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 1811266182)

Field	Value
Entity Type	Organization
Organization	Benefis Community Care, Inc.
Address	315 N 24th St
City	Billings
State	MT
ZIP	59101
Taxonomy	Case Management Agency
NPI Enumerated	December 15, 2011

Payer Source	Total Paid
Medicaid	$10.8M
Medicare	$0

Key Findings

BENEFIS COMMUNITY CARE, INC. shows no Medicare billing on file, making it effectively a Medicaid-focused provider rather than a dual-payer operation; the provider’s entire reported lifetime revenue is Medicaid-based ($10.8M) and there is no Medicare revenue to compare against. This payer concentration implies operational and revenue exposure concentrated to Medicaid policy and reimbursement changes.

Medicaid revenue is highly concentrated in a very small set of service lines: the precomputed top-3 Medicaid codes account for 100.0% of the provider’s total Medicaid revenue, indicating nearly all billing comes from a handful of recurring care-management and related codes. This concentration suggests limited service-line diversification and a dependence on a narrow set of Medicaid-covered activities.

The dominant revenue driver is T2022 (Case management, per month), which accounts for $9.9M or 91.8% of the provider’s Medicaid revenue and is billed across 31.2K claims at an average paid amount of $319 per claim. That scale of monthly case-management billing identifies the organization primarily as a case management agency delivering recurring monthly services rather than episodic clinical procedures.

The second reported code, H0032 (Mental health service plan development by non-physician), contributes $882.7K or 8.2% of Medicaid revenue with 2.4K claims and a $364 average paid/claim, indicating a substantive but much smaller role for care-plan development and non-physician mental-health planning services within the overall mix. Together with T2022, these codes constitute virtually all Medicaid revenue, reinforcing an operational focus on ongoing case management plus related behavioral health planning.

Competitive standing within Montana is modest: T2022 billing ranks #4 of 11 providers in-state (70th percentile; typical, unremarkable volume for this code) and H0032 ranks #3 of 8 providers in-state (71th percentile; typical, unremarkable volume for this code). Those rank/percentile positions indicate the provider is a solid regional participant for these services but not an extreme outlier or dominant statewide leader.

The provider’s NPI was enumerated on 2011-12-15 (~15 years ago), which denotes a multi-year operating history; this tenure aligns with the steady, recurring monthly-case-management revenue profile observed and suggests established Medicaid relationships and workflows for ongoing case management claims.

Given the large share of revenue from T2022 (91.8%) and the top-3 codes accounting for 100.0% of Medicaid revenue, BENEFIS COMMUNITY CARE faces concentrated financial risk if Medicaid policy, eligibility, or rates for monthly case management change. Analysts should monitor state Medicaid reimbursement and authorization rules for T2022 and H0032, as small shifts could materially affect the provider’s financials.

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	31,170	$320	$9.9M
H0032	Mental health service plan development by non-physician	2,430	$360	$882.7K

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	4	10	1,510	$320	$5M
H0032	Mental health service plan development by non-physician	3	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
Billings Clinic	MT	General Practice Physician	$0	$53.8M
Rimrock Foundation	MT	Substance Use Disorder Rehabilitation Clinic/Center	$0	$44.9M
Scl Health Medical Group - Billings LLC	MT	Clinic/Center	$0	$32.2M
Residential Support Services	MT	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$30.6M
Billings Public School District 2	MT	Local Education Agency (LEA)	$0	$19.2M
South Central Montana Regional Mental Health Center	MT	Clinic/Center	$0	$16.6M
Billings Clinic	MT	Emergency Care Clinic/Center	$0	$15.7M
Community Solutions Incorporated	MT	Clinical Medical Laboratory	$0	$14.1M
Scl Health Montana	MT	General Acute Care Hospital	$0	$13.5M
American Medical Response Ambulance Service Inc	MT	Ambulance	$2.1M	$6.7M

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

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

Sign up for Benefis Community Care, 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