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

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

National Mental Health Management, LLC (NPI 1306472568)

National Mental Health Management, LLC is a addiction psychiatry physician provider located in Wheat Ridge, Colorado. This profile covers 0 Medicare and 13 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	National Mental Health Management, LLC
Address	4704 Harlan St Ste 103
City	Wheat Ridge
State	CO
ZIP	80212
Taxonomy	Addiction Psychiatry Physician
NPI Enumerated	March 19, 2020

Payer Source	Total Paid
Medicaid	$6M
Medicare	$0

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	27,390	$100	$2.6M
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	29,180	$60	$1.7M
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…	5,510	$100	$556.8K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	3,430	$130	$456.3K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	2,290	$170	$398.8K
90836	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient in addition to an evaluation and management service in the…	2,770	$70	$190.9K
99204	The provider sees a new 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 provider…	400	$120	$46.8K
G8431	Screening for depression is documented as being positive and a follow-up plan is documented	1,130	$20	$23.7K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	140	$90	$12.8K
G8510	Screening for depression is documented as negative, a follow-up plan is not required	990	$10	$9.9K

Showing 1–10 of 13

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

National Mental Health Management, LLC — 4 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	1,819	2,520	330	$100	$352K
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…	54	2,630	430	$90	$268.2K
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…	157	1,670	550	$100	$229.3K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	42	720	130	$100	$110K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	4	210	270	$50	$104.4K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	88	130	120	$140	$73.8K
99204	The provider sees a new 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 provider…	224	990	90	$120	$57.9K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	191	510	80	$130	$55.8K
90836	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient in addition to an evaluation and management service in the…	3	50	110	$60	$42K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	4	290	50	$140	$31.3K

Showing 1–10 of 13

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dungarvin Colorado, LLC - Denver	CO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$63.5M
Look Optical, PC	CO	Optometrist	$0	$9.3M
Primary Dental LLC	CO	General Practice Dentistry	$0	$6.1M
Altitude Anesthesia Group	CO	Dentist	$0	$5.6M
Strock Medical Group LLC	CO	Adult Health Nurse Practitioner	$0	$3.5M
Kelly Lindauer	CO	Diagnostic Radiology Physician	$180.5K	$0

National Mental Health Management, LLC — Billing Profile & Reimbursement Data

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National Mental Health Management, LLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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Frequently Asked Questions

References