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.

Black Hills Psychology, LLC (NPI 1811290992)

Black Hills Psychology, LLC is a clinical psychologist provider located in Spearfish, South Dakota. This profile covers 0 Medicare and 10 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	Black Hills Psychology, LLC
Address	115 N 7th St Ste 6
City	Spearfish
State	SD
ZIP	57783
Taxonomy	Clinical Psychologist
NPI Enumerated	December 13, 2010

Payer Source	Total Paid
Medicaid	$601.6K
Medicare	$0

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	7,500	$70	$487.5K
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…	1,490	$40	$52.2K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	420	$90	$35.7K
96131	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	40	$240	$8.5K
96137	Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; each additional 30 minutes (List…	60	$150	$8.4K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	100	$30	$2.9K
96130	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	40	$70	$2.4K
96136	The provider, a physician or other qualified healthcare professional, administers two or more psychological or neuropsychological tests and scores them. Report this code for the first 30 minutes of…	60	$40	$2.1K
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…	20	$70	$1.1K
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…	40	$20	$760

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

Black Hills Psychology, LLC — 1 of 10 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

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	303	340	1,010	$100	$511K
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…	97	260	860	$80	$222.6K
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…	10	190	430	$90	$154.1K
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…	10	20	30	$90	$144.2K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	17	70	60	$100	$51.4K
96131	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	4	10	40	$130	$45K
96130	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	3	10	30	$90	$33.4K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	9	20	100	$40	$26.9K
96136	The provider, a physician or other qualified healthcare professional, administers two or more psychological or neuropsychological tests and scores them. Report this code for the first 30 minutes of…	3	10	200	$30	$10.9K
96137	Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; each additional 30 minutes (List…	2	10	50	$80	$9.3K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Echo Kopplin	SD	Physician Assistant	$25.1K	$0
Shannon Maxwell	SD	Clinical Psychologist	$12.7K	$0
Katherine Wilgers	SD	Psychiatric/Mental Health Nurse Practitioner	$11.5K	$0
Brian Brandt	SD	Psychiatric/Mental Health Nurse Practitioner	$2.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northern Hills Training Center, Inc.	SD	Developmentally Disabled Services Day Training Agency	$0	$39.3M
Lutheran Social Services Of Sd	SD	Psychiatric Residential Treatment Facility	$0	$16.9M
A.w. Holdings, LLC	SD	Case Manager/Care Coordinator	$0	$3.7M
Edgewood Spearfish Senior Living LLC	SD	Assisted Living Facility (Behavioral Disturbances)	$0	$2.3M
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$2M
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$1.8M
Spearfish Emergency Ambulance Service	SD	Land Ambulance	$540.7K	$302.3K
West River Transit Authority, Inc.	SD	Bus	$0	$788.1K
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$745.7K
Spearfish Collaborative Care LLC	SD	Assisted Living Facility	$0	$657.7K

Black Hills Psychology, LLC — Billing Profile & Reimbursement Data

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Black Hills Psychology, LLC — 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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