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

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

Prairie Ridge Integrated Behavioral Healthcare (NPI 1952443632)

Field	Value
Entity Type	Organization
Organization	Prairie Ridge Integrated Behavioral Healthcare
Address	320 N Eisenhower Ave
City	Mason City
State	IA
ZIP	50401
Taxonomy	Substance Abuse Rehabilitation Facility
NPI Enumerated	February 12, 2007

Payer Source	Total Paid
Medicaid	$24.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

30 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	46,850	$180	$8.3M
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	34,180	$160	$5.4M
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…	40,280	$90	$3.6M
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…	46,330	$60	$2.5M
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…	17,480	$60	$1M
H0040	Assertive community treatment program, per diem	14,950	$60	$836.9K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	6,350	$120	$736.7K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	3,330	$180	$612.2K
Q3014	Telehealth originating site facility fee	14,600	$20	$277.4K
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…	5,390	$50	$242.6K

Showing 1–10 of 30

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Iowa Distribution

Prairie Ridge Integrated Behavioral Healthcare — 4 of 22 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Iowa

Full comparison — all codes billed, vs. Iowa median

30 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0040	Assertive community treatment program, per diem	11	10	48,800	$60	$4.6M
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	16	60	16,120	$150	$3.8M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	2	20	11,060	$220	$3.7M
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…	16	680	670	$70	$343.5K
T1016	Case management, each 15 minutes	13	20	480	$150	$340.3K
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…	18	20	2,150	$80	$334.3K
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…	2	120	980	$50	$230.3K
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…	42	1,060	480	$40	$154.5K
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…	244	1,310	760	$20	$153.1K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	13	140	210	$120	$152.1K

Showing 1–10 of 30

Related Providers

Other providers that share a Tax Identification Number (TIN) with Prairie Ridge Integrated Behavioral Healthcare, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sameer Arain	MO	Psychiatry Physician	$36.4K	$0

Nearby Providers

Other providers in the same ZIP code as Prairie Ridge Integrated Behavioral Healthcare, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mercy Health Services-iowa Corp	IA	Rural Acute Care Hospital	$0	$45.7M
North Iowa Vocational Center	IA	Developmentally Disabled Services Day Training Agency	$0	$15.3M
Mason City Community School District	IA	Local Education Agency (LEA)	$0	$6.8M
Community Health Center Of Fort Dodge, Inc.	IA	Federally Qualified Health Center (FQHC)	$0	$6.4M
City Of Mason City	IA	Land Ambulance	$616.5K	$4.3M
Todd Hoeppner	IA	Pediatric Dentistry	$0	$4.8M
North Iowa Mercy Clinics	IA	Emergency Medicine Physician	$0	$3.9M
North Iowa Transition Center	IA	Community/Behavioral Health Agency	$0	$3.7M
North Iowa Mercy Clinics	IA	Cardiovascular Disease Physician	$0	$2.7M
Mason City Ambulatory Surgery Center, LLC	IA	Ambulatory Surgical Clinic/Center	$2.2M	$422.9K

Prairie Ridge Integrated Behavioral Healthcare — Billing Profile & Reimbursement Data

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Prairie Ridge Integrated Behavioral Healthcare — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References