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.

Hegira Health, Inc (NPI 1184684979)

Field	Value
Entity Type	Organization
Organization	Hegira Health, Inc
Address	8623 N Wayne Road
City	Westland
State	MI
ZIP	48185
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	March 24, 2006

Payer Source	Total Paid
Medicaid	$109.5M
Medicare	$0

Key Findings

HEGIRA HEALTH, INC is effectively a Medicaid-focused provider: there is no Medicare billing on file while lifetime Medicaid revenue totals $109.5M, indicating the organization's payer mix is overwhelmingly concentrated in state Medicaid programs rather than in Medicare. This makes the entity effectively single-payer in the available data and suggests strategic dependence on Medicaid reimbursement streams.

Revenue concentration is moderately focused: the precomputed top three Medicaid codes account for 36.6% of the provider's total Medicaid revenue, showing that a bit more than one-third of Medicaid dollars are driven by a small set of high-volume services. This concentration suggests that changes to reimbursement or utilization for those top codes would materially affect the provider's overall revenue.

The top Medicaid revenue-driving codes reveal the service mix and operational model: large volumes and revenues for T1017, H0018, and H0039 indicate a combination of targeted case management, short-term residential behavioral-health per diems, and assertive community treatment. Together these codes point to an organization offering intensive community-based and residential behavioral health services rather than primarily office-based medical care.

HEGIRA posts extreme or notably above-typical state volumes on several high-revenue codes, reflecting a strong competitive standing in Michigan for targeted services. For example, H0018 ranks #3 of 68 providers in-state (97th percentile) and T1023 ranks #3 of 107 providers (98th percentile), both labeled notably above typical or extreme outlier volumes; these rankings indicate HEGIRA is a major statewide provider for short-term residential and screening/program-placement services.

At the same time, some high-volume psychotherapy and outpatient codes are extreme outliers in statewide volume: 90837 (71.2K claims, $10.7M) ranks in the 100th percentile and is described as an extreme outlier, and 90834 and 90832 also rank at high state percentiles. This pattern reflects unusually large-scale delivery of psychotherapy services compared with most in-state peers, reinforcing a broad capacity for direct therapeutic encounters in addition to case management and residential care.

Several high-value, time-based community services further characterize HEGIRA’s mix: H0039 (assertive community treatment) and H0036 (community psychiatric supportive treatment) together represent sizable portions of revenue and rank in the 92nd and 71st percentiles respectively, indicating the provider maintains substantial intensive community outreach and face-to-face support programs. These codes’ per-15-minute billing structure implies staffing models with frequent, shorter encounters across community settings.

Although many codes show above-typical statewide volume, HEGIRA is not uniformly dominant across every service line: some codes with meaningful revenue, such as T1017 (ranks #28 of 175, 84th percentile) and H0036 (71st percentile), are described as typical or unremarkable volumes relative to peers. This suggests the provider is a market leader for specific residential and case-management services while competing more modestly on other community-treatment lines.

NPI enumeration date shows stable tenure: HEGIRA’s NPI was registered in 2006-03-24 (about 20 years ago), indicating two decades of operation under the current billing identity. That longevity supports the likelihood that current high-volume Medicaid footprints reflect an established operational scale rather than a short-term surge.

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
T1017	Targeted case management, each 15 minutes	67,570	$220	$14.7M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	49,140	$250	$12.3M
H0039	Assertive community treatment, face-to-face, per 15 minutes	66,980	$180	$12M
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…	71,170	$150	$10.7M
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	25,390	$390	$9.9M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	19,390	$320	$6.1M
H0032	Mental health service plan development by non-physician	39,220	$150	$5.9M
H0031	Mental health assessment, by non-physician	27,980	$150	$4.3M
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…	35,100	$110	$3.9M
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…	36,110	$100	$3.5M

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

Hegira Health, Inc — 11 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
T1017	Targeted case management, each 15 minutes	28	180	10,890	$210	$8.1M
T1040	Medicaid certified community behavioral health clinic services, per diem	30	40	30,550	$80	$6.8M
H0039	Assertive community treatment, face-to-face, per 15 minutes	6	70	20,710	$180	$5.1M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	28	90	8,750	$300	$4.7M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	3	70	3,240	$390	$4.7M
T1016	Case management, each 15 minutes	79	120	8,060	$210	$3.4M
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	15	30	3,980	$460	$2.5M
H2030	Mental health clubhouse services, per 15 minutes	5	60	22,740	$80	$2.3M
H2019	Therapeutic behavioral services, per 15 minutes	19	30	3,330	$200	$1.6M
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	3	110	480	$530	$1.5M

Showing 1–10 of 52

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hegira Health, Inc	MI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$24.4M
Hegira Health, Inc.	MI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$17M
Hegira Health, Inc.	MI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$11.7M
John Head	MI	Psychiatry Physician	$186.1K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Spectrum Community Services	MI	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$166.6M
Barbara Fowkes	MI	Community Health Worker	$0	$9.6M
City Of Westland And 18th District Court	MI	Land Ambulance	$450.8K	$3M
Andrew Colman	MI	General Practice Physician	$166.5K	$0
Jenna Mckeever	MI	Family Nurse Practitioner	$121.3K	$0
Leigh Rubin	MI	Podiatrist	$99.4K	$0
Jennifer Gerteisen	MI	Foot & Ankle Surgery Podiatrist	$71K	$0
Rebecca Szymaszek	MI	Adult Health Nurse Practitioner	$56.1K	$0

Hegira Health, Inc — Billing Profile & Reimbursement Data

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Hegira Health, Inc — 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