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

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

Black Hawk-grundy Mental Health Center Inc. (NPI 1316944598)

Black Hawk-grundy Mental Health Center Inc. is a mental health clinic/center (including community mental health center) provider located in Waterloo, Iowa. 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.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Black Hawk-grundy Mental Health Center Inc.
Address	3251 W 9th St
City	Waterloo
State	IA
ZIP	50702
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	July 5, 2005

Payer Source	Total Paid
Medicaid	$20.7M
Medicare	$0

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
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	50,410	$150	$7.5M
H0037	Community psychiatric supportive treatment program, per diem	11,300	$300	$3.4M
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…	33,940	$100	$3.3M
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…	32,170	$70	$2.4M
90832	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…	20,500	$50	$1.1M
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…	15,950	$60	$940.9K
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…	3,120	$200	$636.5K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	3,360	$130	$449.7K
H0038	Self‑help/peer services, per 15 minutes	30,410	$10	$334.5K
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…	1,880	$100	$179K

Showing 1–10 of 30

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Iowa Distribution

Black Hawk-grundy Mental Health Center Inc. — 5 of 24 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Iowa

Full comparison — all codes billed, vs. Iowa median

30 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2016	Comprehensive community support services, per diem	175	180	10,790	$390	$15.2M
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	9	60	16,120	$150	$3.8M
H0037	Community psychiatric supportive treatment program, per diem	4	30	1,050	$210	$800.8K
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…	21	680	670	$70	$343.5K
T1016	Case management, each 15 minutes	4	20	480	$150	$340.3K
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…	22	1,060	480	$40	$154.5K
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…	113	1,310	760	$20	$153.1K
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…	15	140	210	$120	$152.1K
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…	176	610	550	$70	$145.9K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	132	170	320	$20	$119.2K

Showing 1–10 of 30

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Covenant Medical Center Inc	IA	General Acute Care Hospital	$0	$63.2M
Covenant Medical Center Inc	IA	Family Medicine Physician	$0	$21.9M
Waterloo Community School District	IA	Local Education Agency (LEA)	$0	$19.8M
Iowa Emergency Physicians LLP	IA	Emergency Medicine Physician	$0	$5.1M
Jyoti Chowdhury	IA	Pediatric Dentistry	$0	$2.4M
Covenant Medical Center Inc	IA	Durable Medical Equipment & Medical Supplies	$0	$2.1M
Michael Letkewicz	IA	Oral and Maxillofacial Surgery (Dentist)	$0	$1.7M
Metropolitan Transit Authority Of Black Hawk County	IA	Bus	$0	$1.7M
Michael Puk	IA	Ophthalmology Physician	$1.6M	$0
Carol Halloran	IA	Dentist	$0	$1.6M

Black Hawk-grundy Mental Health Center Inc. — Billing Profile & Reimbursement Data

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Black Hawk-grundy Mental Health Center Inc. — 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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