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.

Northpointe Behavioral Healthcare System (NPI 1205864881)

Field	Value
Entity Type	Organization
Organization	Northpointe Behavioral Healthcare System
Address	715 Pyle Dr
City	Kingsford
State	MI
ZIP	49802
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	June 30, 2006

Payer Source	Total Paid
Medicaid	$67.3M
Medicare	$0

Key Findings

This provider is effectively single‑payer in scope: there is no Medicare billing on file while Medicaid revenue totals $67.3M, so Medicaid dominates the provider’s billed activity and financial footprint. Analysts should treat this entity as a Medicaid-focused community behavioral health operation rather than a mixed Medicare/Medicaid practice.

Revenue is concentrated in a small set of Medicaid service lines: the top three Medicaid codes account for 46.9% of the provider’s total Medicaid revenue, with H2016 alone representing 25.4% ($16.4M). Those three high‑revenue codes drive nearly half the Medicaid book of business and therefore represent the primary operational and reimbursement risk areas.

The code mix indicates this is an operating community mental health clinic that emphasizes programmatic, per‑diem supports and time‑based case management: high‑volume per‑diem community support H2016 (86.3K claims, $190 avg paid/claim), targeted case management T1017 (41.1K claims, $225 avg paid/claim), and community psychiatric supportive treatment H0036 (23.4K claims, $199 avg paid/claim) are the top revenue drivers. In combination with sizable counts of T1016, T1020 and H2015, the pattern is consistent with ongoing, plan‑based community services rather than episodic specialty procedures.

Competitive standing across key Medicaid services is mixed by code. H2016 ranks #21 of 297 providers (93th percentile) but is described as "typical, unremarkable volume for this code," indicating a strong statewide presence without being an extreme outlier; T1017 ranks #53 of 175 (70th percentile) and H0036 ranks #19 of 93 (80th percentile), both characterized as typical volumes that place the provider above median peers but not dominant across all categories.

There are notable relative outliers despite modest absolute dollars: S9446 (patient education, group) is ranked #1 of 9 providers in‑state at the 100th percentile and is labeled "notably above typical state volume for this code," suggesting this provider delivers patient‑education group sessions at a higher relative intensity than most peers even though S9446 contributes $676K (1.0%) of Medicaid revenue. That signal may indicate a localized program emphasis that differentiates the clinic from many in‑state peers.

The provider delivers both clinician‑led psychotherapy and medical evaluation services in addition to community supports: 90837 ($2M, 3.1% of Medicaid revenue) and 90834 ($1.1M, 1.6%) are present alongside E/M codes such as 99214 ($2.2M, 3.4%) and 99213 ($811.4K, 1.3%). This mix shows a blended model with individual psychotherapy and office‑based evaluation and management embedded within a broader community‑based service portfolio.

Operational intensity is reflected in very large claim volumes for per‑diem services: H2016 and T1020 both show 86.3K claims, while T1017 and T1016 show 41.1K and 36.5K claims respectively, highlighting a programmatic delivery model that relies on many short, time‑based encounters. Payers should expect budgetary exposure to high claim counts for routine, recurring services rather than a small number of high‑cost episodic claims.

The provider has an established tenure: the NPI was enumerated on 2006-06-30 (~20 years ago), which, together with $67.3M in Medicaid revenue, supports the characterization of an enduring, regionally established community behavioral health clinic. That longevity makes observed patterns likely to reflect sustained program design rather than a transient billing anomaly.

Medicaid: Complete Services Breakdown

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

48 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2016	Comprehensive community support services, per diem	86,320	$190	$16.4M
T1017	Targeted case management, each 15 minutes	41,150	$230	$9.3M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	23,390	$200	$4.7M
T1016	Case management, each 15 minutes	36,480	$130	$4.6M
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…	86,330	$50	$4.4M
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…	6,120	$430	$2.6M
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	1,310	$1,730	$2.3M
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…	7,930	$280	$2.2M
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…	8,520	$230	$2M
H2030	Mental health clubhouse services, per 15 minutes	11,350	$160	$1.8M

Showing 1–10 of 48

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

Northpointe Behavioral Healthcare System — 1 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

48 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2016	Comprehensive community support services, per diem	21	300	6,660	$310	$8.7M
T1017	Targeted case management, each 15 minutes	53	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…	86	130	11,590	$190	$7.6M
H2015	Comprehensive community support services, per 15 minutes	159	610	14,740	$90	$6M
H0039	Assertive community treatment, face-to-face, per 15 minutes	50	70	20,710	$180	$5.1M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	19	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…	16	220	7,030	$170	$4.6M
H2014	Skills training and development, per 15 minutes	74	130	20,660	$50	$3.8M
T1016	Case management, each 15 minutes	14	120	8,060	$210	$3.4M
H2030	Mental health clubhouse services, per 15 minutes	36	60	22,740	$80	$2.3M

Showing 1–10 of 48

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Claudia Scott	MI	Psychiatric/Mental Health Nurse Practitioner	$2.7K	$0

Nearby Providers

Other providers in the same ZIP code as Northpointe Behavioral Healthcare System, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Guardian Flight LLC	MI	Air Ambulance	$271.1K	$146.7K
Chris Moore	MI	Orthopedic Physical Therapist	$103.1K	$0
Katie Picucci	MI	Family Medicine Physician	$87.6K	$0

Northpointe Behavioral Healthcare System — Billing Profile & Reimbursement Data

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Northpointe Behavioral Healthcare System — 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