Providence St Joseph Medical Center — Billing Profile & Reimbursement Data
NPI 1821184888 · Polson, MT · Critical Access Hospital
Customize your policy alerts
Sign up for Providence St Joseph Medical Center — Billing Profile & Reimbursement Data policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Providence St Joseph Medical Center is a critical access hospital provider located in Polson, Montana. This profile covers 0 Medicare and 148 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Providence St Joseph Medical Center |
| Address | 6 13th Ave E |
| City | Polson |
| State | MT |
| ZIP | 59860 |
| Taxonomy | Critical Access Hospital |
| NPI Enumerated | October 5, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $654.7K |
| Medicare | $0 |
Medicaid: Total Revenue Breakdown by CPT/HCPCS Code
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Medicaid: Complete Services Breakdown
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
148 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99283 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making. | 8,080 | $10 | $96.9K |
| 99285 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making. | 5,390 | $10 | $75.4K |
| 99284 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making. | 7,160 | $10 | $71.6K |
| 74177 | The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs. | 1,410 | $50 | $64.9K |
| 87631 | The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,… | 2,120 | $10 | $29.7K |
| 97110 | Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with… | 6,670 | $1 | $26.7K |
| 87502 | The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly… | 1,750 | $10 | $22.7K |
| 70450 | The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities. | 1,390 | $20 | $20.9K |
| 87636 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic… | 1,110 | $20 | $18.8K |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 16,260 | $1 | $16.3K |
Showing 1–10 of 148
Medicaid: Competitive Analysis & Benchmarks
How this provider's Medicaid billing volume and revenue compare to other Montana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Montana median
148 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99285 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making. | 19 | 60 | 2,160 | $80 | $526.7K |
| 99284 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making. | 22 | 80 | 2,770 | $60 | $471K |
| 99283 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making. | 26 | 90 | 2,330 | $40 | $281.3K |
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 27 | 30 | 3,780 | $40 | $222.6K |
| 97530 | The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity. | 73 | 200 | 1,110 | $60 | $207.2K |
| 74177 | The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs. | 24 | 50 | 1,150 | $50 | $119.8K |
| 93306 | The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent… | 30 | 40 | 430 | $70 | $91.3K |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 20 | 40 | 1,380 | $20 | $71K |
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 27 | 30 | 470 | $80 | $64.1K |
| G0378 | Hospital observation service, per hour | 19 | 30 | 1,610 | $20 | $60.4K |
Showing 1–10 of 148
Nearby Providers
Other providers in the same ZIP code as Providence St Joseph Medical Center, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Polson Ambulance, Inc. | MT | Land Ambulance | $459.3K | $2.1M |
| Polson School District 23 | MT | Local Education Agency (LEA) | $0 | $1.6M |
| Montana Dental Group LLC | MT | General Practice Dentistry | $0 | $1M |
| Michael Windauer | MT | General Practice Dentistry | $0 | $673.1K |
| Kickin It Enterprises | MT | Clinical Social Worker | $0 | $659.3K |
| Jeffrey Bird | MT | General Practice Dentistry | $0 | $619.1K |
| Kalispell Regional Medical Center Inc | MT | Family Medicine Physician | $0 | $418.9K |
| St Lukes Community Hospital | MT | Rural Health Clinic/Center | $0 | $403.3K |
| Shasta Baum-strait | MT | Mental Health Counselor | $0 | $360.7K |
| Willow Canyon Counseling Services | MT | Substance Use Disorder Rehabilitation Clinic/Center | $0 | $341.2K |
Frequently Asked Questions
References
- 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
- 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.