Agency
Capstone Behavioral Healthcare, INC
Capstone Behavioral Healthcare, INC was paid $16.97M by Medicaid between Jan 2018 and Dec 2024, across 27 billing codes. Its largest line is H2016, community support for mental illness or disability, billed per day — 34% of everything it billed.
33Billing provider infoCAPSTONE BEHAVIORAL HEALTHCARE, INC
NEWTON, IA 50208
NEWTON, IA 50208
33aNPI1174598908assigned 02/23/2006
33bProvider typeCommunity/Behavioral Health Agency
28Total paid$16.97M
24GClaims169,118
24DCodes billed27
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Community/Behavioral Health Agency providers in Iowa
Rank by total paid#25 of 134
Median peer was paid$2.44M
This provider vs. median6.9×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 15,336 | $1.47M | |
| 2019 | 18,063 | $1.67M | |
| 2020 | 24,367 | $2.21M | |
| 2021 | 30,172 | $2.55M | |
| 2022 | 32,446 | $3.06M | |
| 2023 | 29,429 | $3.54M | |
| 2024incomplete | 19,305 | $2.46M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| H2016 | Community support for mental illness or disability, billed per dayComprehensive community support services, per diem | 34% | 41,582 | 2,958 | $5.69M |
| 99490 | Ccm add 20min | 19% | 16,745 | 16,046 | $3.17M |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | 13% | 23,859 | 17,162 | $2.29M |
| 90791 | Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation | 6.1% | 7,764 | 7,304 | $1.03M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 5.5% | 16,089 | 15,040 | $930K |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 5.4% | 9,527 | 7,637 | $914K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 5.1% | 10,573 | 9,588 | $859K |
| 96127 | 3.4% | 6,699 | 5,614 | $581K | |
| 90792 | Psychiatric diagnostic evaluation with medical services | 3.0% | 2,446 | 2,342 | $513K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | 1.5% | 5,496 | 3,747 | $255K |
| 96137 | 1.3% | 1,382 | 1,303 | $216K | |
| 96130 | 1.2% | 1,479 | 1,378 | $209K |
15 more codes
| 96136 | <1% | 1,380 | $104K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 731 | $91K |
| 96101 | <1% | 229 | $64K | |
| Q3014 | Telehealth originating site facility fee | <1% | 2,203 | $34K |
| H0037 | Community psychiatric supportive treatment program, per diem | <1% | 147 | $21K |
| 90785 | <1% | 462 | $2K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 739 | $2K |
| G0506 | Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) | <1% | 711 | $64.12 |
| G9008 | Coordinated care fee, physician coordinated care oversight services | <1% | 10,916 | $54.08 |
| 99439 | <1% | 5,162 | $25.58 | |
| H0038 | Self-help/peer services, per 15 minutes | <1% | 1,608 | $14.00 |
| G2058 | Chronic care management services, each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (list separately in addition to code for primary procedure). (do not report g2058 for care management services of less than 20 minutes additional to the first 20 minutes of chronic care management services during a calendar month). (use g2058 in conjunction with 99490). (do not report 99490, g2058 in the same calendar month as 99487, 99489, 99491)). | <1% | 729 | $1.00 |
| S0281 | Medical home program, comprehensive care coordination and planning, maintenance of plan | 0% | 424 | $0.00 |
| 99426 | 0% | 12 | $0.00 | |
| G2065 | Comprehensive care management for a single high-risk disease services, e.g. principal care management, at least 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month with the following elements: one complex chronic condition lasting at least 3 months, which is the focus of the care plan, the condition is of sufficient severity to place patient at risk of hospitalization or have been cause of a recent hospitalization, the condition requires development or revision of disease-specific care plan, the condition requires frequent adjustments in the medication regimen, and/or the management of the condition is unusually complex due to comorbidities | 0% | 24 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialNORTHCUTT, RENAE (ASSISTANT DIRECTOR)