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

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

St. Charles Health System, Inc. (NPI 1780698696)

St. Charles Health System, Inc. is a clinical social worker provider located in Bend, Oregon. This profile covers 0 Medicare and 20 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	St. Charles Health System, Inc.
Address	2542 Ne Courtney Dr
City	Bend
State	OR
ZIP	97701
Taxonomy	Clinical Social Worker
NPI Enumerated	July 28, 2006

Payer Source	Total Paid
Medicaid	$1.4M
Medicare	$0

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	7,740	$60	$425.5K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	3,220	$90	$274K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	7,570	$30	$212K
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…	1,590	$90	$149.1K
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…	2,300	$60	$126.2K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	800	$130	$106.7K
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…	310	$80	$26K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	190	$80	$15.9K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	220	$60	$13.3K
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…	290	$40	$10.3K

Showing 1–10 of 20

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Oregon Distribution

St. Charles Health System, Inc. — 2 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oregon

Full comparison — all codes billed, vs. Oregon median

20 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0004	Behavioral health counseling and therapy, per 15 minutes	263	270	1,660	$90	$681K
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…	360	1,380	540	$140	$363.3K
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…	437	1,500	650	$70	$312.4K
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…	958	1,590	590	$50	$236.5K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	72	90	320	$50	$187.6K
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…	182	400	230	$90	$153.8K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	71	130	230	$110	$152K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	17	100	370	$30	$138.2K
T1016	Case management, each 15 minutes	199	210	410	$50	$126.4K
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…	12	310	280	$70	$82K

Showing 1–10 of 20

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. Charles Health System, Inc.	OR	Critical Access Hospital	$0	$5M
St. Charles Health System, Inc.	OR	General Acute Care Hospital	$0	$4.4M
St. Charles Health System, Inc.	OR	Critical Access Hospital	$0	$1.4M
Heather Hansen-dispenza	OR	Rheumatology Physician	$726.8K	$0
Russell Lewis	OR	Hematology & Oncology Physician	$569.3K	$0
Ian Riddock	OR	Cardiovascular Disease Physician	$400.7K	$0
Alexander Ochman	OR	Interventional Cardiology Physician	$340.8K	$0
Lance Adams	OR	Family Medicine Physician	$315.1K	$0
James Laughlin	OR	Clinical Cardiac Electrophysiology Physician	$187.2K	$0
Eddy Young	OR	Cardiovascular Disease Physician	$181.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ortc, LLC	OR	Substance Abuse Rehabilitation Facility	$747.3K	$16.2M
Telecare Mental Heatlh Service Of Oregon, Inc	OR	Mental Illness Community Based Residential Treatment Facility	$0	$12.8M
Bend Memorial Clinic PC	OR	Family Medicine Physician	$0	$11.7M
Pfeifer & Associates	OR	Community/Behavioral Health Agency	$0	$11.6M
Grants Pass Treatment Center	OR	Substance Abuse Rehabilitation Facility	$0	$9.5M
St. Charles Health System, Inc.	OR	Family Medicine Physician	$0	$8.6M
Deschutes County Oregon	OR	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$7.9M
Central Oregon Pediatric Associates	OR	Pediatrics Physician	$0	$7.2M
Bend Surgery Center LLC	OR	Ambulatory Surgical Clinic/Center	$4.8M	$1.7M
Adam Angeles	OR	Plastic and Reconstructive Surgery Physician	$6.5M	$0

St. Charles Health System, Inc. — Billing Profile & Reimbursement Data

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St. Charles Health System, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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