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.

Family Guidance Center For Behavioral Healthcare (NPI 1164964235)

Field	Value
Entity Type	Organization
Organization	Family Guidance Center For Behavioral Healthcare
Address	724 N 22nd St
City	Saint Joseph
State	MO
ZIP	64506
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	November 7, 2016

Payer Source	Total Paid
Medicaid	$63.4M
Medicare	$0

Key Findings

This provider is effectively single‑payer in scope: there is no Medicare billing on file and Total Medicaid revenue is $63.4M, so all measurable fee-for-service activity in the dataset is Medicaid‑driven. That concentration means payer negotiations, utilization review, and risk exposure will be focused almost entirely on Medicaid arrangements rather than a mixed Medicare/Medicaid book.

Revenue is extremely concentrated in a single code set: the precomputed top 3 Medicaid codes account for 100.0% of this provider's Medicaid revenue, with T1040 alone representing $63.2M (99.8% of the provider's Medicaid revenue). The remaining top two codes are 99213 ($87.8K, 0.1%) and 90832 ($48.2K, 0.1%), highlighting that per‑diem CCBHC billing dominates the financial picture.

The dominance of T1040 (T1040 – Medicaid certified community behavioral health clinic services, per diem) indicates the organization operates primarily as a certified community/behavioral health clinic model with per‑diem reimbursement driving revenue. The presence of many other behavioral health procedure codes in the activity mix but with negligible dollars suggests the per‑diem payment is the primary revenue vehicle while individual service codes are used operationally or for encounter tracking.

Competitive standing for the revenue driver is mid‑market: T1040 ranks #13 of 31 providers in-state (60th percentile; described as typical), so FAMILY GUIDANCE CENTER is a solid, mid‑pack CCBHC per‑diem participant rather than a statewide dominant. By contrast, 99213 is an unusual statistical signal: it ranks #52 of 4312 providers in-state (99th percentile) and is labeled an extreme outlier, far above typical state volume for that code, meaning the provider reports unusually high claim counts for this E/M office visit code relative to peers even though it contributes only $87.8K in Medicaid revenue.

Operational coding and encounter volume show a dichotomy between claim counts and dollars: several behavioral health codes have very large claim volumes but report $0 average paid/claim (examples include H0036: 263.5K claims, $0 avg paid/claim; H0004: 66.8K claims, $0 avg paid/claim; H2010: 30.5K claims, $0 avg paid/claim). This pattern is consistent with a bundled or per‑diem reimbursement structure where T1040 captures the payment and many service-level codes are recorded for clinical, quality reporting, or encounter‑level tracking rather than separate Medicaid payments.

The provider shows elevated use of E/M and short psychotherapy codes relative to peers: 99212 ranks #20 of 1020 providers in-state (98th percentile; notably above typical state volume for this code) and 90832 ranks #17 of 391 providers (96th percentile; described as typical, unremarkable volume). Although these codes generate only small amounts of revenue relative to the T1040 per‑diem, their high percentiles suggest a clinically active outpatient caseload and an administrative coding pattern that merits attention when comparing utilization to other CCBHCs.

The NPI was enumerated on 2016-11-07 (~10 years ago), indicating the provider has an established presence in the market. Combined with a heavy reliance on T1040 per‑diem revenue, this tenure suggests a sustained CCBHC operating model that payers and network planners should consider when assessing capacity, contractual terms, and exposure to concentrated Medicaid reimbursement risk.

Medicaid: Complete Services Breakdown

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

26 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1040	Medicaid certified community behavioral health clinic services, per diem	306,800	$210	$63.2M
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…	29,270	$1	$87.8K
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…	5,350	$10	$48.1K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	6,620	$1	$6.6K
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…	1,470	$1	$5.9K
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…	1,290	$1	$3.9K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	480	$10	$2.9K
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…	110	$20	$1.7K
99203	The provider sees a new 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 provider…	880	$1	$880
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	20	$0	$0

Showing 1–10 of 26

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

Family Guidance Center For Behavioral Healthcare — 3 of 9 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

26 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1040	Medicaid certified community behavioral health clinic services, per diem	13	30	198,100	$260	$125.7M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	10	20	214,040	$20	$10.8M
H2015	Comprehensive community support services, per 15 minutes	8	20	4,550	$50	$2.5M
H2017	Psychosocial rehabilitation services, per 15 minutes	21	20	40,460	$20	$2M
H2012	Behavioral health day treatment, per hour	14	10	33,050	$30	$1.9M
H0001	Alcohol and/or drug assessment	7	10	380	$280	$1.1M
H0004	Behavioral health counseling and therapy, per 15 minutes	5	40	3,680	$30	$978K
H0005	Alcohol and/or drug services; group counseling by a clinician	11	20	16,420	$20	$858.5K
H0040	Assertive community treatment program, per diem	8	10	20,740	$10	$572.6K
H0025	Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior)	10	30	6,100	$10	$339.7K

Showing 1–10 of 26

Nearby Providers

Other providers in the same ZIP code as Family Guidance Center For Behavioral Healthcare, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Res-care Kansas, Inc.	MO	Home Health Agency	$0	$64.8M
Choices Of St Joseph, Inc	MO	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$64.3M
Heartland Regional Medical Center	MO	General Acute Care Hospital	$0	$57.1M
Heartland Residential Care, Inc.	MO	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$49.1M
Peace Of Mind Home Care, LLC	MO	Home Health Agency	$0	$39.8M
Heartland Regional Medical Center	MO	General Practice Physician	$0	$20.4M
Progressive Community Services	MO	Case Management Agency	$0	$14M
United Cerebral Palsy Of Northwest Missouri	MO	Voluntary or Charitable Agency	$0	$12.2M
Regional Emergency Medical Services Authority	MO	Land Ambulance	$1.3M	$7.4M
St Joseph Center For Outpatient Surgery, LLC	MO	Ambulatory Surgical Clinic/Center	$2M	$92.9K

Family Guidance Center For Behavioral Healthcare — Billing Profile & Reimbursement Data

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Family Guidance Center For Behavioral Healthcare — 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