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

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

Ohioguidestone (NPI 1174680557)

Field	Value
Entity Type	Organization
Organization	Ohioguidestone
Address	202 East Bagley Road
City	Berea
State	OH
ZIP	44017
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	January 3, 2007

Payer Source	Total Paid
Medicaid	$195.6M
Medicare	$0

Key Findings

OHIOGUIDESTONE is effectively a single‑payer operation: there is no Medicare billing on file and the organization reports $195.6M in Medicaid revenue. This concentration on Medicaid places the provider squarely within state behavioral health contracting and reimbursement dynamics rather than federal Medicare markets. The provider’s NPI was enumerated 2007-01-03 (~19 years ago), indicating long-tenured participation in the Medicaid market.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 78.0% of total Medicaid revenue. Those top drivers are H2019 ($104.1M, 53.4% of Medicaid revenue), 90837 ($37.5M, 19.2%), and H0040 ($10.6M, 5.4%), which together create a tight dependency on therapeutic behavioral and intensive community-treatment payments. This level of concentration means changes to reimbursement or utilization policy for these codes would materially affect the provider’s topline.

The code mix and volumes point to a behavioral health and community-treatment operating model. Dominant codes are H2019 (Therapeutic behavioral services) and 90837 (long psychotherapy sessions), with substantial volumes also billed for assertive community treatment via H0040 and community psychiatric support via H0036 and H2017. Collectively, these codes suggest the organization focuses on frequent, face‑to‑face therapeutic interventions and intensive community-based case management rather than primary‑care or acute inpatient services.

State-level competitive standing is unusually strong for psychotherapy and therapeutic behavioral services. OHIOGUIDESTONE ranks #2 of 840 providers for H2019 (100th percentile; extreme outlier) and #1 of 2643 providers for 90837 (100th percentile; extreme outlier), indicating it is a dominant statewide provider for those services. H0040 ranks #3 of 24 (91st percentile; notably above typical state volume), showing it is also a major player in assertive community treatment programs.

A broader review of psychotherapy-related codes shows consistently high utilization across multiple service lines, supporting the conclusion of a high-volume psychotherapy footprint. The provider reports 1.1M claims for H2019 and 403.1K claims for 90837, and also bills large volumes for 90832 (124.8K claims), 90834 (77K claims), 90833 (21.7K claims), and 90791 (16.4K claims); several of these are labeled as extreme outliers or near‑extreme outliers in-state. This pattern indicates both depth (long-session psychotherapy) and breadth (shorter and add-on psychotherapy, evaluations) in behavioral health delivery.

Operational implications from the claims mix point to an intensive, community‑based care delivery capacity. Very high claim counts for time-based therapeutic codes (e.g., H2019’s 1.1M claims and large counts for 908xx psychotherapy codes) imply ongoing, repeated interventions per beneficiary and likely infrastructure to support high-touch outpatient and community services. While the data do not specify site count or staffing, the scale is consistent with either large multisite operations or a high-throughput community program.

The provider shows pockets of both extreme concentration and some diversification: the top three codes account for 78.0% of Medicaid revenue, but additional codes such as 99214, 99213, H0036, and several psychotherapy add-ons contribute smaller amounts across many service lines. This means OHIOGUIDESTONE’s revenue base is primarily driven by a small set of behavioral-health codes, while a longer tail of evaluation-and-management and case-management codes provides supplementary revenue streams. That mix reduces some exposure but leaves significant revenue risk tied to policies affecting the top behavioral‑service codes.

Given its ~19 years of enrollment and the extreme outlier ranks for several core codes, OHIOGUIDESTONE appears to be an established, high-volume behavioral health provider within Ohio’s Medicaid system. The combination of entrenched tenure and market dominance for key therapeutic codes suggests strong in‑state market positioning, particularly for therapeutic behavioral services and psychotherapy delivery. Analysts should treat this provider as a major Medicaid behavioral‑health contractor whose performance will be sensitive to state-level reimbursement and utilization changes for H2019 and 90837.

Medicaid: Complete Services Breakdown

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

46 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2019	Therapeutic behavioral services, per 15 minutes	1,131,440	$90	$104.1M
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…	403,080	$90	$37.5M
H0040	Assertive community treatment program, per diem	39,830	$270	$10.6M
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…	87,930	$110	$9.3M
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…	124,800	$50	$6.2M
H2020	Therapeutic behavioral services, per diem	41,420	$150	$6.2M
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…	77,010	$60	$4.9M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	75,600	$40	$3.2M
99354	N/A	28,080	$70	$1.9M
T2022	Case management, per month	9,040	$200	$1.8M

Showing 1–10 of 46

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Ohio Distribution

Ohioguidestone — 12 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. Ohio median

46 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2036	Alcohol and/or other drug treatment program, per diem	84	130	13,910	$220	$5.2M
H0040	Assertive community treatment program, per diem	3	20	3,770	$260	$2.8M
H2019	Therapeutic behavioral services, per 15 minutes	2	840	240	$90	$1.8M
T2022	Case management, per month	8	40	700	$150	$1.8M
H2020	Therapeutic behavioral services, per diem	17	310	1,190	$150	$1.5M
T2023	Targeted case management; per month	11	20	1,050	$380	$1.2M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	33	740	480	$60	$669.5K
H2017	Psychosocial rehabilitation services, per 15 minutes	13	240	1,090	$50	$509.2K
H2015	Comprehensive community support services, per 15 minutes	4	20	320	$160	$507.2K
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…	1	2,640	620	$90	$408.2K

Showing 1–10 of 46

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Geneva Chastanet-severin	MI	Psychiatric/Mental Health Nurse Practitioner	$45.3K	$0
Katelyn Boldon	OH	Psychiatric/Mental Health Nurse Practitioner	$22.9K	$0
Darlene Baliga-brown	OH	Professional Counselor	$980	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ohioguidestone	OH	Community/Behavioral Health Agency	$0	$18.3M
Asana Hospice Cleveland, LLC	OH	Community Based Hospice Care Agency	$0	$9.4M
Ace Wellness Center	OH	Mental Health Counselor	$0	$6.7M
Jon Engle	OH	Optometrist	$147.1K	$0

Ohioguidestone — Billing Profile & Reimbursement Data

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Ohioguidestone — 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