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.

South Central Montana Regional Mental Health Center (NPI 1891781787)

Field	Value
Entity Type	Organization
Organization	South Central Montana Regional Mental Health Center
Address	1245 N 29th St
City	Billings
State	MT
ZIP	59101
Taxonomy	Clinic/Center
NPI Enumerated	September 26, 2005

Payer Source	Total Paid
Medicaid	$16.6M
Medicare	$0

Key Findings

This provider is effectively single-payer: there is no Medicare billing on file and all reported federal payer revenue is Medicaid, with total Medicaid revenue of $16.6M. The absence of Medicare activity indicates the organization’s operations and revenue are concentrated in state Medicaid programs rather than fee-for-service Medicare lines.

Revenue concentration is high: the precomputed top three Medicaid codes account for 83.0% of this provider's total Medicaid revenue, driven by H0040 at $9.3M (56.1%), 90837 at $2.5M (15.0%), and H2012 at $2M (11.9%). This three-code dominance means a small set of service lines explains most of the financial footprint reported here.

The mix of top codes points to a community-based, intensive behavioral health operating model. H0040 (Assertive community treatment program, per diem) at $9.3M and H2012 (Behavioral health day treatment, per hour) at $2M indicate per-diem and hourly community treatment programs, while 90837 (long psychotherapy sessions) at $2.5M reflects a very large psychotherapy volume; together these codes describe an organization focused on intensive outpatient and community mental health services.

Despite H0040 representing 56.1% of the Medicaid revenue, the provider ranks #4 of 5 in-state for that code and is described as having a "typical, unremarkable volume for this code" (25th percentile). In plain terms, H0040 is the single largest revenue driver for this provider but the provider is not a high-volume outlier among the small set of in-state organizations that bill this per-diem service.

For 90837 the provider is an extreme state outlier: 32.3K claims and $2.5M in revenue for 90837 place it at rank #4 of 1203 providers statewide with the label "extreme outlier, far above typical state volume for this code." This suggests the provider operates an unusually large psychotherapy capacity or caseload relative to nearly all other in-state peers.

H2012 is also a material revenue contributor (46.9K claims, $2M revenues) and is ranked #4 of 15 in-state with a "typical, unremarkable volume for this code" (79th percentile). Taken together with H0040 and 90837, the coding mix shows reliance on both structured day-treatment and psychotherapy claims rather than primarily brief primary-care style E/M visits.

Several ancillary codes further characterize service breadth: 90791 (psychiatric evaluation) shows $317.1K in revenue and ranks #5 of 190 providers statewide with a label of "notably above typical state volume for this code" (98th percentile), and H0004 (behavioral health counseling per 15 minutes) ranks #2 of 23 (95th percentile) with $35.5K. These higher-percentile results for evaluation and counseling codes indicate substantial investment in initial assessments and billed counseling in addition to the large ACT and psychotherapy programs.

The provider’s NPI was enumerated on 2005-09-26 (~21 years ago), signaling long tenure in the market. Combined with the concentrated Medicaid revenue base and the large psychotherapy and community-treatment volumes, this longevity suggests an established regional behavioral health program whose financial performance will be sensitive to Medicaid policy, reimbursement changes, or shifts in state-managed care arrangements.

Medicaid: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0040	Assertive community treatment program, per diem	21,690	$430	$9.3M
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…	32,300	$80	$2.5M
H2012	Behavioral health day treatment, per hour	46,880	$40	$2M
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…	10,150	$80	$821.7K
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…	1,970	$190	$369K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	3,730	$90	$317.1K
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…	5,090	$60	$284.8K
T1016	Case management, each 15 minutes	5,230	$50	$261.4K
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…	3,170	$50	$167.7K
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…	9,120	$10	$127.6K

Showing 1–10 of 20

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

South Central Montana Regional Mental Health Center — 3 of 20 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

20 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0040	Assertive community treatment program, per diem	4	10	32,960	$330	$11M
H2012	Behavioral health day treatment, per hour	4	20	27,640	$60	$2M
T1016	Case management, each 15 minutes	22	50	2,720	$50	$1.4M
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	20	1,510	$170	$848K
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…	36	530	580	$70	$224.6K
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…	97	520	730	$40	$196.4K
H0038	Self‑help/peer services, per 15 minutes	13	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…	4	1,200	750	$80	$143.2K
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…	61	160	250	$110	$85.9K
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	110	1,250	$10	$50.5K

Showing 1–10 of 20

Related Providers

Other providers that share a Tax Identification Number (TIN) with South Central Montana Regional Mental Health Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
James Whitworth	MT	Psychiatry Physician	$30.5K	$0

Nearby Providers

Other providers in the same ZIP code as South Central Montana Regional Mental Health Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Billings Clinic	MT	General Practice Physician	$0	$53.8M
Rimrock Foundation	MT	Substance Use Disorder Rehabilitation Clinic/Center	$0	$44.9M
Scl Health Medical Group - Billings LLC	MT	Clinic/Center	$0	$32.2M
Residential Support Services	MT	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$30.6M
Billings Public School District 2	MT	Local Education Agency (LEA)	$0	$19.2M
Billings Clinic	MT	Emergency Care Clinic/Center	$0	$15.7M
Community Solutions Incorporated	MT	Clinical Medical Laboratory	$0	$14.1M
Scl Health Montana	MT	General Acute Care Hospital	$0	$13.5M
Benefis Community Care, Inc.	MT	Case Management Agency	$0	$10.8M
American Medical Response Ambulance Service Inc	MT	Ambulance	$2.1M	$6.7M

South Central Montana Regional Mental Health Center — Billing Profile & Reimbursement Data

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South Central Montana Regional Mental Health Center — 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