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.

West Michigan Community Mental Health System (NPI 1275646309)

Field	Value
Entity Type	Organization
Organization	West Michigan Community Mental Health System
Address	920 Diana St
City	Ludington
State	MI
ZIP	49431
Taxonomy	Mental Health Counselor
NPI Enumerated	August 15, 2006

Payer Source	Total Paid
Medicaid	$101.9M
Medicare	$0

Key Findings

This entity is effectively a Medicaid-focused provider: lifetime Medicaid revenue is $101.9M while there is no Medicare billing on file, indicating a single-payer operational footprint dominated by Medicaid-funded behavioral-health services. The absence of Medicare billing suggests its patient mix or contracting model centers on Medicaid populations rather than Medicare beneficiaries.

Revenue is highly concentrated in a few community- and case-management codes: T1040 ($17.8M, 18.3% of this provider's total Medicaid revenue), T1017 ($16.2M, 16.6%), and H2015 ($14.1M, 14.6%) together account for 49.5% of the provider’s Medicaid revenue. This concentration signals reliance on per-diem community behavioral health clinic services, targeted case management, and 15-minute comprehensive community support units as the financial backbone of operations.

The code mix points to a community-based, multidisciplinary behavioral-health operation: high-volume T1040 (community behavioral health clinic services), T1017 (targeted case management), and H2015 (comprehensive community support services) combined with substantial psychotherapy billing (90834, 90837) and crisis/ACT codes (H2011, H0039) indicate an integrated model that pairs long-duration case management and psychosocial supports with outpatient therapy. This pattern is consistent with an organization delivering both intensive community supports and routine outpatient psychotherapy to Medicaid beneficiaries.

Competitive standing on the state level is mixed for the top revenue drivers: T1040 ranks #11 of 42 providers in-state (76th percentile; typical, unremarkable volume for this code), T1017 ranks #30 of 175 providers in-state (83th percentile; typical, unremarkable volume for this code), and H2015 ranks #77 of 614 providers in-state (88th percentile; typical, unremarkable volume for this code). Those ranks show a solid but not dominant statewide presence in community clinic, case management, and comprehensive support services—strong participation but not market leadership.

The provider reports notably high outpatient psychotherapy and evaluation volumes relative to peers: 90834 accounts for $5.2M and ranks #18 of 950 providers in-state (98th percentile; notably above typical state volume for this code), 90791 accounts for $2.5M and ranks #41 of 784 providers in-state (95th percentile; notably above typical state volume for this code), and 90837 accounts for $2.6M and ranks #123 of 1956 providers in-state (94th percentile; typical, unremarkable volume for this code). These high percentiles for core psychotherapy and diagnostic codes indicate substantial in-house clinical therapy capacity and throughput.

There are distinct statistical outliers and program specializations in the mix: H0050 ($1.2M) ranks #1 of 39 providers in-state (100th percentile; extreme outlier, far above typical state volume for this code), signaling an unusually large program for brief alcohol/drug intervention relative to peers. Other specialized services with elevated standing include H0002 (behavioral health screening) at $1.7M ranking #7 of 96 (94th percentile; typical, unremarkable volume for this code), pointing to sizeable screening and intake activity.

Service breadth extends into developmental and habilitative supports as well as medical E/M care: presence of ABA-related codes 97153 ($2.4M) and 97155 ($1.5M), skills training H2014 ($3.2M), peer services H0038 ($2.5M), and E/M code 99213 ($4.7M, ranks #322 of 4766 providers in-state, 93th percentile; typical, unremarkable volume for this code) suggests the provider treats a mix of behavioral-health and developmental-disability needs and offers both clinical and technician-delivered interventions. This diversified service slate supports an operational model that serves multiple Medicaid-covered needs rather than a narrow single-service shop.

The provider has an established operating tenure: NPI enumerated 2006-08-15 (~20 years ago), which, combined with $101.9M in Medicaid lifetime revenue, indicates long-standing engagement with state Medicaid systems and likely institutional relationships with local payers and referral sources. Given the long tenure and Medicaid concentration, analysts should view this organization as an entrenched regional Medicaid behavioral-health provider rather than a newer entrant or Medicare-focused practice.

Medicaid: Complete Services Breakdown

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

51 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1040	Medicaid certified community behavioral health clinic services, per diem	128,840	$140	$17.8M
T1017	Targeted case management, each 15 minutes	63,870	$250	$16.2M
H2015	Comprehensive community support services, per 15 minutes	118,720	$120	$14.1M
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…	35,540	$150	$5.2M
H0039	Assertive community treatment, face-to-face, per 15 minutes	24,540	$200	$4.8M
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…	18,360	$260	$4.7M
H2014	Skills training and development, per 15 minutes	35,800	$90	$3.2M
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…	13,040	$200	$2.6M
H0038	Self‑help/peer services, per 15 minutes	9,450	$260	$2.5M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	5,100	$480	$2.5M

Showing 1–10 of 51

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

West Michigan Community Mental Health System — 2 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

51 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1017	Targeted case management, each 15 minutes	30	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…	60	130	11,590	$190	$7.6M
T1040	Medicaid certified community behavioral health clinic services, per diem	11	40	30,550	$80	$6.8M
H2015	Comprehensive community support services, per 15 minutes	77	610	14,740	$90	$6M
H0039	Assertive community treatment, face-to-face, per 15 minutes	30	70	20,710	$180	$5.1M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	54	90	8,750	$300	$4.7M
H2014	Skills training and development, per 15 minutes	55	130	20,660	$50	$3.8M
T1016	Case management, each 15 minutes	72	120	8,060	$210	$3.4M
97155	The provider, a physician or other qualified healthcare professional, administers adaptive behavior treatment face–to–face with one patient and makes modifications in the protocol targets and…	62	130	3,170	$180	$2.2M
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	36	110	480	$530	$1.5M

Showing 1–10 of 51

Nearby Providers

Other providers in the same ZIP code as West Michigan Community Mental Health System, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Johns Health Care PC	MI	Home Health Agency	$0	$13.6M
Memorial Medical Center Of West Michigan	MI	General Acute Care Hospital	$0	$11.8M
Andrew Riemer	MI	Ophthalmology Physician	$1.2M	$0
Brandon Riemer	MI	Ophthalmology Physician	$600K	$0
Steven Strbich	MI	Emergency Medical Services (Emergency Medicine) Physician	$96.9K	$0
Alexus Squires	MI	Podiatrist	$82.8K	$0
Michael Greenslait	MI	Pain Medicine (Anesthesiology) Physician	$36.4K	$0
Jennifer Branning	MI	Optometrist	$36.2K	$0
Kodi Bone	MI	Physician Assistant	$14.7K	$0
Amanda Lang	MI	Optometrist	$2.2K	$190

West Michigan Community Mental Health System — Billing Profile & Reimbursement Data

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West Michigan Community Mental Health 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

Nearby Providers

Frequently Asked Questions

References