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

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

Horizons Mental Health Center, Inc (NPI 1366190795)

Field	Value
Entity Type	Organization
Organization	Horizons Mental Health Center, Inc
Address	1600 N Lorraine St Ste 202
City	Hutchinson
State	KS
ZIP	67501
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	March 15, 2022

Payer Source	Total Paid
Medicaid	$31.6M
Medicare	$0

Key Findings

Revenue concentration is extreme: the provider reports $31.6M in Medicaid revenue and no Medicare billing on file, and the precomputed top‑3 Medicaid codes together account for 100.0% of that Medicaid revenue. In the claims detail that revenue is captured entirely by T1040 (137.4K claims, $230 avg paid/claim, $31.6M revenue), indicating a single code drives the provider’s lifetime reported Medicaid payments.

The code mix and revenue allocation indicate an operational model built around per‑diem certified community behavioral health clinic services: T1040 is the Medicaid certified community behavioral health clinic services, per diem code and is the sole revenue source on file. Ancillary behavioral health encounter codes (for example H0036, H0038, H2017, 90837, 90832, 90834) appear extensively in the claims inventory but show $0 avg paid/claim, consistent with a bundled or per‑diem payment model where T1040 captures the payment.

This provider is effectively single‑payer at scale: it reports $31.6M of Medicaid revenue and explicitly has no Medicare billing on file, so payers and analysts should treat Medicaid as the dominant and practically exclusive revenue stream when modeling this entity. The absence of Medicare activity simplifies payer mix assessments but places operational and reimbursement exposure primarily to Medicaid policy and rate changes.

Competitive standing on the per‑diem code is strong in the state: T1040 is ranked #4 of 33 providers in‑state (91th percentile; typical, unremarkable volume for this code), positioning HORIZONS MENTAL HEALTH CENTER, INC among the larger in‑state billers of certified community behavioral health clinic per‑diem services. That rank suggests it is a significant statewide provider for this reimbursement line even if the characterization in the dataset labels the volume as typical.

There is a large mismatch between claims volume and recorded paid revenue for many service codes, which has implications for utilization and audit focus. Examples include H0036 (61.9K claims, $0 avg paid/claim), T1017 (28K claims, $0 avg paid/claim), H0038 (9.7K claims, $0 avg paid/claim), and 90837 (7.6K claims, $0 avg paid/claim); these high claim counts alongside $0 reported paid amounts are consistent with services being bundled under T1040 rather than paid separately.

Several individual service codes show notably high relative volumes in‑state despite contributing no standalone Medicaid revenue on file, which signals substantial service delivery under the per‑diem model. Noteworthy examples are 90837 (7.6K claims; ranks #29 of 731 providers in‑state, 96th percentile; notably above typical state volume) and 99366 (3.6K claims; ranks #2 of 28 providers in‑state, 96th percentile; notably above typical state volume). These rankings imply the provider delivers large volumes of longer psychotherapy sessions and multidisciplinary care coordination activity even though payment appears consolidated.

From a payer perspective, the concentration of paid dollars in T1040 creates specific rate policy and utilization questions: because $31.6M of Medicaid payments are captured in the per‑diem code, reviews should focus on per‑diem length of stay, daily service mix, and whether encounter‑level activity recorded under other codes is appropriately reflected in bundled rates. Contracting or rate change scenarios that affect per‑diem reimbursements are likely to have an outsized financial impact on this provider.

Tenure is relatively recent: the provider’s NPI was enumerated on 2022-03-15 (~4 years ago), and despite this recent enumeration the organization has accumulated substantial Medicaid claim volumes and the $31.6M revenue footprint. That pace of claims and revenue accumulation since enumeration is relevant when benchmarking growth, network impact, and capacity relative to longer‑tenured peers.

Medicaid: Complete Services Breakdown

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1040	Medicaid certified community behavioral health clinic services, per diem	137,370	$230	$31.6M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	1,130	$0	$0
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…	500	$0	$0
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…	4,990	$0	$0
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…	3,720	$0	$0
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…	7,580	$0	$0
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	450	$0	$0
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	200	$0	$0
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	200	$0	$0
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.	450	$0	$0

Showing 1–10 of 22

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kansas Distribution

Horizons Mental Health Center, Inc — 0 of 1 code billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kansas

Full comparison — all codes billed, vs. Kansas median

22 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1040	Medicaid certified community behavioral health clinic services, per diem	4	30	34,540	$260	$13.9M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	20	60	35,080	$100	$4.1M
H2017	Psychosocial rehabilitation services, per 15 minutes	31	60	12,570	$60	$1.5M
H2011	Crisis intervention service, per 15 minutes	11	50	1,840	$270	$1.1M
T1017	Targeted case management, each 15 minutes	31	220	5,390	$40	$599.4K
H0038	Self‑help/peer services, per 15 minutes	9	60	2,130	$50	$223.2K
H0004	Behavioral health counseling and therapy, per 15 minutes	44	70	470	$100	$143.1K
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…	52	880	400	$60	$136K
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…	29	730	440	$80	$128.1K
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…	32	280	320	$50	$87.5K

Showing 1–10 of 22

Nearby Providers

Other providers in the same ZIP code as Horizons Mental Health Center, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Training And Evaluation Center Of Hutchinson Incorporated	KS	Home Health Agency	$0	$38.1M
Horizons Mental Health Center, Inc.	KS	Community/Behavioral Health Agency	$0	$29.3M
Hutchinson Public Schools Usd 308	KS	Local Education Agency (LEA)	$0	$2.7M
Mark Goodman	KS	Clinical Psychologist	$54.6K	$1.2M
Hutchinson Clinic, PA, Inc.	KS	Rural Health Clinic/Center	$0	$1.1M
County Of Reno	KS	Public Health or Welfare Agency	$73.8K	$724.2K
Rogena Johnson	KS	Family Medicine Physician	$116.8K	$0
Shean Mcknight	KS	Psychiatry Physician	$98.8K	$0
Alan Davidson	KS	Family Medicine Physician	$4.6K	$0
Eva Gadberry	KS	Clinical Social Worker	$1.2K	$0

Horizons Mental Health Center, Inc — Billing Profile & Reimbursement Data

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Horizons Mental Health Center, Inc — 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