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.

Eastern Montana Community Mental Health Center (NPI 1992786784)

Field	Value
Entity Type	Organization
Organization	Eastern Montana Community Mental Health Center
Address	2508 Wilson St
City	Miles City
State	MT
ZIP	59301
Taxonomy	Clinic/Center
NPI Enumerated	November 8, 2005

Payer Source	Total Paid
Medicaid	$13.7M
Medicare	$0

Key Findings

Eastern Montana Community Mental Health Center has been NPI-enumerated since 2005-11-08 (about 21 years) and reports no Medicare billing on file; its entire recorded federal payer activity is effectively single-payer Medicaid with total Medicaid revenue of $13.7M. This makes the organization highly exposed to Medicaid policy and reimbursement trends because there is no Medicare revenue to diversify payer risk.

Revenue is highly concentrated: the provider's top three Medicaid codes (H0037, S5102, 90837) account for 65.1% of its total Medicaid revenue. Those three codes individually represent $4.7M (34.5%), $2.3M (16.8%), and $1.9M (13.8%) respectively, indicating reliance on a small set of service lines for the majority of cash flow.

The claims mix and dominant codes point to an operation focused on community-based behavioral health and outpatient/day treatment services rather than traditional medical office care. High revenue from H0037 (community psychiatric supportive treatment per diem) and S5102 (adult day care services, per diem), alongside large volume in 90837 (long psychotherapy sessions), shows the center runs per-diem community programs plus a high intensity psychotherapy practice.

Competitive standing in key service lines is mixed: the center ranks #1 of 4 providers in-state for H0037 and sits at the 100th percentile for that code (noted as typical, unremarkable volume), which means it is the leading provider among a small set of peers for community psychiatric supportive treatment in Montana. In contrast, for 90837 the center ranks #7 of 1203 providers in-state and is described as an extreme outlier (100th percentile), signaling exceptionally high psychotherapy volume compared with statewide peers.

Telehealth appears to be a material part of access strategy: Q3014 shows 11.1K claims and $277.4K revenue (2.0% of Medicaid revenue) and the center ranks #3 of 55 providers in-state at the 96th percentile (notably above typical state volume). This suggests the center operates a well-used telehealth originating site for patients, which may extend reach across rural areas.

Beyond the top three, the provider delivers a broad set of wraparound behavioral health services: H2012 (behavioral health day treatment, $1.7M, 12.5%), H2019 (therapeutic behavioral services, $952.4K, 7.0%), and T1016 (case management, $869.9K, 6.4%) together show a portfolio of day treatment, therapeutic one-on-one services, and case management support. Several of these codes rank above typical state percentiles (for example H2019 at the 89th percentile), indicating meaningful scale across multiple community mental health interventions.

The large claim volumes reported (for example 22.7K claims for 90837, 42.7K claims for H2012, 47.6K claims for H2019) combined with per-diem and per-session reimbursement models suggest operations are built around high-throughput, recurring services rather than infrequent high-dollar procedures. This operational model implies sensitivity to changes in per-diem rates, session length documentation requirements, and utilization management policies.

From a payer/contracting perspective, the center is a major Medicaid provider in specific behavioral health niches (community psychiatric support and long psychotherapy) but is otherwise focused geographically and by payer; absence of Medicare revenue limits bargaining leverage with mixed-payer networks and concentrates reimbursement risk within the Medicaid program. Analysts evaluating growth or risk should prioritize Medicaid policy shifts affecting H0037, S5102, and 90837 because those codes drive the bulk of reported revenue.

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
H0037	Community psychiatric supportive treatment program, per diem	17,430	$270	$4.7M
S5102	Day care services, adult; per diem	21,830	$110	$2.3M
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…	22,740	$80	$1.9M
H2012	Behavioral health day treatment, per hour	42,690	$40	$1.7M
H2019	Therapeutic behavioral services, per 15 minutes	47,620	$20	$952.4K
T1016	Case management, each 15 minutes	22,310	$40	$869.9K
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…	6,550	$40	$281.6K
Q3014	Telehealth originating site facility fee	11,100	$30	$277.4K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	2,440	$90	$229.3K
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…	1,850	$70	$137.1K

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

Eastern Montana Community Mental Health Center — 3 of 19 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
S5102	Day care services, adult; per diem	3	10	16,590	$280	$7.2M
T2016	Habilitation, residential, waiver; per diem	6	10	2,300	$460	$3.2M
H0037	Community psychiatric supportive treatment program, per diem	1	10	10,400	$260	$2.6M
H2012	Behavioral health day treatment, per hour	6	20	27,640	$60	$2M
T1016	Case management, each 15 minutes	13	50	2,720	$50	$1.4M
H2019	Therapeutic behavioral services, per 15 minutes	5	40	3,280	$50	$759.9K
H2015	Comprehensive community support services, per 15 minutes	4	10	8,260	$60	$408.9K
H2017	Psychosocial rehabilitation services, per 15 minutes	2	10	3,210	$30	$286.8K
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…	144	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…	166	520	730	$40	$196.4K

Showing 1–10 of 20

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eastern Mt Community Mental Health Cdu Prog	MT	Clinic/Center	$0	$956.4K
Melinda Truesdell	MT	Psychiatric/Mental Health Nurse Practitioner	$33.7K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eastern Montana Industries	MT	Developmentally Disabled Services Day Training Agency	$0	$19.9M
Miles City Public Schools	MT	Local Education Agency (LEA)	$0	$4.6M
Developmental Educational Assistance Program	MT	Local Education Agency (LEA)	$0	$1.4M
Carrie David	MT	Professional Counselor	$0	$652.1K
Yerger Family Dental, PC	MT	Dentist	$0	$570K
Holy Rosary Healthcare	MT	Critical Access Hospital	$0	$564.7K
Miles City Vision Clinic P C	MT	Optometrist	$0	$563.3K
Pamela Colombik	MT	Mental Health Counselor	$0	$418.5K
Tabitha Williams	MT	Clinical Social Worker	$0	$406.5K
City Of Miles City	MT	Land Ambulance	$200.2K	$188.4K

Eastern Montana Community Mental Health Center — Billing Profile & Reimbursement Data

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Eastern Montana Community 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