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.

Dakota Counseling Institute, Inc. (NPI 1760542278)

Field	Value
Entity Type	Organization
Organization	Dakota Counseling Institute, Inc.
Address	910 W Havens St
City	Mitchell
State	SD
ZIP	57301
Taxonomy	Mental Health Counselor
NPI Enumerated	December 12, 2006

Payer Source	Total Paid
Medicaid	$9.7M
Medicare	$0

Key Findings

DAKOTA COUNSELING INSTITUTE, INC. is effectively a single-payer Medicaid provider with Total Medicaid revenue of $9.7M and no Medicare billing on file; this indicates its payer exposure is heavily concentrated in state Medicaid programs rather than Medicare populations. The practice’s NPI was enumerated on 2006-12-12 (≈20 years ago), indicating long tenure in the market which can support established referral relationships and operational continuity.

Revenue is highly concentrated in a small set of service lines: the precomputed top three Medicaid codes (H2016, 90832, H2021) account for 81.6% of this provider’s total Medicaid revenue. H2016 alone generates $4.5M (46.7% of Medicaid revenue), making comprehensive community support services the single largest revenue driver for the organization.

The code mix suggests a community-based behavioral health operator with both per-diem community supports and intensive per-15-minute wrap-around services: H2016 (comprehensive community support services, per diem) and H2021 (community-based wrap-around services, per 15 minutes) together represent a programmatic emphasis on ongoing community support and multi-session engagement rather than only brief office visits. The sizable contribution from 90832 (short psychotherapy sessions) and 90863 (medication management following psychotherapy) further implies integrated psychotherapy plus pharmacologic management workflows.

Competitive standing varies by code: for psychotherapy 90832 the provider ranks #2 of 72 in-state (99th percentile; notably above typical state volume), indicating it is a major statewide provider of short psychotherapy sessions. By contrast, H2016 ranks #4 of 11 (70th percentile; typical, unremarkable volume), so while H2016 is the largest revenue source, the provider’s share of state volume for that specific per-diem community support service appears typical rather than dominant.

Several ancillary service lines show concentrated usage that complements core behavioral health work: 90791 (psychiatric evaluation) produces $230.1K and ranks #7 of 68 in-state (91th percentile; notably above typical state volume), and Q3014 (telehealth originating site facility fee) has $56.7K in revenue and ranks #2 of 33 in-state (97th percentile; notably above typical state volume). These signals point to substantial evaluation throughput and relatively high telehealth utilization compared with peers.

Substance-use treatment codes are present but smaller contributors: H0015 (intensive outpatient substance use services) accounts for $413.5K (4.3% of Medicaid revenue) and ranks #2 of 8 in-state (86th percentile; typical, unremarkable volume), while H0005 (group counseling) contributes $267K (2.7% of Medicaid revenue) and ranks #3 of 20 (89th percentile; typical, unremarkable volume). These entries indicate established capacity for addiction services that supplements the provider’s broader behavioral health portfolio.

Operational model appears to blend per-diem/day-program payments with high-volume short psychotherapy encounters: large volumes of H2016 claims (36.7K claims) and 90832 claims (16.9K claims) alongside many H2021 units (15.7K claims) suggest steady, repeat engagement across community support and psychotherapy touchpoints rather than reliance on infrequent, high-value inpatient or procedural revenue. This pattern is consistent with community-based outpatient clinics or counseling centers that manage ongoing care for Medicaid populations.

Risk and growth implications: with $9.7M concentrated in Medicaid and no Medicare billing on file, the provider’s financial performance is sensitive to state Medicaid policy, rate changes, and programmatic shifts (e.g., telehealth rules or wrap-around service authorizations). The strong statewide position for 90832 and telehealth uptake (Q3014) could be leveraged for negotiated network placement or program expansion, while the typical ranking on H2016 and H2021 suggests potential room to grow market share in community support and wrap-around service delivery.

Medicaid: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2016	Comprehensive community support services, per diem	36,650	$120	$4.5M
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…	16,920	$110	$1.8M
H2021	Community-based wrap-around services, per 15 minutes	15,720	$100	$1.6M
90863	The provider prescribes and reviews medications for pharmacological management after psychotherapy services at the same encounter.	5,650	$100	$559.4K
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…	6,670	$60	$413.5K
H0005	Alcohol and/or drug services; group counseling by a clinician	4,380	$60	$267K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	1,980	$120	$230.1K
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…	5,160	$20	$82.5K
W0037	N/A	960	$70	$64K
Q3014	Telehealth originating site facility fee	2,580	$20	$56.7K

Showing 1–10 of 15

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

Dakota Counseling Institute, Inc. — 2 of 15 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

15 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	7	10	1,970	$1,550	$3.8M
H2016	Comprehensive community support services, per diem	4	10	29,180	$80	$3.6M
H2021	Community-based wrap-around services, per 15 minutes	9	10	47,600	$90	$3.5M
90863	The provider prescribes and reviews medications for pharmacological management after psychotherapy services at the same encounter.	6	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…	2	10	3,370	$130	$538.5K
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…	31	260	860	$80	$222.6K
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…	2	70	200	$80	$176.7K
H0005	Alcohol and/or drug services; group counseling by a clinician	3	20	520	$80	$128.2K
T1012	Alcohol and/or substance abuse services, skills development	10	10	1,030	$70	$81.9K
H0004	Behavioral health counseling and therapy, per 15 minutes	9	20	390	$90	$61.9K

Showing 1–10 of 15

Nearby Providers

Other providers in the same ZIP code as Dakota Counseling Institute, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lifequest	SD	Developmentally Disabled Services Day Training Agency	$0	$53.1M
Abbott House, Inc.	SD	Psychiatric Residential Treatment Facility	$0	$28.1M
Lifequest	SD	Case Manager/Care Coordinator	$0	$13.2M
Dakota Solace Home Care	SD	In Home Supportive Care Agency	$0	$4.9M
Rural Health Care, Inc	SD	Federally Qualified Health Center (FQHC)	$0	$4.4M
Rosewood Court	SD	Assisted Living Facility	$0	$2.7M
Avera Queen Of Peace	SD	Critical Access Hospital	$0	$1.3M
Sanford Clinic	SD	Obstetrics & Gynecology Physician	$0	$1.2M
Dpt Inc	SD	Home Health Agency	$0	$835.1K
Avera Queen Of Peace	SD	Rural Acute Care Hospital	$0	$803.8K

Dakota Counseling Institute, Inc. — Billing Profile & Reimbursement Data

Sign up for Dakota Counseling Institute, Inc. — Billing Profile & Reimbursement Data policy alerts

Dakota Counseling Institute, Inc. — Billing Profile & Reimbursement Data

Sign up for Dakota Counseling Institute, Inc. — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References