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

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

Presbyterian Hospitality House (NPI 1871624536)

Field	Value
Entity Type	Organization
Organization	Presbyterian Hospitality House
Address	209 Forty Mile Ave
City	Fairbanks
State	AK
ZIP	99701
Taxonomy	Emotionally Disturbed Childrens' Residential Treatment Facility
NPI Enumerated	March 7, 2007

Payer Source	Total Paid
Medicaid	$34.9M
Medicare	$0

Key Findings

The provider’s billing mix is clearly centered on residential and intensive therapeutic behavioral services: the largest single code is H0018 (short-term residential, per diem) and the next-largest are H2020/H2019 (therapeutic behavioral services, per diem and per 15 minutes), with additional material revenue from T2033 (residential care, waiver; per diem) and H2021 (community-based wrap-around services, per 15 minutes). This pattern aligns with the listed taxonomy (Emotionally Disturbed Childrens' Residential Treatment Facility) and indicates operations focused on facility-based residential stays plus supporting in-program therapy and wrap-around care.

Revenue is highly concentrated in a small set of Medicaid codes: the precomputed top three codes account for 69.6% of the provider’s Medicaid revenue. Those top three are H0018 ($13.5M, 38.6%), H2020 ($6.2M, 17.8%), and H2019 ($4.6M, 13.1%), together forming the dominant share of the $34.9M in Medicaid revenue on file.

This entity is effectively a single-payer Medicaid provider: there is no Medicare billing on file while reported Medicaid revenue totals $34.9M, so the provider’s financial exposure and utilization profile are driven almost entirely by state Medicaid policy and reimbursement for behavioral health and residential services.

Competitive standing varies by service line: for H0018 the provider ranks #2 of 11 in-state (90th percentile; typical, unremarkable volume for this code), indicating it is a leading statewide provider of short-term residential services; by contrast H2020 ranks #3 of 6 (60th percentile; typical, unremarkable volume) which is a more modest position among the smaller peer group for that per-diem therapy code. H2019 ranks #10 of 38 (76th percentile; typical, unremarkable volume), signaling solid but not dominant footing in per-15-minute therapeutic behavioral services.

Several other codes show meaningful contributions beyond the top three: T2033 ($3.7M, 10.7%) ranks #3 of 8 (71th percentile; typical, unremarkable volume) and H2021 ($3.7M, 10.5%) ranks #10 of 76 (88th percentile; typical, unremarkable volume), which together suggest the provider also captures significant waiver-residential and community wrap-around revenue streams that support the core residential program.

Service-volume metrics underline an operational model built on high-frequency per-diem and time-based therapy billing: H0018 shows 65.1K claims at $207 avg paid/claim, H2020 shows 21.9K claims at $283 avg paid/claim, and H2019 shows 17K claims at $269 avg paid/claim. These large claim counts are consistent with continuous/residential care plus frequent therapeutic encounters rather than isolated outpatient visits.

Outpatient psychotherapy and ancillary behavioral codes are present but secondary: 90853 (group psychotherapy) generated $1.1M (3.2% of Medicaid revenue) and 90837 (long psychotherapy) generated $972.3K (2.8%), with multiple other psychotherapy and case-management codes contributing smaller amounts. This indicates the provider supplements its residential offerings with in-program group and individual therapy rather than relying on outpatient services as primary revenue drivers.

The provider’s NPI has been active since 2007-03-07 (~19 years ago), suggesting an established presence and likely operational continuity in the state Medicaid market; however, the concentration of revenue in a few high-volume residential and therapeutic codes (top three = 69.6%) implies sensitivity to any Medicaid rate changes or program eligibility shifts that affect those specific service lines.

Medicaid: Complete Services Breakdown

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

17 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	65,100	$210	$13.5M
H2020	Therapeutic behavioral services, per diem	21,950	$280	$6.2M
H2019	Therapeutic behavioral services, per 15 minutes	17,010	$270	$4.6M
T2033	Residential care, not otherwise specified (nos), waiver; per diem	10,260	$370	$3.7M
H2021	Community-based wrap-around services, per 15 minutes	7,880	$470	$3.7M
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…	12,180	$90	$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…	9,170	$110	$972.3K
H0038	Self‑help/peer services, per 15 minutes	690	$410	$277.8K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	1,250	$130	$158.5K
T1016	Case management, each 15 minutes	2,440	$60	$144.1K

Showing 1–10 of 17

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Alaska Distribution

Presbyterian Hospitality House — 0 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alaska

Full comparison — all codes billed, vs. Alaska median

17 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	2	10	23,880	$260	$8.4M
H2020	Therapeutic behavioral services, per diem	3	10	17,020	$280	$4.7M
T2033	Residential care, not otherwise specified (nos), waiver; per diem	3	10	7,460	$490	$3.4M
H2019	Therapeutic behavioral services, per 15 minutes	10	40	3,660	$250	$3.1M
H2021	Community-based wrap-around services, per 15 minutes	10	80	1,070	$330	$1.3M
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…	15	150	1,020	$200	$620.5K
T1016	Case management, each 15 minutes	39	90	1,620	$150	$606.4K
H0038	Self‑help/peer services, per 15 minutes	9	10	1,120	$200	$442.1K
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…	6	60	1,070	$80	$392.9K
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…	41	90	370	$180	$361K

Showing 1–10 of 17

Nearby Providers

Other providers in the same ZIP code as Presbyterian Hospitality House, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tanana Chiefs Conference	AK	Multi-Specialty Clinic/Center	$0	$107.5M
Fairbanks Memorial Hospital, LLC	AK	General Acute Care Hospital	$0	$83.6M
Fairbanks Resource Agency Inc	AK	Community/Behavioral Health Agency	$0	$48M
Fairbanks Native Association	AK	Substance Abuse Rehabilitation Facility	$0	$32.6M
Tanana Chiefs Confenerce	AK	Transportation Broker	$0	$24.1M
Tanana Chiefs Conference	AK	Community/Behavioral Health Agency	$0	$17M
Tanana Chiefs Conference	AK	Multi-Specialty Clinic/Center	$0	$16.3M
Restore LLC	AK	Substance Use Disorder Rehabilitation Clinic/Center	$0	$16.3M
Tanana Valley Clinic LLC	AK	Multi-Specialty Clinic/Center	$0	$15.2M
Tanana Chiefs Conference	AK	Community/Behavioral Health Agency	$0	$14.2M

Presbyterian Hospitality House — Billing Profile & Reimbursement Data

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Presbyterian Hospitality House — 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