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.

Access Community Health Centers, Inc. (NPI 1417055617)

Field	Value
Entity Type	Organization
Organization	Access Community Health Centers, Inc.
Address	3434 E Washington Ave
City	Madison
State	WI
ZIP	53704
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	September 20, 2006

Payer Source	Total Paid
Medicaid	$51.9M
Medicare	$0

Key Findings

ACCESS COMMUNITY HEALTH CENTERS, INC. reports $51.9M in Medicaid revenue and has no Medicare billing on file, making its public payer footprint effectively single‑payer and Medicaid‑centric. This concentration means analyses of utilization and risk should be interpreted in the context of Medicaid policy, rates, and patient mix rather than Medicare benchmarks.

Revenue is highly concentrated in a single encounter code: T1015 accounts for $49.1M (95.0% of the provider's Medicaid revenue) and, together with 99213 ($724.5K, 1.4%) and 99214 ($573.4K, 1.1%), the top three Medicaid codes account for 97.6% of total Medicaid revenue. That extreme dependence on a bundled clinic/encounter code exposes the provider’s topline to changes in FQHC visit policy, rate adjustments for T1015, or auditing focus on encounter-level billing.

The provider’s taxonomy as a Federally Qualified Health Center (FQHC) combined with dominance of T1015 (Clinic visit/encounter, all‑inclusive) and the presence of G0467 underscores an operational model built around high-volume, bundled primary care encounters. The code mix suggests care is delivered primarily through FQHC‑style, per‑encounter visits rather than fee‑for‑service procedural revenue streams.

Dental services are a major volume line despite low per‑claim payments: D1110 (18.6K claims, $37.2K revenue; rank #7 of 497, 99th percentile, extreme outlier), D1206 (36.8K claims, $36.8K revenue; rank #11 of 543, 98th percentile, extreme outlier), D0140 (24.6K claims, $24.6K revenue; rank #2 of 340, 100th percentile, extreme outlier) and D0150 (18.6K claims, $18.6K revenue; rank #8 of 414, 98th percentile, extreme outlier) all show exceptionally high claim volumes for dental prevention and basic restorative services. This pattern indicates a substantial, high‑throughput dental program likely integrated into primary care workflows for the Medicaid population.

Behavioral health and remote care activity are also notable: 90832 psychotherapy (11K claims, $407.1K revenue; rank #2 of 262, 100th percentile, extreme outlier) and telehealth‑related codes such as G2025 (2.1K claims, $26.9K revenue; rank #1 of 60, 100th percentile, extreme outlier) and 99442 (5.8K claims, $86.6K revenue; rank #2 of 114, 99th percentile, extreme outlier) point to robust delivery of mental health and telephonic/telehealth services. Those volumes suggest the FQHC operates a sizable behavioral health and virtual care footprint alongside in‑person encounters.

Preventive and pediatric care features in the mix but at modest revenue share: 99391 (1.8K claims, $83K), 99392 (1.3K claims, $63.2K) and 99393 (879 claims, $43.1K) appear alongside active immunization delivery (90686: 7K claims, $48.9K; 91322: 149 claims, $17.6K). The presence of routine well‑visit and vaccine codes supports a comprehensive primary care offering that includes preventive services for children and adults within the Medicaid population.

Across multiple codes the provider ranks at or near the top of in‑state peers, signaling a dominant regional presence for several service lines: T1015 ranks #2 of 60 (98th percentile, extreme outlier), G2025 ranks #1 of 60 (100th percentile, extreme outlier), and numerous dental and telehealth codes fall in the 97th–100th percentiles. These rank/percentile patterns characterize the organization as a major in‑state provider for bundled clinic encounters, telehealth distant‑site services, behavioral health encounters, and high‑volume dental care.

The provider’s NPI was enumerated 2006-09-20 (~20 years ago), indicating long tenure in the market and sustained Medicaid operations. Given the combination of long standing FQHC status, extreme revenue concentration in T1015, and leading in‑state ranks across telehealth, behavioral health, and dental volumes, the organization appears operationally optimized for high‑volume, Medicaid‑reimbursed, encounter‑based care rather than procedure‑driven Medicare revenue streams.

Medicaid: Complete Services Breakdown

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

101 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	186,620	$260	$49.1M
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…	34,500	$20	$724.5K
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…	17,380	$30	$573.4K
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…	11,000	$40	$407.1K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	4,230	$20	$101.6K
99442	N/A	5,770	$20	$86.6K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	1,840	$50	$83K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	1,320	$50	$63.2K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	6,390	$10	$57.5K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	6,980	$10	$48.9K

Showing 1–10 of 101

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

Access Community Health Centers, Inc. — 18 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

101 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	2	60	4,880	$230	$4.9M
D2930	N/A	53	80	410	$150	$427.7K
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…	73	1,630	270	$40	$205.3K
D7240	N/A	14	20	130	$220	$203.5K
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…	108	120	490	$100	$179.5K
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…	44	1,760	250	$40	$173.2K
D7230	N/A	11	30	110	$180	$163.8K
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.	179	350	300	$50	$157.9K
D2392	Post 2 surface resin‑based composite	15	270	510	$60	$123.3K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	7	220	430	$50	$111.4K

Showing 1–10 of 101

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jake Quinn	WI	Medical Physician Assistant	$115.8K	$0
Kirsten Abramson	WI	Family Medicine Physician	$109.6K	$0
Yao Liu	WI	Ophthalmology Physician	$88.7K	$0
Ford Ballantyne	WI	Cardiovascular Disease Physician	$43.5K	$1K
Vincent Minichiello	WI	Family Medicine Physician	$21.8K	$0
Jeremiah Shaw	WI	Family Medicine Physician	$12.1K	$0
Nicholas Sullivan	WI	Family Medicine Physician	$7.2K	$0

Nearby Providers

Other providers in the same ZIP code as Access Community Health Centers, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dane County Department Of Human Services	WI	Community/Behavioral Health Agency	$0	$187.1M
Dane County Human Services	WI	Community/Behavioral Health Agency	$0	$37.2M
Dane County Human Services	WI	Community/Behavioral Health Agency	$0	$18.1M
Dane County Department Of Human Services	WI	Case Management Agency	$0	$18M
Psychological Addiction Services LLC	WI	Methadone Clinic	$138K	$8.5M
Care Wisconsin First, Inc.	WI	Health Maintenance Organization	$0	$7.4M
Teamwork Associates, Inc	WI	Case Management Agency	$0	$7.3M
Dane County Human Services	WI	Public Health or Welfare Agency	$0	$6.1M
Familia Dental Madison East LLC	WI	Dental Clinic/Center	$0	$5.9M
Brianna Kauer	WI	Behavior Analyst	$0	$1.8M

Access Community Health Centers, Inc. — Billing Profile & Reimbursement Data

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Access Community Health Centers, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References