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.

Northeast Michigan Community Mental Health Authority (NPI 1144378381)

Field	Value
Entity Type	Organization
Organization	Northeast Michigan Community Mental Health Authority
Address	400 Johnson St
City	Alpena
State	MI
ZIP	49707
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	January 6, 2007

Payer Source	Total Paid
Medicaid	$128.1M
Medicare	$0

Key Findings

This entity is effectively a single‑payer Medicaid provider: there is no Medicare billing on file while total Medicaid lifetime revenue is $128.1M, indicating the organization’s financial scale is driven almost entirely by Medicaid-funded services. Analysts should treat Medicare-related comparisons as inapplicable for this profile and focus competitive benchmarking within the Michigan Medicaid market.

Revenue is concentrated in a small set of service lines: the precomputed top 3 Medicaid codes by revenue account for 48.0% of this provider's total Medicaid revenue. Those top contributors are H2015 ($22.3M, 17.8%), T1020 ($20.8M, 16.5%), and H2016 ($17.2M, 13.7%), signaling material dependence on a triad of community‑support and personal‑care billing streams.

The code mix points to a community behavioral health operating model focused on wraparound, community‑based supports rather than facility‑based care. High volumes in H2015 (Comprehensive community support services, per 15 minutes; 134.4K claims, $22.3M revenue), H2016 (Comprehensive community support services, per diem; 136.5K claims, $17.2M revenue) and T1020 (Personal care services, per diem; 136.7K claims, $20.8M revenue) indicate sustained delivery of recurring, time‑based support services and personal care under individualized plans.

Competitive standing across the state is mixed: T1020 is ranked #11 of 221 providers in-state (95th percentile) and is explicitly described as notably above typical state volume, making this provider a clear leading participant for personal care per diem services. By contrast, H2015 (rank #65 of 614, 90th percentile) and H2016 (rank #12 of 297, 96th percentile) are described as typical, unremarkable volume despite relatively high percentiles, so this organization is a major user of some codes but otherwise sits within the broader set of routine community‑mental‑health providers for many of its other service lines.

Operational throughput is substantial: the top three codes each have more than 130K claims (H2015 134.4K claims, T1020 136.7K claims, H2016 136.5K claims), which reflects a high‑volume, repeat‑services delivery model requiring sizeable staff time allocation and care coordination capacity. This volume profile aligns with the presence of other frequent services such as T1017 (55.4K claims, $16.2M revenue) and 99214 (19.7K claims, $6M revenue), underscoring ongoing case management and outpatient evaluation activities.

The provider’s service mix includes both intensive community treatments and conventional clinical care, suggesting integrated behavioral health offerings: notable line items include H0039 assertive community treatment (21.2K claims, $2.8M), H2023 supported employment (25.8K claims, $5.9M), H0043 supported housing (32.7K claims, $5.6M), and psychotherapy/E/M codes such as 90834 (10.3K claims, $1.4M) and 99214 (19.7K claims, $6M). This combination implies the organization manages populations requiring both social support services and clinician‑delivered mental health care.

The provider has long tenure in the federal NPI system (NPI enumerated 2007-01-06, ~19 years ago), which supports interpretation of these patterns as established, operational behaviors rather than short‑term anomalies. Given the longevity and the Medicaid‑concentrated revenue base, analysts should consider state Medicaid policy, rate settings, and care‑coordination incentives as primary levers that would materially affect this provider’s financial and operational performance.

Medicaid: Complete Services Breakdown

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

52 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2015	Comprehensive community support services, per 15 minutes	134,370	$170	$22.3M
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…	136,710	$150	$20.8M
H2016	Comprehensive community support services, per diem	136,540	$130	$17.2M
T1017	Targeted case management, each 15 minutes	55,430	$290	$16.2M
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…	19,740	$310	$6M
H2023	Supported employment, per 15 minutes	25,780	$230	$5.9M
H0043	Supported housing, per diem	32,690	$170	$5.6M
T1016	Case management, each 15 minutes	15,250	$280	$4.3M
S5161	Emergency response system; service fee, per month (excludes installation and testing)	1,720	$2,120	$3.6M
H0039	Assertive community treatment, face-to-face, per 15 minutes	21,180	$130	$2.8M

Showing 1–10 of 52

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

Northeast Michigan Community Mental Health Authority — 3 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

52 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2016	Comprehensive community support services, per diem	12	300	6,660	$310	$8.7M
T1017	Targeted case management, each 15 minutes	38	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…	93	130	11,590	$190	$7.6M
H2015	Comprehensive community support services, per 15 minutes	65	610	14,740	$90	$6M
H0039	Assertive community treatment, face-to-face, per 15 minutes	33	70	20,710	$180	$5.1M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	53	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…	11	220	7,030	$170	$4.6M
H0043	Supported housing, per diem	26	130	10,330	$210	$4.5M
S5161	Emergency response system; service fee, per month (excludes installation and testing)	26	40	4,680	$30	$4M
H2014	Skills training and development, per 15 minutes	124	130	20,660	$50	$3.8M

Showing 1–10 of 52

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mymichigan Medical Center Alpena	MI	Rural Acute Care Hospital	$0	$21.2M
Northeast Michigan Community Service Agency, Inc.	MI	Case Management Agency	$0	$19.4M
Sunrise Centre Inc	MI	Substance Abuse Rehabilitation Facility	$0	$11.7M
Catholic Human Services Inc.	MI	Community/Behavioral Health Agency	$0	$8.2M
Northeast Michigan Home Health Care	MI	Home Health Agency	$0	$7.6M
City Of Alpena	MI	Land Ambulance	$428.6K	$1.2M
Mario Lacerna	MI	Radiation Oncology Physician	$715.7K	$0
David Dargis	MI	Family Medicine Physician	$455.5K	$73.9K
Rajabhau Chhapamohan	MI	Physical Therapist	$75.7K	$419.7K
Robert Currier	MI	Ophthalmology Physician	$445.9K	$0

Northeast Michigan Community Mental Health Authority — Billing Profile & Reimbursement Data

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Northeast Michigan Community 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