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.

Rimrock Foundation (NPI 1821126004)

Field	Value
Entity Type	Organization
Organization	Rimrock Foundation
Address	1231 N 29th St
City	Billings
State	MT
ZIP	59101
Taxonomy	Substance Use Disorder Rehabilitation Clinic/Center
NPI Enumerated	March 1, 2007

Payer Source	Total Paid
Medicaid	$44.9M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and reports $44.9M in lifetime Medicaid revenue, indicating it operates effectively as a Medicaid-focused provider rather than a dual-payer clinic. The absence of Medicare activity makes Medicaid the primary and dominant payer relationship to evaluate for competitive and utilization analysis.

Revenue is highly concentrated: the precomputed top 3 Medicaid codes account for 74.5% of the provider's Medicaid revenue, led by H0018 at $23.3M (52.2%), followed by H0012 at $5.2M (11.5%) and H0015 at $4.8M (10.8%). This concentration means a small set of SUD-related services drive the vast majority of reported Medicaid dollars.

The code mix (H0018, H0012, H0015) and their descriptions point to a business model centered on substance use disorder treatment across the residential-to-outpatient continuum: short-term residential stays (H0018), sub-acute detox (H0012/H0010), and intensive outpatient programming (H0015). High claim counts for these codes suggest the organization runs substantial residential and program-based outpatient capacity rather than only episodic office-based care.

Competitive standing is uneven by service line: H0015 (intensive outpatient) is a clear statewide leader — $4.8M revenue, ranks #1 of 22 and is labeled an extreme outlier — while H0012 (sub-acute detox outpatient) also ranks #1 of 2 (100th percentile) but is described as a typical volume within a very small comparator set. By contrast, H0018 (short-term residential) generates $23.3M and ranks #2 of 6 (80th percentile; typical, unremarkable), marking it as the single largest revenue generator but not a statewide outlier in relative rank.

Beyond the top three, the provider shows very high-volume behavioral health and peer-service activity: 90837 ($2.2M, 5.0%) ranks #5 of 1203 and is an extreme outlier, H0038 ($1.8M, 3.9%) ranks #1 of 35 and is an extreme outlier, and 90853 ($591.9K, 1.3%) ranks #1 of 106 and is an extreme outlier. These patterns indicate substantial delivery of long psychotherapy sessions, group therapy, and peer-support services, reflecting breadth across clinical and recovery-support modalities.

The revenue profile is heavily dependent on a single code class: H0018 alone represents $23.3M (52.2%) of Medicaid revenue. Such concentration creates sensitivity to changes in Medicaid reimbursement policy or utilization patterns for short-term residential services, because more than half of Medicaid dollars come from that single service line.

The provider shows sustained operational scale and tenure: the NPI was enumerated 2007-03-01 (~19 years ago) and the data include very large claim volumes for core codes (for example, H0018 with 49.9K claims and H0015 with 30.5K claims). This longevity coupled with high claim counts supports the interpretation of an established SUD treatment operator with extensive throughput.

Additional code-level leadership spans both higher-acuity and preventive/screening services: 99222 ($581.7K, 1.3%) ranks #1 of 19 and is an extreme outlier for initial inpatient/observation E/M, while 99409 ($92.2K, 0.2%) ranks #1 of 11 and is described as notably above typical state volume for brief substance-use interventions. These results suggest the provider manages care across a range of acuity levels from inpatient/observation to brief intervention and community support.

Medicaid: Complete Services Breakdown

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

38 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	49,900	$470	$23.3M
H0012	Behavioral health day treatment, per hour	36,800	$140	$5.2M
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…	30,530	$160	$4.8M
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…	28,800	$80	$2.2M
H0038	Self‑help/peer services, per 15 minutes	34,550	$50	$1.8M
H0040	Assertive community treatment program, per diem	6,090	$290	$1.7M
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	4,820	$310	$1.5M
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…	10,320	$90	$877.2K
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…	37,000	$20	$591.9K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	5,020	$120	$581.7K

Showing 1–10 of 38

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

Rimrock Foundation — 10 of 25 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

38 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0040	Assertive community treatment program, per diem	5	10	32,960	$330	$11M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	2	10	3,620	$460	$10.3M
H0012	Behavioral health day treatment, per hour	1	10	18,440	$140	$2.6M
T1016	Case management, each 15 minutes	18	50	2,720	$50	$1.4M
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	1	10	2,590	$480	$1.2M
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	1,510	$170	$848K
H2019	Therapeutic behavioral services, per 15 minutes	27	40	3,280	$50	$759.9K
H0016	Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting)	13	20	3,030	$140	$643.2K
H2034	Alcohol and/or drug abuse halfway house services, per diem	3	10	260	$240	$542.3K
H2015	Comprehensive community support services, per 15 minutes	3	10	8,260	$60	$408.9K

Showing 1–10 of 38

Related Providers

Other providers that share a Tax Identification Number (TIN) with Rimrock Foundation, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Frances Horn-charnesky	MT	Clinical Social Worker	$0	$603K
Callie Puls	MT	Adult Health Nurse Practitioner	$76.2K	$0
Darlene Sanders	MT	Physician Assistant	$22.8K	$40.1K
Laurie Mcnew	MT	Physician Assistant	$40.1K	$0
Beth Cohen	MT	Medical Physician Assistant	$15.1K	$0

Nearby Providers

Other providers in the same ZIP code as Rimrock Foundation, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Billings Clinic	MT	General Practice Physician	$0	$53.8M
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
Benefis Community Care, Inc.	MT	Case Management Agency	$0	$10.8M
American Medical Response Ambulance Service Inc	MT	Ambulance	$2.1M	$6.7M

Rimrock Foundation — Billing Profile & Reimbursement Data

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Rimrock Foundation — 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