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

Why is the Medicaid comparison limited to South Dakota 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. South Dakota (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.

Wellspring Inc. (NPI 1891823332)

Field	Value
Entity Type	Organization
Organization	Wellspring Inc.
Address	117 Knollwood Dr
City	Rapid City
State	SD
ZIP	57701
Taxonomy	Psychiatry Physician
NPI Enumerated	February 28, 2007

Payer Source	Total Paid
Medicaid	$7.4M
Medicare	$0

Key Findings

WELLSPRING INC. bills almost exclusively to Medicaid — Total Medicare revenue: none (no Medicare billing on file) while Total Medicaid revenue: $7.4M — making the organization effectively single‑payer in the available claims data and highly dependent on state Medicaid reimbursement. This concentration in one payer should be treated as the primary commercial profile for analysts assessing revenue risk and contracting leverage.

Revenue is extremely concentrated in a narrow set of long‑stay behavioral health codes: the precomputed note states the top 3 Medicaid codes by revenue account for 99.5% of this provider's total Medicaid revenue. The single code H0019 alone comprises $6.9M (93.5% of Medicaid revenue), driven by 4.6K claims at an average paid/claim of $1499, indicating the bulk of billing flows through one service line.

The code mix and dominant codes indicate WELLSPRING operates as a long‑term residential behavioral health provider: H0019 is for long‑term residential (without room and board), and T2048 (with room and board) further supports a per‑diem residential treatment model. Ancillary codes H0001 (Alcohol and/or drug assessment) and H0005 (group counseling) are present but together represent only a small fraction of revenue, consistent with residential programs that also provide SUD assessment and group therapy.

This provider’s market position on its primary revenue driver is meaningful but not singular: H0019 ranks #2 of 7 providers in‑state (83th percentile; typical, unremarkable volume for this code), so WELLSPRING is a significant state participant in the non‑room‑and‑board long‑term residential segment but not the clear statewide leader. Analysts should interpret the “typical, unremarkable volume” label as indicating the provider’s activity level is within common bounds for peers despite the large dollar share.

For the room‑and‑board variant T2048, WELLSPRING’s footprint is modest: 203 claims produced $377.2K revenue (5.1% of Medicaid revenue) and the provider ranks #7 of 8 in‑state (14th percentile; typical, unremarkable volume for this code). This low percentile position suggests WELLSPRING primarily bills the non‑room‑and‑board per‑diem (H0019) rather than the with‑room‑and‑board service, or that room‑and‑board placements are a smaller part of its operational mix.

Smaller clinical services are present but not revenue drivers: H0001 (243 claims, $274 avg paid/claim, $66.6K revenue; 0.9% of Medicaid revenue, ranks #7 of 16, 60th percentile) and H0005 (405 claims, $97 avg paid/claim, $39.3K revenue; 0.5% of Medicaid revenue, ranks #13 of 20, 37th percentile) indicate the provider delivers assessments and group counseling typically associated with SUD treatment programs, but these services are ancillary to the residential per‑diem model.

The billing model shows elevated per‑diem average payments for the residential codes (H0019 avg paid/claim $1499; T2048 avg paid/claim $1858), which underscores operational reliance on bed‑based, ongoing care rather than high volumes of brief outpatient encounters. Given that the top three codes account for 99.5% of Medicaid revenue, changes to per‑diem reimbursement or utilization of residential stays could materially affect the provider’s revenue profile.

WELLSPRING’s NPI tenure (NPI enumerated 2007-02-28 (~19 years ago)) indicates an established presence in the market; combined with the concentrated Medicaid revenue mix and the provider’s in‑state ranks, this suggests a stable, specialized operator in long‑term residential behavioral health rather than a broad ambulatory psychiatry practice.

Medicaid: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	4,600	$1,500	$6.9M
T2048	Behavioral health; long-term care residential (non-acute care in a residential treatment program where stay is typically longer than 30 days), with room and board, per diem	200	$1,860	$377.2K
H0001	Alcohol and/or drug assessment	240	$270	$66.6K
H0005	Alcohol and/or drug services; group counseling by a clinician	410	$100	$39.3K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Dakota Distribution

Wellspring Inc. — 0 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. South Dakota median

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2048	Behavioral health; long-term care residential (non-acute care in a residential treatment program where stay is typically longer than 30 days), with room and board, per diem	7	10	3,270	$1,840	$23.2M
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	2	10	1,970	$1,550	$3.8M
H0005	Alcohol and/or drug services; group counseling by a clinician	13	20	520	$80	$128.2K
H0001	Alcohol and/or drug assessment	7	20	160	$150	$45.2K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Behavior Management Systems, Inc.	SD	Community/Behavioral Health Agency	$0	$19.8M
Monument Health Rapid City Hospital, Inc	SD	Multi-Specialty Clinic/Center	$0	$18.7M
Monument Health Rapid City Hospital, Inc.	SD	General Acute Care Hospital	$0	$11.5M
Community Health Center Of The Black Hills Inc	SD	Federally Qualified Health Center (FQHC)	$0	$10.2M
Jrk Services, Inc	SD	Home Health Agency	$0	$10.1M
Black Hills Pediatrics, LLP	SD	Pediatrics Physician	$0	$9.7M
Rapid City Emergency Services PA	SD	Emergency Medicine Physician	$0	$8.2M
Prema Abraham	SD	Retina Specialist (Ophthalmology) Physician	$7.1M	$0
Radiology Associates Prof, LLC	SD	Diagnostic Radiology Physician	$0	$5.3M
Monument Health Rapid City Hospital, Inc.	SD	Multi-Specialty Clinic/Center	$0	$5.2M

Wellspring Inc. — Billing Profile & Reimbursement Data

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Wellspring 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

Nearby Providers

Frequently Asked Questions

References