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

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

Mount Prospect Academy, Inc. (NPI 1720281264)

Field	Value
Entity Type	Organization
Organization	Mount Prospect Academy, Inc.
Address	350 Main St
City	Plymouth
State	NH
ZIP	03264
Taxonomy	Emotionally Disturbed Childrens' Residential Treatment Facility
NPI Enumerated	June 11, 2007

Payer Source	Total Paid
Medicaid	$76.6M
Medicare	$0

Key Findings

MOUNT PROSPECT ACADEMY, INC. is effectively a Medicaid-focused provider with no Medicare billing on file and $76.6M in lifetime Medicaid revenue reported; this makes the organization single-payer in practice for the claims dataset available and indicates operations concentrated on services reimbursed by state Medicaid programs.

Revenue concentration is extreme: the top three Medicaid codes account for 98.0% of the provider’s total Medicaid revenue, signaling a highly concentrated service mix where a small set of per-diem behavioral and residential codes dominate overall earnings.

H0019 is the primary revenue driver by a large margin, representing $67M and 87.5% of the provider’s Medicaid revenue through 10.9K claims at a $6137 avg paid/claim. The code description (long-term residential behavioral health per diem, excluding room and board) and these volumes indicate the organization operates primarily as a long-term residential treatment program for emotionally disturbed children.

Competitive standing on H0019 is mid-to-high within the state: the provider ranks #4 of 13 in-state and sits at the 75th percentile, which suggests it is a meaningful regional provider of long-term residential behavioral health services but not the single dominant statewide entity for this code. The characterization provided as "typical, unremarkable volume for this code" further implies its scale is consistent with established peers rather than an outlier.

Secondary revenue streams are modest by comparison: H0040 contributes $5.3M (7.0% of Medicaid revenue) across 2.8K claims and ranks #8 of 12 in-state (36th percentile), while H2022 contributes $2.7M (3.5% of Medicaid revenue) across 1.1K claims and ranks #9 of 15 (43rd percentile). These per-diem and wrap-around service codes show the provider also bills for community-based and assertive outpatient supports, but at volumes well below its residential business.

The presence of 99341 (home/residence E/M new patient) generating $1.2M (1.6% of Medicaid revenue) across 1.2K claims suggests the provider also delivers in-home evaluation services as part of its continuum, likely tied to outreach or transition activities for the pediatric population served. This code ranks #4 of 7 in the state (50th percentile), indicating typical mid-range participation among comparable providers.

Tenure is long-standing: the NPI was enumerated on 2007-06-11 (approximately 19 years ago), which supports that the facility has an established operational history and sustained Medicaid engagement over nearly two decades.

Across all reported Medicaid codes the percentiles and rank positions are repeatedly labeled as "typical, unremarkable volume" or mid-percentile, which together indicate the provider is a stable, regionally significant service provider focused on residential treatment rather than an extreme outlier or rapid-growth anomaly in the state marketplace.

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	10,920	$6,140	$67M
H0040	Assertive community treatment program, per diem	2,750	$1,940	$5.3M
H2022	Community-based wrap-around services, per diem	1,120	$2,380	$2.7M
99341	The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves straightforward medical decision making or the provider spends at least 15…	1,220	$990	$1.2M
T1025	Intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, mental and psychosocial impairments, per diem	280	$1,180	$328.6K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Hampshire Distribution

Mount Prospect Academy, Inc. — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Hampshire

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

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	4	10	5,180	$1,400	$17.7M
H2022	Community-based wrap-around services, per diem	9	20	3,860	$200	$5M
H0040	Assertive community treatment program, per diem	8	10	3,700	$270	$2.8M
99341	The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves straightforward medical decision making or the provider spends at least 15…	4	10	1,220	$480	$870.2K
T1025	Intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, mental and psychosocial impairments, per diem	6	10	360	$240	$527.9K

Nearby Providers

Other providers in the same ZIP code as Mount Prospect Academy, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Speare Memorial Hospital	NH	Critical Access Hospital	$0	$9.2M
Speare Memorial Hospital	NH	Rural Health Clinic/Center	$0	$6.4M
Mid-state Health Center	NH	Federally Qualified Health Center (FQHC)	$0	$5.5M
Speare Memorial Hospital	NH	Rural Health Clinic/Center	$0	$1.1M
Speare Memorial Hospital	NH	Rural Health Clinic/Center	$0	$817.5K
Speare Health Ventures, Inc.	NH	Urgent Care Clinic/Center	$0	$388.4K
Paul Musco	NH	Ophthalmology Physician	$337K	$0
Pemi Baker Regional School District	NH	Local Education Agency (LEA)	$0	$318K
Plymouth School District	NH	Local Education Agency (LEA)	$0	$312.5K
Pemi-baker Hospice & Home Health	NH	Home Health Agency	$0	$298.5K

Mount Prospect Academy, Inc. — Billing Profile & Reimbursement Data

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Mount Prospect Academy, Inc. — 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