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

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

Berrien Mental Health Authority (NPI 1033280763)

Field	Value
Entity Type	Organization
Organization	Berrien Mental Health Authority
Address	1485 S. M-139
City	Benton Harbor
State	MI
ZIP	49022
Taxonomy	Psychiatry Physician
NPI Enumerated	November 13, 2006

Payer Source	Total Paid
Medicaid	$67.5M
Medicare	$0

Key Findings

BERRIEN MENTAL HEALTH AUTHORITY reports no Medicare billing on file and $67.5M in lifetime Medicaid revenue, making its operating footprint effectively single‑payer (Medicaid) based on available claims data. This concentration implies the organization's reimbursement risk and payer contracting focus are centered on Medicaid programs rather than Medicare populations.

Revenue is highly concentrated within a small set of Medicaid codes: the top three Medicaid codes account for 47.5% of the provider's Medicaid revenue. Those top three are T1017 ($12.8M, 19.3%), T1016 ($12.2M, 18.4%), and 99214 ($6.5M, 9.8%), indicating nearly half of Medicaid receipts come from two case‑management codes and a single level‑4 E/M office visit code.

The code mix signals an operation built around community‑based case management and high‑volume outpatient evaluation and management: T1017 and T1016 are both time‑based case management codes and together generate roughly $25M of revenue, while 99214 ($6.5M) and several psychotherapy codes (90837 $3.9M, 90834 $1.9M, 90832 $733.7K) point to substantial face‑to‑face clinical throughput. In addition, per‑15‑minute community treatment codes (H0036 $5.6M, H0039 $4.5M) and per‑diem community supports (H2016 $2.9M) reinforce a multidisciplinary, time‑driven service model.

Competitive standing is mixed by code: the provider ranks strongly above peers on several outpatient clinical measures—99214 is #92 of 4380 providers in‑state (98th percentile, noted as "notably above typical state volume"), and 90837 is #47 of 1956 (98th percentile, "notably above typical state volume"). These high percentiles indicate the organization is a major statewide provider of moderate‑complexity E/M visits and long psychotherapy sessions relative to most in Michigan.

Despite large dollar totals in case management, the provider's statewide ranking for the two highest case‑management codes is middling rather than dominant: T1017 is #43 of 175 (76th percentile) and T1016 is #26 of 123 (80th percentile), both characterized as "typical, unremarkable volume for this code." Similarly, several community service codes (H0036, H0039, H2016) are described as typical volumes, suggesting strong absolute Medicaid revenue but not monopoly market share in case management.

The billing profile shows breadth across behavioral health service lines beyond case management: community psychiatric supportive treatment (H0036 $5.6M), assertive community treatment (H0039 $4.5M), comprehensive community support services (H2016 $2.9M), supported employment (H2023 $1.1M), and substance use intensive outpatient (H0015 $966K) together demonstrate a mix of rehabilitation, treatment, and social‑support services paid by Medicaid. This diversity indicates capacity to deliver both clinical psychotherapy and non‑clinical community supports within Medicaid programs.

Operationally, the provider relies heavily on time‑based and per‑diem billing: several top codes bill per 15 minutes (T1017, T1016, H0036, H0039) and H2016 is a per‑diem code, which implies staffing models oriented toward repeated, time‑intensive contacts (e.g., community visits, ACT teams, case managers) rather than episodic procedural care. That structure typically requires multi‑disciplinary teams and sustained engagement with clients to generate the reported volumes.

The NPI was enumerated on 2006-11-13 (~20 years ago), indicating long tenure in the market. This established presence likely supports the large Medicaid revenue base and sustained contracts or program relationships needed to deliver high volumes of time‑based community services.

Medicaid: Complete Services Breakdown

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

45 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1017	Targeted case management, each 15 minutes	47,570	$270	$12.8M
T1016	Case management, each 15 minutes	26,820	$460	$12.2M
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…	29,160	$220	$6.5M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	15,700	$360	$5.6M
H0039	Assertive community treatment, face-to-face, per 15 minutes	22,950	$200	$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…	25,650	$150	$3.9M
H2016	Comprehensive community support services, per diem	14,590	$200	$2.9M
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…	13,850	$160	$2.2M
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…	15,820	$120	$1.9M
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	4,700	$370	$1.7M

Showing 1–10 of 45

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Michigan Distribution

Berrien Mental Health Authority — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

45 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2016	Comprehensive community support services, per diem	110	300	6,660	$310	$8.7M
T1017	Targeted case management, each 15 minutes	43	180	10,890	$210	$8.1M
T1040	Medicaid certified community behavioral health clinic services, per diem	16	40	30,550	$80	$6.8M
H2015	Comprehensive community support services, per 15 minutes	416	610	14,740	$90	$6M
H0039	Assertive community treatment, face-to-face, per 15 minutes	31	70	20,710	$180	$5.1M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	34	90	8,750	$300	$4.7M
T1020	Personal care services, per diem, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	81	220	7,030	$170	$4.6M
T1016	Case management, each 15 minutes	26	120	8,060	$210	$3.4M
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	17	110	480	$530	$1.5M
H2023	Supported employment, per 15 minutes	47	110	5,150	$90	$1.5M

Showing 1–10 of 45

Nearby Providers

Other providers in the same ZIP code as Berrien Mental Health Authority, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Intercare Community Health Network	MI	Federally Qualified Health Center (FQHC)	$0	$20.5M
Harbortown Treatment Center PLLC	MI	Methadone Clinic	$62.8K	$10.5M
The Center For Growth And Independence	MI	Community/Behavioral Health Agency	$0	$9.3M
Community Emergency Service	MI	Land Ambulance	$937.9K	$5M
The Avenue Family Network, Inc.	MI	Adult Day Care Clinic/Center	$0	$5.7M

Berrien Mental Health Authority — Billing Profile & Reimbursement Data

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Berrien Mental Health Authority — 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

Nearby Providers

Frequently Asked Questions

References