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

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

County Of Portage (NPI 1386720043)

Field	Value
Entity Type	Organization
Organization	County Of Portage
Address	817 Whiting Ave
City	Stevens Point
State	WI
ZIP	54481
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	October 27, 2006

Payer Source	Total Paid
Medicaid	$19.9M
Medicare	$0

Key Findings

COUNTY OF PORTAGE has no Medicare billing on file and is effectively a single-payer Medicaid provider at scale, reporting $19.9M in lifetime Medicaid revenue and no Medicare revenue; this creates a concentrated payer mix where Medicaid policy and reimbursement changes will materially affect its cash flow. The provider's NPI was enumerated on 2006-10-27 (≈20 years ago), indicating a long-tenured presence in the market which supports continuity in its Medicaid-focused operations.

Revenue is highly concentrated in a very small set of service codes: the top 3 Medicaid codes together account for 96.8% of the provider's total Medicaid revenue, with H2017 alone representing $15M (75.3% of Medicaid revenue). That level of concentration implies that changes to coverage, rates, or utilization management for those specific codes would disproportionately affect overall receipts.

The code mix points to a community mental health and rehabilitation operating model: H2017 (psychosocial rehabilitation services, per 15 minutes) is dominant with 143K claims and a $105 avg paid/claim, while T1016 (case management, each 15 minutes) contributes $2.9M from 42.7K claims at $68 avg paid/claim. Together these time‑based, frequent-unit codes indicate day-to-day service delivery is organized around short interval encounters and care coordination rather than high-fee episodic procedures.

COUNTY OF PORTAGE’s competitive standing varies by service line: for H2017 it ranks #19 of 58 providers in-state (68th percentile), indicating typical to modest leadership at the state level rather than dominance; for T1016 it ranks #33 of 224 (86th percentile), showing a relatively stronger statewide position in case management. The third top code, 99199, ranks #16 of 57 (73rd percentile), consistent with a mid-to-upper state percentile presence across its main Medicaid service lines.

The provider relies materially on the unlisted/other-services code 99199 ($1.4M revenue, 35.7K claims, $39 avg paid/claim; 7.0% of Medicaid revenue), which suggests a nontrivial portion of billed services are being captured with a catch‑all code for items not otherwise classified. For payers and auditors this pattern signals a need to review service descriptions attached to 99199 claims to understand the mix of care elements being billed under that code.

Several ancillary or lower-revenue services are present but not significant relative to the main mental-health portfolio: crisis intervention S9484 is small ($15.7K, ranks #59 of 65, 9th percentile) and pediatric prophylaxis D1120 is minimal ($612, ranks #454 of 519, 13th percentile). These low-percentile ranks show COUNTY OF PORTAGE is not a major statewide provider for those specific services and that its operations are tightly focused on psychosocial rehab and case management.

From an operational and contracting perspective, the dominant use of per-15-minute codes (H2017 and T1016) and high claim volumes (143K and 42.7K claims respectively) imply staffing models with frequent, short-duration encounters and high administrative throughput. Payers negotiating rates or utilization controls should account for the provider’s volume sensitivity to per‑unit reimbursement changes and the potential administrative impact of any edits to time‑based billing policies.

Medicaid: Complete Services Breakdown

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

31 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2017	Psychosocial rehabilitation services, per 15 minutes	142,950	$110	$15M
T1016	Case management, each 15 minutes	42,670	$70	$2.9M
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	35,700	$40	$1.4M
T1017	Targeted case management, each 15 minutes	3,730	$70	$272.2K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	800	$70	$58.2K
T1999	Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks"	420	$130	$54.3K
D1351	Sealant - per tooth	2,540	$20	$40.6K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	570	$60	$34.4K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	2,870	$10	$34.4K
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…	1,450	$20	$26.2K

Showing 1–10 of 31

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wisconsin Distribution

County Of Portage — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

31 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2017	Psychosocial rehabilitation services, per 15 minutes	19	60	57,750	$100	$18.9M
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	16	60	16,890	$60	$2.9M
S9484	Crisis intervention mental health services, per hour	59	70	7,330	$60	$2.5M
T1017	Targeted case management, each 15 minutes	37	90	3,130	$100	$2M
T1016	Case management, each 15 minutes	33	220	7,110	$70	$1.7M
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…	793	1,630	270	$40	$205.3K
A9999	Miscellaneous dme supply or accessory, not otherwise specified	46	60	460	$170	$177.3K
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…	514	1,760	250	$40	$173.2K
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.	143	350	300	$50	$157.9K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	398	500	3,140	$20	$148.9K

Showing 1–10 of 31

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
County Of Portage	WI	Land Ambulance	$390.6K	$786K

Nearby Providers

Other providers in the same ZIP code as County Of Portage, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
La Clinica De Los Campesinos, Inc	WI	Federally Qualified Health Center (FQHC)	$0	$24.3M
Aspirus Stevens Point Hospital & Clinics, Inc.	WI	General Acute Care Hospital	$0	$15.6M
Inclusa Inc	WI	Health Maintenance Organization	$0	$6.4M
Brittany Printz	WI	Behavior Analyst	$0	$5.2M
Stevens Point Area Public School District	WI	Local Education Agency (LEA)	$0	$3.1M
Emily Paschen	WI	Behavior Analyst	$0	$2.9M
Lincare Inc	WI	Durable Medical Equipment & Medical Supplies	$0	$2.2M
Northwest Counseling & Guidance Clinic	WI	Adolescent and Children Mental Health Clinic/Center	$0	$2M
Aspirus Stevens Point Hospital & Clinics, Inc.	WI	General Practice Physician	$0	$2M
Ambulatory Surgical Center Of Stevens Point LLC	WI	Ambulatory Surgical Clinic/Center	$553.8K	$0

County Of Portage — Billing Profile & Reimbursement Data

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County Of Portage — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References