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

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

Ozark Center (NPI 1104368315)

Field	Value
Entity Type	Organization
Organization	Ozark Center
Address	1105 E 32nd St
City	Joplin
State	MO
ZIP	64804
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	November 7, 2016

Payer Source	Total Paid
Medicaid	$165.3M
Medicare	$0

Key Findings

OZARK CENTER has no Medicare billing on file and $165.3M in lifetime Medicaid revenue, making it effectively a Medicaid-focused provider rather than a dual-payer operation. Analysts should treat Medicaid as the sole material public-payer exposure when assessing this entity’s scale and contracting leverage.

Revenue is extremely concentrated: the precomputed top three Medicaid codes account for 99.7% of the provider’s total Medicaid revenue, and a single code, T1040, delivers $164.3M or 99.4% of that $165.3M total. This indicates that nearly all dollars flow through the Medicaid-certified community behavioral health clinic per-diem line rather than distributed fee-for-service payments.

The code mix and descriptions identify OZARK CENTER as operating primarily as a Medicaid-certified community behavioral health clinic (CCBHC): T1040 (Medicaid certified community behavioral health clinic services, per diem) dominates dollars, while high-volume psychotherapy codes (90834, 90837, 90832) and E/M codes (99214, 99213) appear as the encounter-level services feeding that per-diem model. This pattern is consistent with a clinic that bills a daily/per-diem CCBHC rate for comprehensive behavioral health services while also recording large counts of individual psychotherapy and E/M encounters.

Although T1040 accounts for almost all revenue, OZARK CENTER’s statewide competitive standing on that per-diem is not dominant: T1040 ranks #5 of 31 providers in-state (87th percentile; typical, unremarkable volume). In contrast, several visit-level codes are statistical outliers in volume—90834 ranks #4 of 1059 (100th percentile; notably above typical), 99214 ranks #29 of 3166 (99th percentile; extreme outlier), and 90837 ranks #4 of 439 (99th percentile; extreme outlier)—so the center is unusually high-volume for specific psychotherapy/E/M encounters even if its per-diem rank is comparatively ordinary.

Some codes show large claim counts but negligible paid dollars: multiple H-codes (for example H0036, H2017, H2012, H0037) and other service codes report many claims with $0 avg paid/claim in the file. This disconnect between high claim volume and $0 reported revenue suggests payment is being captured through the T1040 per-diem or other non-fee-for-service arrangements, or that encounter reporting differs from fee-for-service remittance; payers should validate how those services are reconciled with capitation or bundled payments.

There are specific clinical-service hotspots where OZARK CENTER is a statewide leader by utilization even though those services represent a small share of Medicaid dollars: 90847 (family psychotherapy with patient present) ranks #1 of 146 providers in-state (100th percentile; extreme outlier) but generates only $32.8K in revenue. This indicates operational emphasis and high throughput for certain psychotherapy modalities that may be central to clinical delivery but not to revenue.

Operational and contracting implications are clear: because nearly all revenue is driven by the T1040 per-diem, payer negotiations and utilization management should focus on per-diem rate-setting, care-day definitions, and how encounter-level services (psychotherapy and E/M codes) are credited against per-diem payments. Analysts should also review encounter reporting and capitation reconciliation given the prevalence of high-count, low-paid or $0-paid claim lines.

OZARK CENTER’s NPI was enumerated on 2016-11-07 (~10 years ago), establishing roughly a decade of billing history; the persistence of a CCBHC per-diem revenue model and repeated outlier volumes for psychotherapy/E/M visits suggest stable programmatic practices that have been operating long enough to influence local behavioral health capacity and referral patterns.

Medicaid: Complete Services Breakdown

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

42 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1040	Medicaid certified community behavioral health clinic services, per diem	733,330	$220	$164.3M
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…	34,400	$10	$275.2K
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…	33,670	$10	$235.7K
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…	15,120	$10	$196.6K
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…	48,230	$1	$144.7K
90832	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…	12,180	$10	$60.9K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	2,240	$20	$49.3K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	3,500	$10	$49K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	2,980	$10	$32.8K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	1,530	$10	$18.4K

Showing 1–10 of 42

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Missouri Distribution

Ozark Center — 7 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. Missouri median

42 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1040	Medicaid certified community behavioral health clinic services, per diem	5	30	198,100	$260	$125.7M
H0037	Community psychiatric supportive treatment program, per diem	9	20	56,420	$120	$11.7M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	8	20	214,040	$20	$10.8M
H2036	Alcohol and/or other drug treatment program, per diem	8	10	17,770	$200	$7.4M
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	2	10	15,660	$360	$5.6M
H2015	Comprehensive community support services, per 15 minutes	6	20	4,550	$50	$2.5M
H2017	Psychosocial rehabilitation services, per 15 minutes	9	20	40,460	$20	$2M
H2012	Behavioral health day treatment, per hour	5	10	33,050	$30	$1.9M
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	12	10	1,150	$160	$1.4M
H0001	Alcohol and/or drug assessment	9	10	380	$280	$1.1M

Showing 1–10 of 42

Nearby Providers

Other providers in the same ZIP code as Ozark Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jasper County Sheltered Facilities Assoc	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$62.1M
Mercy Hospital Joplin	MO	General Acute Care Hospital	$0	$46.7M
The Arc Of The Ozarks	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$44.5M
Freeman-oak Hill Health System	MO	General Acute Care Hospital	$0	$33.2M
The Independent Living Center, Inc.	MO	Attendant Care Provider	$0	$24.7M
Jasper County Sheltered Facilities Board	MO	Case Management Agency	$0	$21.3M
Mercy Clinic Joplin LLC	MO	Family Medicine Physician	$0	$20.4M
Freeman-oak Hill Health System	MO	Multi-Specialty Clinic/Center	$0	$14.7M
Jasper County Sheltered Facilities Assoc	MO	Developmentally Disabled Services Day Training Agency	$0	$13.2M
The Independent Living Center, Inc.	MO	Personal Care Attendant	$0	$12.4M

Ozark Center — Billing Profile & Reimbursement Data

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Ozark Center — 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