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.

Dodge County (NPI 1417105958)

Field	Value
Entity Type	Organization
Organization	Dodge County
Address	199 County Road Df 3rd Floor
City	Juneau
State	WI
ZIP	53032
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	September 8, 2008

Payer Source	Total Paid
Medicaid	$30.5M
Medicare	$0

Key Findings

This entity has no Medicare billing on file and is effectively a single-payer Medicaid operation, reporting total Medicaid revenue of $30.5M. Analysts should treat Medicaid as the sole source of fee-for-service Medicare/Medicaid claims data for this profile when assessing payer mix and financial exposure.

Revenue is highly concentrated: the precomputed top 3 Medicaid codes account for 100.0% of this provider's total Medicaid revenue. H2017 drives the majority of revenue at $23.1M (75.8% of Medicaid revenue; 215.9K claims, $107 avg paid/claim), followed by 99199 at $7.3M (24.0% of Medicaid revenue; 103.1K claims, $71 avg paid/claim), and S9484 contributing $39.9K (0.1% of Medicaid revenue; 1.1K claims, $35 avg paid/claim).

The code mix signals a community behavioral health service model focused on time-based psychosocial rehabilitation: H2017 (Psychosocial rehabilitation services, per 15 minutes) is the dominant billing code, implying frequent, unitized session delivery rather than primarily procedure-driven care. The large share billed to 99199 (unlisted other medicine services) suggests substantial use of non-specific or catch-all billing categories alongside standard psychosocial rehab units, which indicates a mix of standard session-based services and other less-standardized interventions.

Competitive standing within the state is mixed by code. For H2017 the provider ranks #11 of 58 providers in-state (82th percentile; typical, unremarkable volume for this code), indicating above-median activity but not a statewide leader; for 99199 it ranks #7 of 57 providers in-state (89th percentile; typical, unremarkable volume for this code), reflecting comparatively high activity for that unlisted-category billing; S9484 ranks #54 of 65 providers in-state (17th percentile; typical, unremarkable volume for this code), showing very limited crisis-hour billing relative to peers.

Despite the large dollar concentration in H2017 and 99199, the statistical characterization supplied for each code is 'typical, unremarkable volume for this code.' This suggests that, while revenue is concentrated, volumes fall within ordinary ranges observed across in-state peers rather than being flagged as extreme outliers in the supplied metrics.

The reliance on two codes for virtually all Medicaid revenue creates operational and reimbursement concentration risk: policy, rate, or audit changes affecting H2017 or 99199 reimbursement could materially impact the provider's $30.5M Medicaid revenue base. Analysts evaluating sustainability or contract negotiations should prioritize how changes to unit rates, utilization controls, or coding guidance for these codes would affect revenue.

NPI enrollment date indicates a long-tenured presence: NPI enumerated 2008-09-08 (~18 years ago). Combined with $30.5M in Medicaid revenue and high volumes of unitized psychosocial rehab claims (215.9K H2017 claims), this tenure and scale point to an established community/behavioral health agency with a sizable operational footprint in its service area.

The minimal use of crisis intervention billing (S9484: 1.1K claims, $39.9K revenue, ranks #54 of 65 in-state) indicates either limited provision or different billing practices for crisis services relative to peers. For payers and network planners, this suggests crisis intervention is a minor revenue line for this provider and should not be assumed to be a core delivered service based on Medicaid claims alone.

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2017	Psychosocial rehabilitation services, per 15 minutes	215,910	$110	$23.1M
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	103,090	$70	$7.3M
S9484	Crisis intervention mental health services, per hour	1,140	$40	$39.9K

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

Dodge County — 0 of 3 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

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2017	Psychosocial rehabilitation services, per 15 minutes	11	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.	7	60	16,890	$60	$2.9M
S9484	Crisis intervention mental health services, per hour	54	70	7,330	$60	$2.5M

Dodge County — Billing Profile & Reimbursement Data

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Dodge County — 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