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

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

Mental Health Cooperative, Inc (NPI 1083632897)

Field	Value
Entity Type	Organization
Organization	Mental Health Cooperative, Inc
Address	275 Cumberland Bnd
City	Nashville
State	TN
ZIP	37228
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	July 18, 2006

Payer Source	Total Paid
Medicaid	$363.2M
Medicare	$0

Key Findings

This entity is effectively a Medicaid-focused behavioral health provider: there is no Medicare billing on file while lifetime Medicaid revenue totals $363.2M, indicating the organization’s operations and reimbursement relationships are overwhelmingly centered on state Medicaid programs rather than Medicare fee-for-service.

Revenue concentration is highly skewed toward a small set of Medicaid service codes: the top 3 Medicaid codes by revenue account for 85.9% of the provider’s total Medicaid revenue, which signals that a few programmatic services constitute the vast majority of this provider’s billing and cash flow.

S0280 (Medical home program, comprehensive care coordination and planning, initial plan) is the single largest revenue driver, generating $243.4M or 67.1% of Medicaid revenue and accounting for 1.4M claims. The provider ranks #1 of 40 in-state for S0280 and is described as an extreme outlier, which implies a dominant operational emphasis on medical-home/comprehensive care coordination programs at scale relative to peers.

T2023 (Targeted case management; per month) is the second major driver with $55.6M (15.3% of Medicaid revenue) from 1M claims and the provider ranks #1 of 14 in-state. The notably above-typical volume for T2023 together with S0280 suggests the organization runs large case-management and care-coordination operations that are core to its service model.

Other service lines contributing meaningful but much smaller shares include supported housing (H0043, $12.7M, 3.5%) and community psychiatric supportive treatment (H0037, $11.6M, 3.2%), indicating the provider combines care coordination with residential and day-program supports to manage behavioral health needs across settings.

The provider shows frequent high-volume use of outpatient evaluation/management and psychotherapy codes (e.g., 99214: 194.6K claims, $5.8M; 90834: 114.1K claims, $5.4M; 90791: 60.8K claims, $4.7M), and many of these codes are at or near the top statewide percentiles (several listed as 99–100th percentile). This mix indicates substantial clinic-based evaluation and therapy capacity layered on top of the care coordination and case management model.

Several codes are labeled as extreme outlier or 100th percentile in-state beyond the two largest codes: 99214, 90792, and 99213 are all in the highest percentile ranks for Tennessee, signaling that the provider’s clinic-level visit volumes are unusually large relative to the state distribution and reinforcing its role as a high-volume service hub.

Despite the concentration in a few codes, the provider also bills a broad array of behavioral health services (group psychotherapy, supported housing per diem, substance use treatment codes and crisis psychotherapy), reflecting a diversified menu of community mental health and supportive services that likely supports full-pathway care for complex patients.

The organization has long tenure in the NPI directory, enumerated since 2006-07-18 (approximately 20 years), which combined with its dominant in-state rankings for core Medicaid codes suggests an established presence and capability to scale state-funded behavioral health program contracts over time.

Medicaid: Complete Services Breakdown

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

58 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S0280	Medical home program, comprehensive care coordination and planning, initial plan	1,382,830	$180	$243.4M
T2023	Targeted case management; per month	1,029,730	$50	$55.6M
H0043	Supported housing, per diem	58,320	$220	$12.7M
H0037	Community psychiatric supportive treatment program, per diem	179,130	$70	$11.6M
T2022	Case management, per month	22,400	$380	$8.6M
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…	194,580	$30	$5.8M
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…	114,090	$50	$5.4M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	60,830	$80	$4.7M
H2016	Comprehensive community support services, per diem	27,680	$130	$3.5M
H2015	Comprehensive community support services, per 15 minutes	9,220	$330	$3M

Showing 1–10 of 58

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Mental Health Cooperative, Inc — 11 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

58 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2023	Targeted case management; per month	1	10	11,790	$410	$75.3M
S0280	Medical home program, comprehensive care coordination and planning, initial plan	1	40	22,180	$140	$21.3M
H0037	Community psychiatric supportive treatment program, per diem	5	20	20,260	$150	$19.4M
H0043	Supported housing, per diem	11	20	69,350	$180	$18.6M
T2022	Case management, per month	3	20	1,370	$240	$5.5M
H2016	Comprehensive community support services, per diem	3	10	32,860	$130	$4.8M
H2015	Comprehensive community support services, per 15 minutes	2	10	5,740	$110	$2.4M
H0016	Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting)	34	130	620	$200	$655.5K
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…	5	360	350	$50	$414.4K
H0014	Alcohol and/or drug services; ambulatory detoxification	45	80	250	$250	$405.4K

Showing 1–10 of 58

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
David Patzer	TN	Child & Adolescent Psychiatry Physician	$57.9K	$0
Dena Wampler	TN	Psychiatric/Mental Health Nurse Practitioner	$14.7K	$0
Justin Stone	NH	Psychiatric/Mental Health Nurse Practitioner	$12.6K	$0
Jacob Orin	IL	Psychiatric/Mental Health Nurse Practitioner	$10.9K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Aegis Sciences Corporation	TN	Clinical Medical Laboratory	$34.5M	$193.8M
Consumer Direct For Tennessee, LLC	TN	In Home Supportive Care Agency	$0	$126M
Privia Medical Group Tennessee LLC	TN	Family Medicine Physician	$0	$5M
Opry Medical Group LLC	TN	Durable Medical Equipment & Medical Supplies	$0	$3.1M
Katherine Bhadra	TN	Family Nurse Practitioner	$219.4K	$3.9K
Debra Dooley	TN	Family Nurse Practitioner	$169.6K	$0
Aida Valencia	TN	Anatomic Pathology & Clinical Pathology Physician	$56.1K	$0
Delaney Mills	TN	Acute Care Nurse Practitioner	$47.6K	$0
Melissa May	TN	Gerontology Nurse Practitioner	$37.4K	$0
Okasha Naqvi	TN	Family Nurse Practitioner	$12K	$0

Mental Health Cooperative, Inc — Billing Profile & Reimbursement Data

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Mental Health Cooperative, Inc — 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