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.

Recovery Centers Of Montana LLC (NPI 1851906895)

Field	Value
Entity Type	Organization
Organization	Recovery Centers Of Montana LLC
Address	390 Hodgson Rd
City	Columbia Falls
State	MT
ZIP	59912
Taxonomy	Substance Use Disorder Rehabilitation Clinic/Center
NPI Enumerated	September 15, 2020

Payer Source	Total Paid
Medicaid	$21.7M
Medicare	$0

Key Findings

RECOVERY CENTERS OF MONTANA LLC has no Medicare billing on file and reports $21.7M in lifetime Medicaid revenue, making its public payer footprint effectively single‑payer in the available data. Its NPI was enumerated on 2020-09-15 (~6 years ago), indicating a relatively recent entry into the claims universe compared with longer-tenured institutions.

Revenue is extremely concentrated: the precomputed top 3 Medicaid codes by revenue account for 99.5% of the provider's total Medicaid revenue, with H0018 alone accounting for $21.2M (97.3% of Medicaid revenue) from 75.9K claims. This concentration indicates the vast majority of billed services and reimbursement flow through a single per‑diem residential treatment code.

The code mix points to a core business model centered on short-term residential substance use disorder treatment: H0018 is defined as short-term residential (non-hospital residential treatment program), without room and board, per diem, and it dominates both volume and dollars. Ancillary social-support and care-coordination services — H0038 (self-help/peer services, $392.7K; 6K claims) and T1016 (case management, $81.5K; 2.7K claims) — together represent small, complementary revenue streams consistent with a residential-treatment operation.

On competitive standing for the primary code, H0018 ranks #1 of 6 providers in-state (100th percentile; notably above typical state volume for this code), marking the provider as a dominant statewide participant for Medicaid-funded short-term residential treatment. That ranking and the $21.2M reported for H0018 suggest above-typical capacity or utilization relative to other in‑state residential providers.

The provider's activity in supportive services is more modest: H0038 ranks #7 of 35 providers in-state (82th percentile; typical, unremarkable volume for this code) and T1016 ranks #27 of 53 providers in-state (50th percentile; typical, unremarkable volume for this code). These percentile/rank positions indicate the organization is a regular — but not outlier — provider of peer-support and case-management services compared with state peers.

Outpatient psychotherapy and evaluation codes appear as minor revenue contributors, which reinforces the residential focus: 90837 generated $50.5K from 532 claims (0.2% of Medicaid revenue) and 90791 generated $35.6K from 356 claims (0.2% of Medicaid revenue). The presence of these codes suggests some clinical assessment and psychotherapy capacity, but at a scale that is clearly secondary to the H0018 residential billing.

Ancillary operational services show low per-claim reimbursement despite moderate claim counts: H0048 (collection and handling for non-blood specimens) produced 1.3K claims but only $10.3K in revenue, and Q3014 (telehealth originating site facility fee) produced 112 claims for $3.4K. These patterns point to routine use of testing and occasional telehealth origination billing, but neither serves as a meaningful revenue driver.

Given that H0018 drives 97.3% of Medicaid revenue and the top three codes together account for 99.5% of Medicaid revenue, the provider's financial performance in the Medicaid channel is highly sensitive to state Medicaid per‑diem rates, utilization rules, and any changes to coverage of short-term residential services. This concentration presents both an operational focus and exposure tied to reimbursement policy and utilization trends for that single service line.

Medicaid: Complete Services Breakdown

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

9 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	75,880	$280	$21.2M
H0038	Self‑help/peer services, per 15 minutes	6,040	$70	$392.7K
T1016	Case management, each 15 minutes	2,720	$30	$81.5K
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…	530	$100	$50.5K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	360	$100	$35.6K
H0048	Alcohol and/or other drug testing: collection and handling only, specimens other than blood	1,290	$10	$10.3K
Q3014	Telehealth originating site facility fee	110	$30	$3.4K
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…	40	$60	$2.3K
90832	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	$50	$860

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

Recovery Centers Of Montana LLC — 1 of 9 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

9 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	1	10	3,620	$460	$10.3M
T1016	Case management, each 15 minutes	27	50	2,720	$50	$1.4M
H0038	Self‑help/peer services, per 15 minutes	7	40	1,050	$50	$171.5K
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…	703	1,200	750	$80	$143.2K
Q3014	Telehealth originating site facility fee	38	60	350	$20	$45.9K
90832	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…	156	170	310	$20	$38.7K
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…	193	230	300	$30	$38.1K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	53	190	60	$70	$36.9K
H0048	Alcohol and/or other drug testing: collection and handling only, specimens other than blood	7	10	1,030	$10	$22.8K

Nearby Providers

Other providers in the same ZIP code as Recovery Centers Of Montana LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Flathead County School District No 6	MT	Local Education Agency (LEA)	$0	$3.2M
Hidden Meadow Management LLC	MT	Assisted Living Facility	$0	$2.6M
Riverstone Management	MT	Assisted Living Facility	$0	$1.7M
Price Assisted Living Services LLC	MT	Assisted Living Facility	$0	$1.4M
Columbia Falls Family Dental Center PC	MT	General Practice Dentistry	$0	$1.2M
Shadrach Barney	MT	Denturist	$0	$984.5K
Berube Physical Therapy, Inc	MT	Multi-Specialty Clinic/Center	$0	$751.2K
Glacier Hope Homes, Inc.	MT	Substance Abuse Rehabilitation Facility	$0	$358.1K
Kelly Ewalt	MT	Professional Counselor	$0	$343.5K
Heavens Peak Healthcare LLC	MT	Nurse Practitioner	$0	$335.2K

Recovery Centers Of Montana LLC — Billing Profile & Reimbursement Data

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Recovery Centers Of Montana LLC — 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

Nearby Providers

Frequently Asked Questions

References