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.

Rosecrance Inc (NPI 1346656923)

Field	Value
Entity Type	Organization
Organization	Rosecrance Inc
Address	2704 N Main St
City	Rockford
State	IL
ZIP	61103
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	July 3, 2014

Payer Source	Total Paid
Medicaid	$43.5M
Medicare	$0

Key Findings

No Medicare billing on file and Medicaid is the sole reported payer for this entity: lifetime Medicaid revenue is $43.5M and there is explicitly no Medicare billing on file. The provider’s NPI was enumerated on 2014-07-03 (~12 years ago), indicating roughly a decade of active enrollment under this identifier.

Revenue is highly concentrated in a few community behavioral-health codes: H2016 ($9.2M, 21.1%), H0004 ($8.2M, 18.9%), and H2000 ($7.2M, 16.5%) together account for 56.4% of the provider’s total Medicaid revenue. This concentration signals that a small set of service lines—comprehensive community supports, time-based therapy, and multidisciplinary evaluations—drive the majority of billed Medicaid dollars.

The code mix points to a community-based, outpatient behavioral-health model with substantial time-based and multidisciplinary activity. High-volume, per-15-minute therapy (H0004; 105.2K claims, $78 avg paid/claim) and sizable per-diem/per-visit community support and evaluation codes (H2016 and H2000) indicate the provider operates at scale delivering counseling, structured supports, and formal multidisciplinary assessments.

Competitive standing within Illinois is uneven but strong in core outpatient services: H0004 ranks #12 of 804 providers in-state at the 99th percentile (labeled an “extreme outlier”) and H2000 ranks #7 of 423 providers at the 99th percentile (also an “extreme outlier”), signaling statewide leadership in therapy and multidisciplinary evaluations. By contrast H2016 ($9.2M) ranks #6 of 58 providers at the 91st percentile, which is high but described as typical volume for that narrower provider set; overall, the provider is a major Medicaid participant for certain high-volume outpatient codes.

The provider also bills substantial amounts for intensive community and crisis services, consistent with care for higher-acuity behavioral-health populations: H0039 (assertive community treatment) generated $5.9M (13.6%, 33.3K claims) and H2011 (crisis intervention) generated $4.4M (10.1%, 21.3K claims). H2011 is ranked #12 of 155 providers at the 93rd percentile (notably above typical state volume), underscoring an elevated role in crisis-response and intensive community treatment.

Operational scale is evident from very large claim volumes across multiple time-based codes, implying significant staffing and throughput: examples include 105.2K claims for H0004, 64K claims for H2016, and 55.9K claims for H2000. Average paid amounts are moderate to mid-range (e.g., $78 per H0004 claim, $143 per H2016 claim, $128 per H2000 claim), so total revenue is driven primarily by volume rather than very high per-claim reimbursement.

Several lower-dollar codes show comparatively high percentile ranks, indicating the provider performs particular administrative and assessment functions at elevated rates versus peers. For example, H0031 (mental health assessment) produced $168.4K and ranks #11 of 222 at the 95th percentile (notably above typical state volume), and H0032 (service plan development) produced $114.1K and ranks #14 of 221 at the 94th percentile (notably above typical state volume).

Because the provider’s billing is effectively single-payer (Medicaid-only on file) and heavily weighted toward a few high-volume codes, its revenue profile is sensitive to Medicaid policy, rate changes, or contracting terms that affect community support, therapy, and multidisciplinary evaluation services. Analysts should treat the organization as a Medicaid-centric behavioral-health operator with concentrated exposure to a small set of service lines.

Medicaid: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2016	Comprehensive community support services, per diem	64,010	$140	$9.2M
H0004	Behavioral health counseling and therapy, per 15 minutes	105,170	$80	$8.2M
H2000	Comprehensive multidisciplinary evaluation	55,910	$130	$7.2M
H0039	Assertive community treatment, face-to-face, per 15 minutes	33,320	$180	$5.9M
H2011	Crisis intervention service, per 15 minutes	21,310	$210	$4.4M
H2015	Comprehensive community support services, per 15 minutes	59,760	$70	$3.9M
S9484	Crisis intervention mental health services, per hour	8,720	$290	$2.5M
T1016	Case management, each 15 minutes	34,270	$50	$1.6M
H0031	Mental health assessment, by non-physician	1,620	$100	$168.4K
H0032	Mental health service plan development by non-physician	1,330	$90	$114.1K

Showing 1–10 of 15

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

Rosecrance Inc — 3 of 15 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

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0039	Assertive community treatment, face-to-face, per 15 minutes	11	50	14,910	$140	$4.1M
H2016	Comprehensive community support services, per diem	6	60	11,700	$130	$3.5M
H2015	Comprehensive community support services, per 15 minutes	32	430	3,260	$80	$1.3M
S9484	Crisis intervention mental health services, per hour	11	80	1,600	$260	$972.5K
H0004	Behavioral health counseling and therapy, per 15 minutes	12	800	2,480	$90	$962.2K
H2011	Crisis intervention service, per 15 minutes	12	160	1,060	$180	$959.9K
H2000	Comprehensive multidisciplinary evaluation	7	420	1,450	$100	$631.8K
T1016	Case management, each 15 minutes	27	470	1,830	$60	$475.9K
H0034	Medication training and support, per 15 minutes	93	110	1,030	$40	$179.2K
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…	12	20	130	$110	$161.4K

Showing 1–10 of 15

Related Providers

Other providers that share a Tax Identification Number (TIN) with Rosecrance Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rosecrance Inc	IL	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$13.1M
Rosecrance, Inc.	IL	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$6.2M
Rosecrance Inc	IL	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$5.6M
Rosecrance Inc	IL	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$5.1M
Rosecrance Inc	IL	Substance Use Disorder Rehabilitation Clinic/Center	$0	$4.9M
Rosecrance Inc	IL	Substance Use Disorder Rehabilitation Clinic/Center	$0	$3.5M
Rosecrance Inc	IL	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$3.4M
Rosecrance, Inc.	IL	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$3M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Stepping Stones Of Rockford, Inc	IL	Mental Health Clinic/Center (Including Community Mental Health Center)	$8.4K	$38.2M
Julie Kafka	IL	Family Medicine Physician	$223.1K	$384.1K
Walid Abdallah	IL	Ophthalmology Physician	$547.9K	$0
Gregory Nowak	IL	Cardiovascular Disease Physician	$206K	$152K
Rose Stocker	IL	Family Medicine Physician	$71.5K	$245.3K
Faisal Raja	IL	Neurology Physician	$29.5K	$194.3K
Abdullah Altayeh	IL	Pulmonary Disease Physician	$92.6K	$81.1K
Diane Boone	IL	Ophthalmology Physician	$166.7K	$0
Jeffrey Smith	IL	Cardiovascular Disease Physician	$32K	$28K
Altaf Dawood	IL	Gastroenterology Physician	$44.5K	$10.4K

Rosecrance Inc — Billing Profile & Reimbursement Data

Sign up for Rosecrance Inc — Billing Profile & Reimbursement Data policy alerts

Rosecrance Inc — Billing Profile & Reimbursement Data

Sign up for Rosecrance Inc — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References