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

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

Frontier Behavioral Health (NPI 1861495327)

Field	Value
Entity Type	Organization
Organization	Frontier Behavioral Health
Address	107 S Division St
City	Spokane
State	WA
ZIP	99202
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	May 27, 2005

Payer Source	Total Paid
Medicaid	$34.3M
Medicare	$0

Key Findings

FRONTIER BEHAVIORAL HEALTH is effectively a single-payer Medicaid provider: total Medicare revenue is none (no Medicare billing on file) while total Medicaid revenue is $34.3M, indicating Medicaid accounts for virtually all reported public-payer activity for this NPI. This payer concentration shapes the organization’s billing profile and risk exposure to Medicaid policy and rate changes.

Revenue is highly concentrated in a small set of Medicaid per-diem and waiver services: the precomputed top 3 Medicaid codes (H2013, S9485, T2025) together account for 80.8% of the provider’s total Medicaid revenue. H2013 alone generates $17.5M (51.1% of Medicaid revenue), followed by S9485 with $5.7M (16.7%) and T2025 with $4.5M (13.0%), which signals heavy dependence on facility-based psychiatric per-diems, crisis intervention, and waiver services.

The service-line mix implied by the top codes points to a facility-centered behavioral health operator with high-volume crisis and waiver programming: H2013 (psychiatric health facility service, per diem) and S9485 (crisis intervention mental health services, per diem) are top revenue drivers, and T2025 (waiver services; nos) is also material. High claim counts for these codes (H2013: 19.6K claims; S9485: 13.4K claims; T2025: 30K claims) suggest the organization operates continuous per-diem beds and runs large-scale crisis/waiver programs rather than being primarily an office-based psychotherapy practice.

Competitive standing in-state is dominant for specific per-diem and crisis codes: FRONTIER ranks #1 of 8 providers in-state for H2013 and sits at the 100th percentile, described as notably above typical state volume for this code. By contrast, S9485 (rank #3 of 19, 89th percentile) and T2025 (rank #4 of 17, 81th percentile) are sizable but more typical within the in-state competitive set, indicating market leadership concentrated in psychiatric per-diem capacity rather than across every behavioral service line.

Several outpatient psychotherapy and assessment codes show extreme claim volumes relative to peers but contribute small dollar amounts, consistent with a high-volume, low-unit-payment operating model: 90837 appears with 191.8K claims and $383.5K revenue (1.1% of Medicaid revenue) and ranks #3 of 934 providers in-state (100th percentile; extreme outlier). Similarly, 90791 (30.5K claims, $91.5K revenue) and 90832 (58.7K claims, $58.7K revenue) are each ranked #1 in-state at the 100th percentile and labeled extreme outliers, which suggests very large encounter counts paid at low average rates per claim.

Unit-rate dynamics amplify the high-volume profile: many psychotherapy and brief-service CPT/H codes report very low avg paid/claim amounts (examples include 90837 at $2 avg paid/claim and 90834 at $2 avg paid/claim), meaning substantial clinical throughput is required to generate revenue. This pattern indicates operational emphasis on throughput and standardized, time-based behavioral services rather than high-reimbursement procedures.

Beyond the top three revenue codes, FRONTIER shows state-level dominance on multiple specialized behavioral codes: H2011 (crisis intervention service, per 15 minutes) ranks #1 of 58 providers in-state at the 100th percentile and is labeled an extreme outlier, and H2031 (mental health clubhouse services, per diem) ranks #1 of 2 providers in-state (100th percentile) though smaller in absolute revenue. Those standings reinforce that the provider is a major local hub for crisis and community-based behavioral programs.

The NPI tenure indicates an established presence: the provider’s NPI was enumerated on 2005-05-27 (~21 years ago), so the organization has long-standing participation in Medicaid billing. Combined with the concentrated revenue base and repeated top-state rankings, this tenure suggests sustained operational focus on facility-based behavioral health and crisis/waiver services in the Spokane area.

Medicaid: Complete Services Breakdown

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

58 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2013	Psychiatric health facility service, per diem	19,640	$890	$17.5M
S9485	Crisis intervention mental health services, per diem	13,360	$430	$5.7M
T2025	Waiver services; not otherwise specified (nos)	30,000	$150	$4.5M
H2012	Behavioral health day treatment, per hour	22,520	$130	$2.9M
G9149	National committee for quality assurance - level 2 medical home	4,270	$250	$1.1M
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…	191,750	$1	$383.5K
H2036	Alcohol and/or other drug treatment program, per diem	21,550	$20	$323.3K
H2011	Crisis intervention service, per 15 minutes	144,450	$1	$288.9K
T1041	Medicaid certified community behavioral health clinic services, per month	360	$610	$216.2K
H0004	Behavioral health counseling and therapy, per 15 minutes	68,460	$1	$205.4K

Showing 1–10 of 58

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Washington Distribution

Frontier Behavioral Health — 13 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. Washington median

58 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1041	Medicaid certified community behavioral health clinic services, per month	14	30	270	$2,060	$3.7M
T2025	Waiver services; not otherwise specified (nos)	4	20	18,710	$150	$3.5M
H2013	Psychiatric health facility service, per diem	1	10	520	$870	$3M
S9485	Crisis intervention mental health services, per diem	3	20	3,730	$310	$1.8M
G9149	National committee for quality assurance - level 2 medical home	31	90	1,680	$200	$1.5M
H0043	Supported housing, per diem	112	140	1,690	$110	$602.5K
H0004	Behavioral health counseling and therapy, per 15 minutes	9	320	2,080	$60	$495.5K
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…	189	1,820	480	$60	$379.6K
H2012	Behavioral health day treatment, per hour	3	30	3,580	$40	$360.5K
H2019	Therapeutic behavioral services, per 15 minutes	22	40	1,600	$120	$346.5K

Showing 1–10 of 58

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
James Foster	WA	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$225.6K	$0
Jennifer Gaston	WA	Psychiatry Physician	$14.1K	$0
Aileen Hetrick	WA	Social Worker	$9.1K	$0

Nearby Providers

Other providers in the same ZIP code as Frontier Behavioral Health, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Multicare Health System	WA	Internal Medicine Physician	$0	$46.6M
Dungarvin Washington Children's Services, LLC	WA	Developmental Disabilities Clinic/Center	$0	$21.3M
Community Health Association Of Spokane	WA	Federally Qualified Health Center (FQHC)	$0	$8.2M
Providence Health & Services- Washington	WA	Rehabilitation Hospital	$0	$8M
Compass Career Solutions LLC	WA	Developmentally Disabled Services Day Training Agency	$0	$7.7M
Inland Imaging LLC	WA	Diagnostic Radiology Physician	$0	$6.8M
Northwest Autism Center	WA	Community/Behavioral Health Agency	$0	$5.9M
Northwest Pediatric Ophthalmology	WA	Ophthalmology Physician	$0	$4.2M
Inland Northwest Renal Care Group, LLC	WA	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4.1M
Collin Perri	WA	Physician Assistant	$3.8M	$0

Frontier Behavioral Health — 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