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

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

The Thresholds (NPI 1275912289)

Field	Value
Entity Type	Organization
Organization	The Thresholds
Address	4423 N Ravenswood Ave
City	Chicago
State	IL
ZIP	60640
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	May 22, 2015

Payer Source	Total Paid
Medicaid	$33.9M
Medicare	$0

Key Findings

This entity is effectively a Medicaid-centric operator: there is no Medicare billing on file and the provider reports $33.9M in lifetime Medicaid revenue, indicating a single-payer revenue footprint concentrated on state Medicaid programs rather than a mixed Medicare/Medicaid business model. Analysts should treat Medicare network or fee-schedule exposure as negligible for competitive comparisons.

Revenue is highly concentrated in only a few service lines: the precomputed top 3 Medicaid codes by revenue account for 82.6% of this provider's total Medicaid revenue, driven by H2016 ($11M, 32.5%), H0039 ($8.9M, 26.4%), and H2015 ($8M, 23.7%). This concentration means most margin and utilization trends will be determined by policy and contract performance for these three codes.

The code mix points to a high-intensity, community-based behavioral health operation: heavy use of H2016 (comprehensive community support services, per diem), H2015 (comprehensive community support services, per 15 minutes) and H0039 (assertive community treatment, per 15 minutes) indicates sustained, time-based, multidisciplinary services and assertive outreach/case-management models rather than episodic outpatient office visits. The prominence of per-diem and per-15-minute codes suggests team-based care and frequent, longitudinal contact with high-need behavioral health patients.

Operational scale is substantial for its service types: H2016 has 103K claims at $107 avg paid/claim, H2015 has 92.1K claims at $87 avg paid/claim, and H0039 has 68.3K claims at $131 avg paid/claim, reflecting very high encounter volumes and extensive time-based billing activity. These claim counts imply a large on-the-ground care delivery operation with sustained utilization of intensive community supports.

On in-state competitive standing, the provider is a market leader for several top codes: H2016 ranks #3 of 58 providers in-state (96th percentile; notably above typical state volume for this code) and H2015 ranks #14 of 431 providers in-state (97th percentile; notably above typical state volume for this code), signaling outsized share in comprehensive community support services. H0039, while a top revenue driver here, ranks #5 of 47 providers in-state (91th percentile; typical, unremarkable volume for this code), so its assertive community treatment volume is large but not an extreme outlier versus peers.

The provider also bills meaningful ancillary and case-management services that diversify revenue within Medicaid: T1016 (case management, each 15 minutes) contributes $2.6M (7.6%) and ranks #16 of 465 providers in-state (97th percentile; notably above typical state volume for this code), while H0004 (behavioral health counseling and therapy) and H2000 (comprehensive multidisciplinary evaluation) add $1.7M (5.1%) and $1.4M (4.2%) respectively and rank in more typical peer ranges (H0004: #118 of 804, 85th percentile; H2000: #48 of 423, 89th percentile). This mix shows significant case-management orientation with supplementary therapeutic and assessment activity.

The heavy concentration in a small set of time-based community service codes creates strategic sensitivity: because the top three codes together drive 82.6% of Medicaid revenue and there is no Medicare portfolio to offset disruption, payments, policy changes, or contract shifts affecting H2016/H2015/H0039 could materially affect overall revenue. Risk management and contract monitoring for these specific codes should be a priority for payers and network managers.

The provider has an established operational history in the Medicaid market, with an NPI enumerated 2015-05-22 (~11 years ago), supporting the interpretation that these billing patterns reflect a sustained, Medicaid-focused service model rather than a short-term or recently pivoted activity set. That tenure combined with high in-state ranks on key codes indicates durable market positioning within Illinois for comprehensive community support and related services.

Medicaid: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2016	Comprehensive community support services, per diem	102,980	$110	$11M
H0039	Assertive community treatment, face-to-face, per 15 minutes	68,300	$130	$8.9M
H2015	Comprehensive community support services, per 15 minutes	92,150	$90	$8M
T1016	Case management, each 15 minutes	55,900	$50	$2.6M
H0004	Behavioral health counseling and therapy, per 15 minutes	19,510	$90	$1.7M
H2000	Comprehensive multidisciplinary evaluation	13,980	$100	$1.4M
H2011	Crisis intervention service, per 15 minutes	320	$220	$70.2K
H0031	Mental health assessment, by non-physician	380	$110	$42.2K
H0032	Mental health service plan development by non-physician	320	$70	$23.3K
H2017	Psychosocial rehabilitation services, per 15 minutes	710	$30	$18.4K

Showing 1–10 of 12

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Illinois Distribution

The Thresholds — 3 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Illinois

Full comparison — all codes billed, vs. Illinois median

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0039	Assertive community treatment, face-to-face, per 15 minutes	5	50	14,910	$140	$4.1M
H2016	Comprehensive community support services, per diem	3	60	11,700	$130	$3.5M
H2015	Comprehensive community support services, per 15 minutes	14	430	3,260	$80	$1.3M
H0004	Behavioral health counseling and therapy, per 15 minutes	118	800	2,480	$90	$962.2K
H2011	Crisis intervention service, per 15 minutes	99	160	1,060	$180	$959.9K
H2000	Comprehensive multidisciplinary evaluation	48	420	1,450	$100	$631.8K
H2017	Psychosocial rehabilitation services, per 15 minutes	49	60	5,920	$50	$621.3K
T1016	Case management, each 15 minutes	16	470	1,830	$60	$475.9K
H0034	Medication training and support, per 15 minutes	101	110	1,030	$40	$179.2K
H0002	Behavioral health screening to determine eligibility for admission to treatment program	123	330	210	$110	$97.4K

Showing 1–10 of 12

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Counseling Centers Of Chicago	IL	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$41.1M
Envision Unlimited	IL	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$23.5M
Heartland Alliance Health	IL	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$8.5M
Lester And Rosalie Anixter Center	IL	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$7.1M
Ab4u, Inc.	IL	Durable Medical Equipment & Medical Supplies	$0	$6.5M
Shephali Patel	IL	Psychiatry Physician	$186.4K	$3.8M
Sundance Methadone Treatment Center,llc	IL	Methadone Clinic	$164.3K	$3.1M
Victor C. Neumann Association	IL	Community/Behavioral Health Agency	$0	$3.3M
Erie Family Health Center, Inc	IL	Federally Qualified Health Center (FQHC)	$0	$2.9M
Jody Reed	IL	Psychiatry Physician	$128.4K	$2.6M

The Thresholds — Billing Profile & Reimbursement Data

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The Thresholds — 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