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

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

Center For Mental Health (NPI 1144251885)

Field	Value
Entity Type	Organization
Organization	Center For Mental Health
Address	915 1st Ave S
City	Great Falls
State	MT
ZIP	59401
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	July 5, 2006

Payer Source	Total Paid
Medicaid	$55.2M
Medicare	$0

Key Findings

CENTER FOR MENTAL HEALTH is effectively a single-payer provider: it has no Medicare billing on file and reports $55.2M in lifetime Medicaid revenue. This concentration means the organization’s financial footprint and payer risk are closely tied to Medicaid policy and contracted rates rather than Medicare reimbursement trends.

Revenue is highly concentrated: the top three Medicaid codes account for 58.2% of this provider’s Medicaid revenue. Those codes are H0040 ($14.9M, 27.0%), S5102 ($10.4M, 18.8%), and S5140 ($6.8M, 12.4%), indicating a handful of program types drive the majority of receipts.

The code mix points to a community-based adult services operation rather than a traditional medical clinic. High revenue from H0040 (Assertive community treatment per diem), S5102 (Day care services, adult per diem), and S5140 (Foster care, adult per diem), together with material receipts from H2012 (Behavioral health day treatment, per hour, $5.7M, 10.2%) and T2016 (Habilitation, residential, waiver, $5.5M, 9.9%), suggests a mix of intensive community outreach, day-treatment programs, and residential/habilitation services.

Competitive standing across key Medicaid lines is mixed: H0040 is substantial but not dominant (ranks #2 of 5 providers in-state, 75th percentile; typical, unremarkable volume for this code), S5102 shows moderate presence (ranks #5 of 8, 43th percentile; typical, unremarkable volume for this code), while S5140 is a statewide leader (ranks #1 of 2, 100th percentile; typical, unremarkable volume for this code). H2012 is a clear outlier in volume for its code (ranks #1 of 15 providers in-state, 100th percentile; notably above typical state volume for this code), indicating particular strength in hour-based day treatment.

Psychotherapy services are a pronounced outlier relative to peers: 90837 shows 33.3K claims and $2.5M revenue (4.5% of Medicaid revenue) and is labeled an "extreme outlier" in the dataset (ranks #3 of 1203 providers in-state, 100th percentile; extreme outlier, far above typical state volume for this code). This suggests an unusually high throughput of long psychotherapy sessions compared with other Medicaid providers in the state.

The provider also reports heavy use of case management and peer supports, consistent with a community mental health model: T1016 (Case management, each 15 minutes) has 74.4K claims and $3.2M revenue (5.8%) and ranks #7 of 53 (88th percentile; typical, unremarkable volume), while H0038 (Self-help/peer services) has 9.8K claims and $599.1K (1.1%) and ranks #3 of 35 (94th percentile; typical, unremarkable volume). These volumes reinforce an operational focus on ongoing engagement and care coordination rather than episodic medical procedures.

The claims-level pricing profile shows a combination of high-volume, low-unit-rate services and higher-paid per-diem programs. Examples include per-claim averages of $278 for H0040, $636 for S5102, $368 for S5140 and $41 per claim for H2012, indicating revenue derives both from high-volume hour-based day treatment and from per-diem funding streams for residential and day programs, which has implications for staffing mix and capacity planning.

CENTER FOR MENTAL HEALTH has an established presence in the state Medicaid market, with its NPI enumerated 2006-07-05 (~20 years ago) and $55.2M in lifetime Medicaid revenue. That tenure plus the provider’s specialized mix of ACT, day-treatment, foster-care and habilitation services implies operational continuity and a deep integration with state behavioral health programs, but also concentrated exposure to Medicaid policy and reimbursement changes.

Medicaid: Complete Services Breakdown

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

33 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0040	Assertive community treatment program, per diem	53,600	$280	$14.9M
S5102	Day care services, adult; per diem	16,300	$640	$10.4M
S5140	Foster care, adult; per diem	18,570	$370	$6.8M
H2012	Behavioral health day treatment, per hour	137,810	$40	$5.7M
T2016	Habilitation, residential, waiver; per diem	11,390	$480	$5.5M
T1016	Case management, each 15 minutes	74,400	$40	$3.2M
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…	33,300	$70	$2.5M
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…	14,910	$90	$1.4M
H0037	Community psychiatric supportive treatment program, per diem	5,550	$220	$1.2M
H2019	Therapeutic behavioral services, per 15 minutes	28,240	$30	$960.3K

Showing 1–10 of 33

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Montana Distribution

Center For Mental Health — 6 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. Montana median

33 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0040	Assertive community treatment program, per diem	2	10	32,960	$330	$11M
S5102	Day care services, adult; per diem	5	10	16,590	$280	$7.2M
S5140	Foster care, adult; per diem	1	10	9,830	$430	$4.2M
T2016	Habilitation, residential, waiver; per diem	3	10	2,300	$460	$3.2M
H0037	Community psychiatric supportive treatment program, per diem	3	10	10,400	$260	$2.6M
H2012	Behavioral health day treatment, per hour	1	20	27,640	$60	$2M
H2020	Therapeutic behavioral services, per diem	7	10	1,970	$120	$1.7M
T1016	Case management, each 15 minutes	7	50	2,720	$50	$1.4M
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…	14	20	1,510	$170	$848K
H2019	Therapeutic behavioral services, per 15 minutes	6	40	3,280	$50	$759.9K

Showing 1–10 of 33

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bottom Line Incontinence Supply Inc	MT	Durable Medical Equipment & Medical Supplies	$0	$5.6M
Rainbow Assited Living	MT	Assisted Living Facility	$0	$5.1M
Ideal Option, PLLC	MT	Addiction Medicine (Family Medicine) Physician	$0	$3.3M
Gateway Community Services	MT	Addiction (Substance Use Disorder) Counselor	$0	$2M
Seeking Recovery LLC	MT	Substance Use Disorder Rehabilitation Clinic/Center	$0	$1.4M
Rocky Front Counseling Services, LLC	MT	Mental Health Counselor	$0	$1.3M
Enlightening Minds, LLC	MT	Mental Health Counselor	$0	$1M
Rainbow Senior Living	MT	Assisted Living Facility	$0	$993.5K
Eye Clinic Of Great Falls, P.C.	MT	Optometrist	$0	$708.2K
Adlera Laboratory LLC	MT	Clinical Medical Laboratory	$37.8K	$635K

Center For Mental Health — Billing Profile & Reimbursement Data

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Center For Mental Health — 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