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

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

Jackson Recovery Centers, Inc. (NPI 1811994973)

Field	Value
Entity Type	Organization
Organization	Jackson Recovery Centers, Inc.
Address	800 5th St
City	Sioux City
State	IA
ZIP	51101
Taxonomy	Substance Abuse Rehabilitation Facility
NPI Enumerated	July 5, 2005

Payer Source	Total Paid
Medicaid	$28.5M
Medicare	$0

Key Findings

The provider’s claim mix is consistent with a substance abuse residential and outpatient model: the largest revenue line is H0018 (short-term residential per diem) at $10.6M (37.4% of Medicaid revenue), complemented by H2034 (halfway house per diem) at $4M (14.2%) and high-volume group psychotherapy under 90853 at $3.6M (12.5%). These top codes point to a service mix centered on per-diem residential services plus high-throughput group therapy rather than a traditional physician office model.

Revenue is highly concentrated: the top three Medicaid codes (H0018, H2034, 90853) account for 64.1% of the provider’s total Medicaid revenue. That concentration indicates the business depends primarily on a few behavioral-health service lines to generate the majority of its $28.5M Medicaid revenue.

This entity is effectively single-payer at scale in the available data: there is no Medicare billing on file while Medicaid totals $28.5M. The absence of Medicare revenue means the organization’s financial performance and contracting exposure are driven almost entirely by Medicaid policy and rates.

Competitive standing is mixed by service line: the provider is a clear state leader for group psychotherapy (90853), where it ranks #1 of 124 providers in-state (100th percentile; labeled an extreme outlier), and it also ranks at or near the top for intensive outpatient and partial hospitalization lines (H0015 and H0035 are both #1 in-state at the 100th percentile). In contrast, its H0018 residential per diem volume is more typical within the state (H0018 ranks #4 of 15, 79th percentile), suggesting dominance in some behavioral-health niches but not uniformly across all residential services.

Utilization volumes reinforce a group-focused, high-throughput model: 90853 shows 66.1K claims, H0018 has 17.4K claims, and H2034 shows 30.6K claims; other high-use codes include 90834 with 34K claims and 90791 with 10.2K claims. Those claim counts, together with per-diem and group-based codes, imply large census-based billing and frequent short encounters rather than low-volume, high-complexity outpatient visits.

The provider also maintains substantial ancillary screening and testing activity supporting its behavioral-health services: 80305 (presumptive drug test) has 13.8K claims and ranks #3 of 69 in-state (97th percentile), H0003 (laboratory analysis for drugs/alcohol) has 3.9K claims and ranks #2 of 18 (94th percentile), and 81000 appears with 1.4K claims. This pattern is consistent with routine toxicology and monitoring workflows integrated into residential and outpatient substance-use programs.

The NPI tenure indicates long-standing operation: the provider was enumerated on 2005-07-05 (~21 years ago), suggesting extended continuity in the market. That longevity, paired with top-state rankings in multiple behavioral-health codes, supports an interpretation of an established regional operator rather than a recent entrant.

Because 64.1% of Medicaid revenue is concentrated in three codes and Medicaid is the only payer on file, the provider’s revenue base is potentially sensitive to changes in Medicaid coverage, per-diem rates, or utilization controls for residential and group psychotherapy services. Analysts should consider monitoring state Medicaid policy and utilization-management trends for H0018, H2034, and 90853 when assessing financial or contracting risk.

Medicaid: Complete Services Breakdown

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

45 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	17,430	$610	$10.6M
H2034	Alcohol and/or drug abuse halfway house services, per diem	30,640	$130	$4M
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	66,120	$50	$3.6M
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…	33,980	$80	$2.8M
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…	19,080	$120	$2.2M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	15,270	$120	$1.8M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	10,160	$110	$1.1M
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…	3,640	$190	$673.4K
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…	11,710	$60	$643.9K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	13,780	$10	$179.2K

Showing 1–10 of 45

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Iowa Distribution

Jackson Recovery Centers, Inc. — 11 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Iowa

Full comparison — all codes billed, vs. Iowa median

45 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	4	20	11,060	$220	$3.7M
H2034	Alcohol and/or drug abuse halfway house services, per diem	3	10	23,870	$100	$2.6M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	1	10	920	$150	$420.1K
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…	20	680	670	$70	$343.5K
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…	1	20	2,150	$80	$334.3K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	1	120	980	$50	$230.3K
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…	67	120	1,100	$30	$162.6K
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…	71	1,060	480	$40	$154.5K
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…	326	1,310	760	$20	$153.1K
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…	12	140	210	$120	$152.1K

Showing 1–10 of 45

Related Providers

Other providers that share a Tax Identification Number (TIN) with Jackson Recovery Centers, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dorcas Kamau	WA	Psychiatric/Mental Health Nurse Practitioner	$24.5K	$0

Nearby Providers

Other providers in the same ZIP code as Jackson Recovery Centers, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Siouxland Mental Health Services, Inc.	IA	Community/Behavioral Health Agency	$0	$25.7M
City Of Sioux City Accounting Division	IA	Ambulance	$520.5K	$19.2M
Marian Health Center-smhc	IA	General Acute Care Hospital	$0	$15.5M
Family Health Care Of Siouxland Plc	IA	Family Medicine Physician	$0	$11.1M
Family Wellness Associates, Inc.	IA	Community/Behavioral Health Agency	$0	$4M
Woodbury Emergency Group, PC	IA	Emergency Medicine Physician	$0	$3M
Donald Wender	IA	Hematology & Oncology Physician	$2.6M	$0
Building Bridges Counseling & Associates Inc	IA	Community/Behavioral Health Agency	$0	$2.5M
Mercy Medical Services	IA	Internal Medicine Physician	$0	$2M
Counseling And Support Services Inc	IA	Social Worker	$0	$1.8M

Jackson Recovery Centers, Inc. — Billing Profile & Reimbursement Data

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Jackson Recovery Centers, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References