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NPI 1275580524 · Manhattan, KS · Mental Health Clinic/Center (Including Community Mental Health Center)
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Pawnee Mental Health Service, Inc. is a mental health clinic/center (including community mental health center) provider located in Manhattan, Kansas. This profile covers 0 Medicare and 30 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Pawnee Mental Health Service, Inc. |
| Address | 2001 Claflin Rd |
| City | Manhattan |
| State | KS |
| ZIP | 66502 |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| NPI Enumerated | May 30, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $25.6M |
| Medicare | $0 |
This provider is effectively single-payer in practice: there is no Medicare billing on file and all recorded federal payer activity is Medicaid, with total Medicaid revenue of $25.6M. The absence of Medicare activity indicates the organization’s revenue stream and clinical focus are concentrated entirely in Medicaid-funded behavioral health programs.
Revenue is highly concentrated in a narrow set of Medicaid service lines: the precomputed top 3 Medicaid codes account for 72.3% of this provider’s total Medicaid revenue, driven by H0036 ($9.3M revenue, 36.3%), H2011 ($5.1M revenue, 19.8%), and H2017 ($4.2M revenue, 16.2%). This concentration signals operational dependence on a few time-based, community-focused service codes.
The mix of leading codes (H0036, H2011, H2017) describes a community mental health operating model that emphasizes time-based, face-to-face supportive, crisis, and psychosocial rehabilitation services (multiple entries are billed per 15 minutes). High claim volumes for these codes (H0036: 65.9K claims; H2017: 60.3K claims; H2011: 10.7K claims) suggest sustained throughput of community-based visits, crisis responses, and rehabilitation programming rather than episodic specialty medical care.
Despite driving most revenue, the three largest codes do not uniformly indicate market dominance: H0036 ranks #19 of 63 in-state (71th percentile; typical, unremarkable volume for this code), H2011 ranks #5 of 47 (91th percentile; typical, unremarkable volume for this code), and H2017 ranks #8 of 63 (89th percentile; typical, unremarkable volume for this code). In aggregate this positions the provider as a solid regional participant in core community behavioral health services but not uniquely dominant across all of those categories.
The provider shows very high relative activity in psychotherapy services compared with peers: 90837 is an extreme outlier (12.9K claims, $926.1K revenue, 3.6% of Medicaid revenue; rank #15 of 731, 98th percentile; extreme outlier, far above typical state volume for this code) and 90834 is notably above typical (13.2K claims, $724.2K revenue, 2.8% of Medicaid revenue; rank #8 of 278, 97th percentile). This indicates a substantial commitment to longer and mid-length psychotherapy sessions alongside the time-based community services.
Several evaluation and E/M codes also appear at higher-than-typical state volumes, which implies significant diagnostic and clinical assessment capacity: 99213 (16.9K claims, $270.6K, 1.1% of Medicaid revenue; rank #45 of 1047, 96th percentile; notably above typical), 90791 (1.9K claims, $190.4K, 0.7% of Medicaid revenue; rank #7 of 153, 96th percentile; notably above typical), and 99212 (2K claims, $28.3K, 0.1% of Medicaid revenue; rank #14 of 336, 96th percentile; notably above typical). This pattern supports the view that the clinic pairs community-based supports with formal psychiatric evaluation and standard outpatient E/M activity.
Secondary revenue streams further reflect a broad community-support footprint: S5150 unskilled respite care ($1.3M, 5.1%), H0038 self-help/peer services ($1.2M, 4.9%), and T1019 personal care services ($951.9K, 3.7%) together supply meaningful supplemental revenue beyond core therapeutic and crisis services. These lines point to integrated non-clinical supports (respite, peer support, personal care) that complement the provider’s intensive time-based clinical offerings.
The organization has a long-standing presence in the market, with NPI enumeration dated 2006-05-30 (~20 years ago), and $25.6M in Medicaid revenue consistent with an established, mid-sized community mental health center. Given the revenue concentration (72.3% from the top three codes), the provider’s financial and operational performance will be sensitive to Medicaid coverage or rate changes affecting those specific time-based community services.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
30 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| H0036 | Community psychiatric supportive treatment, face-to-face, per 15 minutes | 65,890 | $140 | $9.3M |
| H2011 | Crisis intervention service, per 15 minutes | 10,720 | $470 | $5.1M |
| H2017 | Psychosocial rehabilitation services, per 15 minutes | 60,280 | $70 | $4.2M |
| S5150 | Unskilled respite care, not hospice; per 15 minutes | 13,730 | $100 | $1.3M |
| H0038 | Self‑help/peer services, per 15 minutes | 12,720 | $100 | $1.2M |
| T1019 | Personal care services, per 15 minutes, 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… | 28,840 | $30 | $951.9K |
| 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… | 12,860 | $70 | $926.1K |
| 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… | 13,170 | $60 | $724.2K |
| T1017 | Targeted case management, each 15 minutes | 22,020 | $30 | $572.6K |
| 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… | 16,910 | $20 | $270.6K |
Showing 1–10 of 30
How this provider's Medicaid billing volume and revenue compare to other Kansas providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Kansas median
30 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| T1019 | Personal care services, per 15 minutes, 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… | 25 | 60 | 21,510 | $90 | $8.5M |
| H0036 | Community psychiatric supportive treatment, face-to-face, per 15 minutes | 19 | 60 | 35,080 | $100 | $4.1M |
| H2017 | Psychosocial rehabilitation services, per 15 minutes | 8 | 60 | 12,570 | $60 | $1.5M |
| H2011 | Crisis intervention service, per 15 minutes | 5 | 50 | 1,840 | $270 | $1.1M |
| S5150 | Unskilled respite care, not hospice; per 15 minutes | 4 | 20 | 3,040 | $150 | $827.4K |
| T1017 | Targeted case management, each 15 minutes | 40 | 220 | 5,390 | $40 | $599.4K |
| H2021 | Community-based wrap-around services, per 15 minutes | 15 | 30 | 3,140 | $60 | $441K |
| 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… | 45 | 1,050 | 560 | $80 | $266.8K |
| H0038 | Self‑help/peer services, per 15 minutes | 8 | 60 | 2,130 | $50 | $223.2K |
| S0311 | Comprehensive management and care coordination for advanced illness, per calendar month | 22 | 30 | 680 | $130 | $182K |
Showing 1–10 of 30
Other providers in the same ZIP code as Pawnee Mental Health Service, Inc., ranked by combined Medicare and Medicaid revenue.
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