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

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

Ausable Valley Community Mental Health Services Board (NPI 1417011701)

Field	Value
Entity Type	Organization
Organization	Ausable Valley Community Mental Health Services Board
Address	1199 W Harris Ave
City	Tawas City
State	MI
ZIP	48764
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	December 20, 2006

Payer Source	Total Paid
Medicaid	$116.5M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-centric behavioral health agency: there is no Medicare billing on file and total Medicaid revenue is $116.5M. The NPI was enumerated on 2006-12-20 (~20 years ago), indicating the organization has been operating under this billing identity for roughly two decades.

Revenue is highly concentrated in a small set of Medicaid service lines: the top 3 Medicaid codes by revenue account for 58.9% of total Medicaid revenue. Those top drivers are H2015 ($40.8M, 35.2%), T1017 ($15.1M, 13.0%), and H2016 ($12.4M, 10.7%), indicating most dollars flow from comprehensive community support and targeted case management services.

The code mix signals a predominantly community-based, long-term support model: H2015 (Comprehensive community support services, per 15 minutes) and H2016 (Comprehensive community support services, per diem) together with T1017 (Targeted case management, each 15 minutes) point to a business built around ongoing, frequent contact, care coordination, and per-diem supports rather than one-time procedural care. This suggests operational emphasis on programmatic staffing for frequent community visits, case managers, and day-to-day service delivery infrastructure.

Competitive standing on the largest single code is relatively strong but characterized as typical by the underlying peer flags: H2015 generated $40.8M (35.2% of Medicaid revenue) and ranks #39 of 614 providers in-state (94th percentile; typical, unremarkable volume for this code), meaning the provider is among higher-volume billers for this service but peers consider this level within the expected range. The presence of a high absolute revenue dollar for H2015 nonetheless reinforces the provider’s role as a sizable regional supplier of community support services.

Supported housing and personal-care services also make meaningful contributions to the mix: T1020 (Personal care services, per diem) produced $7.9M (6.8%) and ranks #36 of 221 providers in-state (84th percentile; typical, unremarkable volume for this code), while H0043 (Supported housing, per diem) produced $7.7M (6.7%) and ranks #11 of 130 providers in-state (92th percentile; typical, unremarkable volume for this code). These rankings signal particular strength in housing-related supports relative to many in-state peers.

The provider also maintains a substantial clinical psychotherapy and psychiatric evaluation footprint: 90837 generated $4.8M (4.1%) and ranks #93 of 1956 providers in-state (95th percentile; typical, unremarkable volume for this code), 90791 generated $2.6M (2.2%) and ranks #40 of 784 providers in-state (95th percentile; notably above typical state volume for this code), and 90834 generated $2.1M (1.9%) and ranks #91 of 950 providers in-state (91th percentile; typical, unremarkable volume for this code). The mix indicates in-house clinical capacity for both psychotherapy and psychiatric assessment in addition to community supports.

The provider’s engagement with specialized intensive programs is mixed: H0039 (Assertive community treatment, face-to-face, per 15 minutes) produced $4M (3.5%) but ranks #43 of 67 providers in-state (36th percentile; typical, unremarkable volume for this code), and H0036 (Community psychiatric supportive treatment, face-to-face, per 15 minutes) produced $988.2K (0.9%) and ranks #68 of 93 providers in-state (27th percentile; typical, unremarkable volume for this code). These lower percentiles suggest the organization is not a dominant statewide provider of ACT or certain intensive casework models despite measurable billing in those areas.

From a financial and contracting perspective, the combination of Medicaid-only scale ($116.5M) and concentration (58.9% of Medicaid revenue from three codes) means the provider’s revenue profile is highly sensitive to Medicaid policy, rate changes, or utilization shifts affecting community support and case management lines. For payer or network analysts, this identifies Medicaid reimbursement terms and program definitions for H2015, T1017, and H2016 as the most consequential levers for this entity’s revenue trajectory.

Medicaid: Complete Services Breakdown

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

35 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2015	Comprehensive community support services, per 15 minutes	211,390	$190	$40.8M
T1017	Targeted case management, each 15 minutes	63,450	$240	$15.1M
H2016	Comprehensive community support services, per diem	50,360	$250	$12.4M
T1020	Personal care services, per diem, 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…	50,360	$160	$7.9M
H0043	Supported housing, per diem	53,710	$140	$7.7M
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…	16,730	$290	$4.8M
H0039	Assertive community treatment, face-to-face, per 15 minutes	15,230	$270	$4M
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…	15,510	$220	$3.3M
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…	17,590	$160	$2.7M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	5,370	$480	$2.6M

Showing 1–10 of 35

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Michigan Distribution

Ausable Valley Community Mental Health Services Board — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

35 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2016	Comprehensive community support services, per diem	45	300	6,660	$310	$8.7M
T1017	Targeted case management, each 15 minutes	31	180	10,890	$210	$8.1M
H2015	Comprehensive community support services, per 15 minutes	39	610	14,740	$90	$6M
H0039	Assertive community treatment, face-to-face, per 15 minutes	43	70	20,710	$180	$5.1M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	68	90	8,750	$300	$4.7M
T1020	Personal care services, per diem, 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…	36	220	7,030	$170	$4.6M
H0043	Supported housing, per diem	11	130	10,330	$210	$4.5M
S5161	Emergency response system; service fee, per month (excludes installation and testing)	35	40	4,680	$30	$4M
H2014	Skills training and development, per 15 minutes	72	130	20,660	$50	$3.8M
T1016	Case management, each 15 minutes	59	120	8,060	$210	$3.4M

Showing 1–10 of 35

Ausable Valley Community Mental Health Services Board — Billing Profile & Reimbursement Data

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Ausable Valley Community Mental Health Services Board — 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

Frequently Asked Questions

References