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

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

Moonlight Mountain Recovery, Inc (NPI 1861983413)

Field	Value
Entity Type	Organization
Organization	Moonlight Mountain Recovery, Inc
Address	5230 W Moonlight Mine Rd
City	Pocatello
State	ID
ZIP	83201
Taxonomy	Substance Abuse Rehabilitation Facility
NPI Enumerated	May 18, 2018

Payer Source	Total Paid
Medicaid	$17.7M
Medicare	$0

Key Findings

MOONLIGHT MOUNTAIN RECOVERY, INC is effectively a Medicaid-focused behavioral health/substance-use treatment provider: it reports no Medicare billing on file and $17.7M in lifetime Medicaid revenue, so its commercial/Medicare exposure is effectively nil while Medicaid is the primary payer supporting operations. The provider’s taxonomy as a Substance Abuse Rehabilitation Facility aligns with the Medicaid service mix dominated by structured program codes rather than routine office E/M encounters.

Revenue is highly concentrated in a single service line: H0035 accounts for $16M in Medicaid revenue and represents 90.7% of this provider’s total Medicaid revenue, and the precomputed top-3 Medicaid codes together account for 98.8% of Medicaid revenue. That concentration implies the facility’s financial performance is largely dependent on partial-hospitalization/less-than-24-hour structured treatment activity.

The top billing codes describe the operational model: the dominance of H0035 (Mental health partial hospitalization, treatment, less than 24 hours) together with substantial H0015 (intensive outpatient) and smaller T1017 (targeted case management) indicates the provider runs intensive day-treatment programs and associated care coordination rather than predominately office-based primary care or long-term residential services. This mix is consistent with a programmatic focus on multi-hour-per-day behavioral health treatment modalities.

Competitive standing for the flagship service is strong within Idaho: H0035 revenue places the provider at rank #1 of 7 in-state and in the 100th percentile, described in the source as notably above typical state volume for this code. By contrast, H0015 is rank #2 of 8 (86th percentile) and T1017 is rank #62 of 186 (67th percentile), indicating the provider is a dominant regional provider for partial hospitalization but a more typical participant for intensive outpatient and case-management services.

Other Medicaid codes confirm limited diversification into standard outpatient evaluation and psychotherapy: codes such as 90791 ($90.1K, 0.5% of Medicaid revenue) and 99212/90853 (small revenue shares) appear in the top-25 listing but each contributes only a fractional share of overall revenue. The presence of 90791 at rank #22 of 215 (90th percentile) suggests the provider performs psychiatric evaluations as part of its program mix, but these services are not primary revenue drivers.

The provider’s dependence on a few high-volume program codes creates operational sensitivity: with H0035 alone comprising $16M of $17.7M in Medicaid revenue, changes in coverage, utilization management, or program eligibility for partial-hospitalization services would disproportionately affect the organization’s revenue. The small contributions from many other CPT/HCPCS codes indicate limited alternative revenue streams to offset disruption to the primary service line.

Tenure and billing history: the NPI was enumerated on 2018-05-18 (~8 years ago), which gives the provider several years of Medicaid billing history concentrated in behavioral health day-treatment programs. This timeline supports that the current code mix and market positions (particularly the H0035 leadership) reflect an established program rather than a very new operation.

From a payer-strategy perspective, MOONLIGHT MOUNTAIN RECOVERY, INC should be viewed as a specialist Medicaid behavioral health provider anchored by partial hospitalization services (H0035). For payers and network planners, the provider represents a high-capacity, high-volume state resource for partial-hospitalization care but a single-payer concentration risk because Medicare revenue is absent and the top three Medicaid codes account for 98.8% of Medicaid revenue.

Medicaid: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0035	Mental health partial hospitalization, treatment, less than 24 hours	39,930	$400	$16M
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…	10,090	$130	$1.3M
T1017	Targeted case management, each 15 minutes	2,340	$50	$112.2K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	700	$130	$90.1K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	790	$40	$29.1K
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…	1,080	$30	$28.2K
H0038	Self‑help/peer services, per 15 minutes	600	$40	$25.6K
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…	270	$50	$14.2K
99204	The provider sees a new 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 provider…	70	$130	$8.9K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	30	$120	$3.9K

Showing 1–10 of 12

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Idaho Distribution

Moonlight Mountain Recovery, Inc — 1 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. Idaho median

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0035	Mental health partial hospitalization, treatment, less than 24 hours	1	10	1,920	$400	$3.1M
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…	2	10	2,310	$130	$717.4K
H0038	Self‑help/peer services, per 15 minutes	72	110	1,730	$90	$436.4K
T1017	Targeted case management, each 15 minutes	62	190	1,060	$60	$221.8K
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…	436	670	740	$40	$193.6K
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…	556	620	560	$60	$191.8K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	104	140	100	$90	$54.4K
99204	The provider sees a new 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 provider…	85	180	70	$110	$45.6K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	22	220	60	$100	$25.5K
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…	107	140	190	$30	$14.2K

Showing 1–10 of 12

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Brett Zundel	ID	Medical Physician Assistant	$158K	$0
Andrew Thayne	ID	Family Medicine Physician	$71.9K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pocatello Children & Adolescent Clinic	ID	Pediatrics Physician	$0	$11M
Speech Therapy Services, LLC	ID	Speech-Language Pathologist	$0	$8.5M
Pocatello Chubbuck School District #25	ID	Local Education Agency (LEA)	$0	$7.9M
Facial & Oral Surgery Associates, Inc.	ID	Oral and Maxillofacial Surgery (Dentist)	$0	$6.3M
Health West, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$6.2M
Pocatello Hospital LLC	ID	General Acute Care Hospital	$0	$6.1M
Health West, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$5.9M
Rocky Mountain Physician Group LLC	ID	Emergency Medicine Physician	$0	$5.5M
Community Mental Health	ID	Community/Behavioral Health Agency	$0	$4.3M
Medical Imaging Associates Of Idaho Falls, Inc	ID	Diagnostic Radiology Physician	$0	$4.2M

Moonlight Mountain Recovery, Inc — Billing Profile & Reimbursement Data

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Moonlight Mountain Recovery, 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