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.

Western Montana Mental Health Center (NPI 1912079328)

Field	Value
Entity Type	Organization
Organization	Western Montana Mental Health Center
Address	1321 Wyoming St
City	Missoula
State	MT
ZIP	59801
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	November 14, 2006

Payer Source	Total Paid
Medicaid	$87.8M
Medicare	$0

Key Findings

WESTERN MONTANA MENTAL HEALTH CENTER is effectively a Medicaid-centric provider: it reports $87.8M in lifetime Medicaid revenue and has no Medicare billing on file. The NPI was enumerated on 2006-11-14 (~20 years ago), indicating long tenure in the market but very limited payer diversification beyond Medicaid.

Revenue is highly concentrated in a small set of per-diem behavioral health programs: the precomputed top 3 Medicaid codes account for 60.6% of the provider’s total Medicaid revenue, led by H0040 at $23.9M (27.5%), followed by S5102 at $18.9M (21.7%) and S9485 at $9.8M (11.3%). H0040 alone represents the single largest revenue line, showing the business relies heavily on assertive community treatment funding.

The code mix points to a community-based behavioral health operating model focused on per-diem programs and high-volume outpatient psychotherapy. High-revenue per-diem lines such as H0040 (Assertive community treatment), S5102 (Day care services, adult), S9485 (Crisis intervention per diem), T2016 (Habilitation, residential, waiver), and H0018 (short-term residential) indicate the organization runs intensive community treatment and residential/waiver programs alongside ambulatory services.

Competitive standing is mixed across those leading codes: H0040 ranks #1 of 5 in-state (100th percentile; typical, unremarkable volume) indicating it is a top provider of Assertive Community Treatment within a small peer set, while S5102 ranks #6 of 8 (29th percentile; typical, unremarkable volume) and S9485 is listed as #1 of 1 (0th percentile; no state peer volume comparison available). In short, the center is a dominant provider for some per-diem services within narrow peer groups but not uniformly dominant across all per-diem lines.

WESTERN MONTANA delivers exceptionally high volumes of psychotherapy and E/M services relative to state peers: for example, 90837 shows 53.4K claims and $4.3M revenue (4.9% of Medicaid) and ranks #2 of 1203 providers in-state (100th percentile; extreme outlier), while 90832 (24.1K claims, $914.1K, 1.1%) and 90791 (10.4K claims, $912.3K, 1.1%) also rank at 99th percentile or higher and are labeled extreme outliers. These patterns indicate a large outpatient psychotherapy throughput and suggest behavioral health visits are a major operational volume driver beyond the per-diem programs.

The provider also runs very high-volume case management and day-treatment operations: T1016 shows 69.7K claims and $3.3M revenue (3.8%), and H2012 shows 85.2K claims and $3.1M revenue (3.5%), both ranking in high state percentiles (T1016 at 87th; H2012 at 93th percentile). This combination of high-count, lower-unit-value services (case management and day treatment) alongside high-unit-value residential/per-diem codes reflects a blended model of intensive service delivery plus high-touch care coordination.

Several high-unit per-diem codes contribute meaningful revenue per claim and point to residential/habilitation capacity: T2016 reports $4.5M revenue with a $1499 avg paid/claim (5.2% of Medicaid) and H0018 reports $3M revenue with a $1415 avg paid/claim (3.5% of Medicaid). The presence of these higher-paid per-diem services indicates the organization receives material revenue from residential and waiver habilitation programs in addition to outpatient volumes.

For payers and analysts, two implications stand out: first, the center’s heavy reliance on Medicaid (no Medicare billing on file) makes its financial and utilization profile particularly sensitive to state Medicaid policy and rate changes; second, the combination of concentrated per-diem revenue (top 3 = 60.6%) and multiple psychotherapy/E/M codes flagged as extreme outliers suggests a need for detailed benchmarking of utilization patterns, program eligibility, and capacity against state program design and peer providers.

Medicaid: Complete Services Breakdown

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

52 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0040	Assertive community treatment program, per diem	54,850	$440	$23.9M
S5102	Day care services, adult; per diem	14,690	$1,290	$18.9M
S9485	Crisis intervention mental health services, per diem	10,250	$960	$9.8M
T2016	Habilitation, residential, waiver; per diem	2,990	$1,500	$4.5M
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…	53,430	$80	$4.3M
H0037	Community psychiatric supportive treatment program, per diem	15,260	$260	$4M
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…	40,090	$90	$3.7M
T1016	Case management, each 15 minutes	69,650	$50	$3.3M
H2012	Behavioral health day treatment, per hour	85,190	$40	$3.1M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	2,130	$1,420	$3M

Showing 1–10 of 52

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

Western Montana Mental Health Center — 10 of 25 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

52 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0040	Assertive community treatment program, per diem	1	10	32,960	$330	$11M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	5	10	3,620	$460	$10.3M
S9485	Crisis intervention mental health services, per diem	1	10	10,250	$960	$9.8M
S5102	Day care services, adult; per diem	6	10	16,590	$280	$7.2M
S5140	Foster care, adult; per diem	2	10	9,830	$430	$4.2M
T2016	Habilitation, residential, waiver; per diem	5	10	2,300	$460	$3.2M
H0037	Community psychiatric supportive treatment program, per diem	2	10	10,400	$260	$2.6M
H0012	Behavioral health day treatment, per hour	2	10	18,440	$140	$2.6M
H2012	Behavioral health day treatment, per hour	2	20	27,640	$60	$2M
H2020	Therapeutic behavioral services, per diem	9	10	1,970	$120	$1.7M

Showing 1–10 of 52

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Marie Pettit	MT	Professional Counselor	$0	$341.9K
Tammy Alexander	MT	Professional Counselor	$0	$327K
Kali Neumeister	MT	Professional Counselor	$0	$220.5K
Kevin Dobi	CO	Psychiatric/Mental Health Nurse Practitioner	$130.4K	$0
Lisa Turk	MT	Psychiatric/Mental Health Nurse Practitioner	$23.8K	$27K
Patricia White	MT	Physician Assistant	$27.1K	$0
Jane Mergy	MT	Family Nurse Practitioner	$21.5K	$0
Ann Finnegan	MT	Clinical Social Worker	$19.7K	$0
Sarah Mcnair	MT	Clinical Social Worker	$7.7K	$0
Chelsea Boggess	MT	Clinical Social Worker	$6.7K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Opportunity Resources Inc	MT	Developmentally Disabled Services Day Training Agency	$0	$48.5M
Missoula Developmental Service Corp	MT	Non-emergency Medical Transport (VAN)	$0	$33.6M
Express Personnel Services	MT	Nursing Care Agency	$0	$20.4M
3 Rivers Mental Health Solutions LLC	MT	Community/Behavioral Health Agency	$0	$16.7M
Missoula County Public Schools	MT	Local Education Agency (LEA)	$0	$16.3M
Meadowlark Home Care LLC	MT	Home Health Agency	$0	$12.9M
Client Dedicated Services, Inc	MT	Home Health Agency	$0	$10.6M
Children's Dentistry Of The Rockies	MT	Pediatric Dentistry	$0	$10.1M
Missoula Pediatric Dentistry PC	MT	Pediatric Dentistry	$0	$9.3M
Missoula Oral Surgery	MT	Oral and Maxillofacial Surgery Clinic/Center	$0	$8M

Western Montana Mental Health Center — Billing Profile & Reimbursement Data

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Western Montana 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