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.

Genesee Health System (NPI 1043554348)

Field	Value
Entity Type	Organization
Organization	Genesee Health System
Address	1040 W Bristol Rd
City	Flint
State	MI
ZIP	48507
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	November 27, 2012

Payer Source	Total Paid
Medicaid	$159.9M
Medicare	$0

Key Findings

This provider is effectively single-payer Medicaid in scale: no Medicare billing is on file while total Medicaid revenue is $159.9M, indicating its operations and billing are overwhelmingly focused on the Medicaid population rather than Medicare beneficiaries. The absence of Medicare activity suggests limited engagement with the senior/disabled fee-for-service Medicare market.

Revenue is highly concentrated in a small set of Medicaid codes: the precomputed top 3 Medicaid codes by revenue account for 43.2% of this provider's total Medicaid revenue, led by T1017 at $39M (26.3%), followed by 99214 at $14.2M (9.6%), and H0032 at $11M (7.4%). This concentration means a large share of cash flow depends on case management and mid-complexity outpatient E/M and non-physician mental health plan services.

The code mix signals a community mental health/system-of-care model: very large volumes of targeted case management and case management (T1017: 177.9K claims, $39M revenue; T1016: 60.6K claims, $10.6M revenue) alongside non-physician mental health plan development (H0032: 36.5K claims, $11M revenue) point to a heavy emphasis on care coordination, population management, and wrap-around supports. High volumes of community psychiatric supportive treatment (H0036), assertive community treatment (H0039), and wrap-around services (H2021) further indicate intensive community-based programming rather than a narrow outpatient therapy shop.

The provider is a high-volume, above-peer performer on several codes: 99214 (48.7K claims, $14.2M) ranks #46 of 4380 providers in-state (99th percentile) and is labeled an "extreme outlier," while 90791 (10.9K claims, $4.9M) ranks #9 of 784 providers (99th percentile) and is also an "extreme outlier." These rankings show the provider is a major statewide participant for moderate-complexity E/M visits and initial psychiatric evaluations compared with in-state peers.

Case management and targeted case management are standout operational drivers: T1017 ranks #9 of 175 providers in-state (95th percentile; notably above typical state volume) and T1016 ranks #6 of 123 providers (96th percentile; notably above typical state volume). The very large claim counts (177.9K for T1017; 60.6K for T1016) and their combined revenue share among the top codes imply substantial investment in outreach, coordination staff, and non-face-to-face administrative activity.

While several codes are unusually large, other service lines appear typical for a community mental health center: codes such as H0036 ($7.1M, rank #18 of 93, 82nd percentile), H0039 ($6.1M, rank #28 of 67, 59th percentile), and 97153 ($5.1M, rank #15 of 131, 89th percentile) are characterized as "typical, unremarkable volume," suggesting breadth of services without extreme dominance in those specific buckets. This mix indicates both specialized high-volume areas and a broad roster of standard community mental health services.

The provider bills both high-frequency, lower-paid units and lower-frequency, higher-paid procedures: large claim counts for unit-based case management and ABA/behavior codes (e.g., 97153: 73.4K claims, $5.1M) coexist with fewer but higher-paid psychiatric procedures (90792: 4.7K claims, $3.6M at $750 avg paid/claim; 97151: 928 claims, $2.1M at $2243 avg paid/claim). This combination suggests operational complexity with substantial frontline staff delivering minute-based services and a complementary set of higher-reimbursement clinical assessments.

The NPI tenure and scale reinforce this provider's established role in the local safety-net: NPI enumerated on 2012-11-27 (~14 years ago) and reporting $159.9M in Medicaid revenue, with multiple codes ranked in the top percentiles statewide. Taken together, the longevity plus repeated high-percentile ranks (including several "extreme outlier" and "notably above typical" labels) point to a well-established, large community mental health system with market-leading presence in several Medicaid service lines.

Medicaid: Complete Services Breakdown

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

65 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1017	Targeted case management, each 15 minutes	177,860	$220	$39M
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…	48,740	$290	$14.2M
H0032	Mental health service plan development by non-physician	36,550	$300	$11M
T1016	Case management, each 15 minutes	60,630	$180	$10.6M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	25,810	$280	$7.1M
H0039	Assertive community treatment, face-to-face, per 15 minutes	25,740	$240	$6.1M
H2021	Community-based wrap-around services, per 15 minutes	7,640	$700	$5.3M
H2014	Skills training and development, per 15 minutes	53,880	$100	$5.3M
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	73,430	$70	$5.1M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	10,930	$450	$4.9M

Showing 1–10 of 65

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

Genesee Health System — 7 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

65 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1017	Targeted case management, each 15 minutes	9	180	10,890	$210	$8.1M
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	15	130	11,590	$190	$7.6M
T1040	Medicaid certified community behavioral health clinic services, per diem	14	40	30,550	$80	$6.8M
H0039	Assertive community treatment, face-to-face, per 15 minutes	28	70	20,710	$180	$5.1M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	18	90	8,750	$300	$4.7M
H2014	Skills training and development, per 15 minutes	43	130	20,660	$50	$3.8M
T1016	Case management, each 15 minutes	6	120	8,060	$210	$3.4M
H2030	Mental health clubhouse services, per 15 minutes	22	60	22,740	$80	$2.3M
97155	The provider, a physician or other qualified healthcare professional, administers adaptive behavior treatment face–to–face with one patient and makes modifications in the protocol targets and…	21	130	3,170	$180	$2.2M
H2019	Therapeutic behavioral services, per 15 minutes	5	30	3,330	$200	$1.6M

Showing 1–10 of 65

Related Providers

Other providers that share a Tax Identification Number (TIN) with Genesee Health System, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Genesee Health System	MI	Federally Qualified Health Center (FQHC)	$0	$7.7M
Genesee Health System	MI	Federally Qualified Health Center (FQHC)	$0	$5.3M

Nearby Providers

Other providers in the same ZIP code as Genesee Health System, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Flint Odyssey House Inc.	MI	Substance Abuse Rehabilitation Facility	$0	$42.4M
First Day Homecare, LLC	MI	Nursing Care Agency	$0	$14.3M
Patriot Ambulance Service, Inc.	MI	Land Ambulance	$1.8M	$12.3M
Jawad A Shah, Md PC	MI	Specialist	$0	$11.5M
Regional Medical Imaging, P.C.	MI	Diagnostic Radiology Physician	$0	$11.1M
Alternative Community Living Inc	MI	Adult Mental Health Clinic/Center	$0	$9.3M
Deluxe Dental Associates PLLC	MI	General Practice Dentistry	$0	$7.6M
Alternative Community Living Inc	MI	Adult Mental Health Clinic/Center	$0	$7M
Swartz Ambulance Service Inc	MI	Ambulance	$205.1K	$6.6M
Family Orthopedic Associates P L C	MI	Orthopaedic Surgery Physician	$0	$6.6M

Genesee Health System — 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