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

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

Benefis Community Care, Inc. (NPI 1801165170)

Field	Value
Entity Type	Organization
Organization	Benefis Community Care, Inc.
Address	2210 Us Highway 93 S Unit A
City	Kalispell
State	MT
ZIP	59901
Taxonomy	Case Management Agency
NPI Enumerated	December 15, 2011

Payer Source	Total Paid
Medicaid	$6.8M
Medicare	$0

Key Findings

BENEFIS COMMUNITY CARE, INC. appears to be effectively a Medicaid-focused provider: it has no Medicare billing on file and reports $6.8M in lifetime Medicaid revenue. This means the organization operates as a single-payer Medicaid participant in the available data rather than a dual Medicare/Medicaid billing entity.

Revenue is highly concentrated: the top 3 Medicaid codes by revenue account for 100.0% of this provider's total Medicaid revenue, and a single procedure dominates the mix. T2022 (Case management, per month) alone represents $6.2M revenue, or 91.0% of the provider's Medicaid revenue, indicating that monthly case management services are the primary revenue driver.

The provider’s taxonomy (Case Management Agency) aligns with its code mix: heavy billing for T2022 (monthly case management) and supplemental billing for H0032 (Mental health service plan development by non-physician) suggests an operational focus on ongoing care coordination and behavioral health care planning. The presence of sustained, monthly case management billing implies recurring client engagement and programmatic delivery rather than one-off procedures.

T2022 volume is substantial in absolute terms (19.3K claims at a $321 avg paid/claim) but competitively modest at the state level: the provider ranks #5 of 11 in-state (60th percentile), which the source labels as typical, unremarkable volume for this code. This ranking indicates the provider is a solid but not dominant regional player for monthly case management services.

H0032 contributes $613.6K (9.0% of Medicaid revenue) across 1.7K claims with a $365 avg paid/claim, and it ranks #6 of 8 providers in-state (29th percentile). The data describe this standing as typical, unremarkable volume for this code, reflecting a limited but consistent role in non-physician mental health service plan development relative to peers.

The organization’s NPI was enumerated on 2011-12-15 (~15 years ago), signaling a long-tenured presence in the market. That tenure, combined with concentrated revenues, suggests an established operational model centered on case management programs.

Because T2022 accounts for 91.0% of Medicaid revenue and the top 3 codes together make up 100.0% of Medicaid revenue, the provider’s financial profile shows limited service diversification. This concentration creates sensitivity to reimbursement, eligibility, or programmatic changes affecting monthly case management payments and indicates a strategic reliance on a narrow set of billable services.

Medicaid: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2022	Case management, per month	19,280	$320	$6.2M
H0032	Mental health service plan development by non-physician	1,680	$370	$613.6K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Montana Distribution

Benefis Community Care, Inc. — 0 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. Montana median

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2022	Case management, per month	5	10	1,510	$320	$5M
H0032	Mental health service plan development by non-physician	6	10	1,920	$360	$1.4M

Nearby Providers

Other providers in the same ZIP code as Benefis Community Care, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Flathead Industries	MT	Community/Behavioral Health Agency	$0	$40.7M
A Plus Health Care Inc	MT	In Home Supportive Care Agency	$0	$28.2M
Gabriel Dawson	MT	Pediatric Dentistry	$0	$10.7M
Kalispell Regional Medical Center Inc	MT	General Acute Care Hospital	$0	$8.8M
Kiddsteeth PLLC	MT	Pediatric Dentistry	$0	$6.7M
Kalispell Regional Medical Center, Inc	MT	Clinic/Center	$0	$6.2M
Kalispell Public Schools	MT	Local Education Agency (LEA)	$0	$6M
Kalispell Regional Medical Center Inc	MT	Psychiatry Physician	$0	$5.9M
Kalispell Regional Medical Center Inc	MT	Emergency Medicine Physician	$0	$5.4M
Sunburst Community Service Foundation, Inc	MT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$5.3M

Benefis Community Care, Inc. — Billing Profile & Reimbursement Data

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Benefis Community Care, 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