Behavioral
Providence Health & Services MT
Providence Health & Services MT was paid $1.80M by Medicaid between Jan 2018 and Dec 2024, across 20 billing codes. Its largest line is 90837, psychotherapy session, about an hour — 31% of everything it billed.
33Billing provider infoPROVIDENCE HEALTH & SERVICES MT
MISSOULA, MT 59802
MISSOULA, MT 59802
33aNPI1558530683assigned 02/22/2008
33bProvider typeClinical Social Worker
28Total paid$1.80M
24GClaims20,984
24DCodes billed20
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Clinical Social Worker providers in Montana
Rank by total paid#7 of 347
Median peer was paid$54K
This provider vs. median33×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official ANDERSON, DONALD controls 20+ related entities in our dataset. Read more
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 | 2,098 | $152K | |
| 2019 | 2,321 | $160K | |
| 2020 | 1,687 | $124K | |
| 2021 | 2,066 | $168K | |
| 2022 | 3,534 | $341K | |
| 2023 | 4,415 | $408K | |
| 2024incomplete | 4,863 | $448K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | 31% | 6,656 | 3,215 | $552K |
| 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 | 29% | 4,872 | 4,441 | $525K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 16% | 1,710 | 1,550 | $284K |
| 90839 | 13% | 3,396 | 3,243 | $240K | |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 2.4% | 888 | 581 | $43K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 1.9% | 508 | 265 | $34K |
| 90791 | Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation | 1.4% | 348 | 320 | $25K |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | 1.2% | 229 | 207 | $22K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | 1.1% | 312 | 93 | $20K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | <1% | 249 | 245 | $10K |
| 96127 | <1% | 1,466 | 1,339 | $10K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | <1% | 131 | 125 | $9K |
8 more codes
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 39 | $7K |
| 99205 | Prolong outpt/office vis | <1% | 26 | $7K |
| 99443 | <1% | 70 | $4K | |
| G2212 | Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215, 99483 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes) | <1% | 27 | $4K |
| 99223 | Prolong inpt eval add15 m | <1% | 13 | $3K |
| 90840 | <1% | 13 | $592.54 | |
| 98968 | <1% | 18 | $370.58 | |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | 0% | 13 | $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 officialANDERSON, DONALD (ASSISTANT SECRETARY ENROLLMENT)
Parent organizationPROVIDENCE HEALTH & SERVICES MT
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.