and contracting teams should prioritize review of T2016 and related waiver service terms when assessing reimbursement and utilization management strategies.

The provider has a long tenure in the NPI registry, enumerated on 2005-09-26 (~21 years), indicating an established operating history in the state; that longevity, coupled with the concentrated waiver service footprint, suggests an experienced operator whose local market position is mature and driven by long‑standing Medicaid relationships.

Medicaid: Complete Services Breakdown

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

28 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	8,320	$2,860	$23.8M
T2020	Day habilitation, waiver; per diem	6,900	$770	$5.3M
H2016	Comprehensive community support services, per diem	30,940	$80	$2.4M
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	7,650	$310	$2.4M
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…	11,790	$100	$1.1M
H2021	Community-based wrap-around services, per 15 minutes	11,850	$80	$948K
T2017	Habilitation, residential, waiver; 15 minutes	930	$830	$777.2K
90863	The provider prescribes and reviews medications for pharmacological management after psychotherapy services at the same encounter.	6,210	$90	$558.5K
T2014	Habilitation, prevocational, waiver; per diem	1,450	$380	$545.6K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	2,560	$110	$270.9K

Showing 1–10 of 28

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

Human Service Agency — 3 of 25 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

28 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	7	20	6,880	$1,660	$31.6M
T2020	Day habilitation, waiver; per diem	12	20	7,340	$500	$8.9M
H2016	Comprehensive community support services, per diem	5	10	29,180	$80	$3.6M
H2021	Community-based wrap-around services, per 15 minutes	10	10	47,600	$90	$3.5M
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	6	20	6,090	$420	$3M
T2025	Waiver services; not otherwise specified (nos)	19	20	5,410	$180	$1.9M
90863	The provider prescribes and reviews medications for pharmacological management after psychotherapy services at the same encounter.	5	10	5,650	$90	$550.2K
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	8	10	3,370	$130	$538.5K
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…	154	340	1,010	$100	$511K
T2017	Habilitation, residential, waiver; 15 minutes	3	10	470	$270	$437.9K

Showing 1–10 of 28

Nearby Providers

Other providers in the same ZIP code as Human Service Agency, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Brown Clinic Pllp	SD	Family Medicine Physician	$0	$3.1M
Thane Evans Crump Dds PC	SD	Endodontics	$0	$2.3M
Human Service Agency	SD	Case Management Agency	$0	$2.3M
Sanford Clinic	SD	Family Medicine Physician	$0	$2M
Prairie Lakes Health Care System Inc	SD	Rural Acute Care Hospital	$0	$2M
Prairie Lakes Home Connections	SD	Supports Brokerage Agency	$0	$1.2M
Big Stone Therapies Watertown, LLC	SD	Physical Therapy Clinic/Center	$0	$1.1M
City Of Watertown	SD	Land Ambulance	$475.4K	$390.4K
Bridgeway Counseling Center Inc.	SD	Psychologist	$0	$813.1K
Prairie Lakes Health Care System Inc	SD	Rural Acute Care Hospital	$0	$703.4K

Human Service Agency — Billing Profile & Reimbursement Data

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Human Service Agency — 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