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NPI 1437127131 · Rockford, IL · Mental Health Clinic/Center (Including Community Mental Health Center)
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Stepping Stones Of Rockford, Inc is a mental health clinic/center (including community mental health center) provider located in Rockford, Illinois. This profile covers 1 Medicare and 15 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Stepping Stones Of Rockford, Inc |
| Address | 706 N Main St |
| City | Rockford |
| State | IL |
| ZIP | 61103 |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| NPI Enumerated | March 9, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $38.2M |
| Medicare | $8.4K |
This provider is overwhelmingly Medicaid-focused: reported lifetime Medicaid revenue is $38.2M compared with just $8.4K in Medicare revenue, so financially the practice is effectively single-payer with Medicaid as the dominant source of billings. The tiny Medicare total suggests limited engagement with traditional Medicare clinical billing outside of a specific telehealth role.
Medicaid revenue is highly concentrated: the precomputed top three Medicaid codes account for 91.0% of the provider's Medicaid revenue, driven primarily by H2015 (80.2%), with H0004 (6.4%) and T1016 (4.4%) making up the remainder of that top-three share. This concentration indicates the business model centers on a narrow set of service lines rather than a broad mix of outpatient medical E/M codes.
H2015 (Comprehensive community support services) is the single dominant Medicaid line: 311.9K claims, $98 avg paid/claim, $30.6M revenue (80.2% of this provider's total Medicaid revenue) and it ranks #1 of 431 providers in-state (100th percentile; extreme outlier). That combination of claim volume and rank identifies the organization as a statewide leader in delivering intensive community support services and implies substantial staff capacity and program scale devoted to those per-15-minute services.
The provider’s Medicare footprint is narrowly focused on telehealth originating-site fees: Q3014 accounts for 100.0% of Medicare revenue with 433 claims, $19 avg paid/claim, $8.2K revenue, and ranks #41 of 1090 providers nationally (96th percentile; notably above typical national volume for this code). Operationally, this pattern suggests they primarily serve as an originating site for telehealth visits rather than billing Medicare for in-person psychiatric or evaluation-and-management services.
Beyond the top Medicaid code, the clinical mix includes therapy, case management, multidisciplinary evaluation, and medication support: H0004 (21.6K claims, $114 avg, $2.5M; 6.4%), T1016 (34.3K claims, $49 avg, $1.7M; 4.4%), and H2000 (12.4K claims, $117 avg, $1.4M; 3.8%) together reflect counseling, care coordination, and evaluation capacity. Notably, H0034 (32.3K claims, $42 avg, $1.4M) ranks #4 of 112 in-state (97th percentile; extreme outlier), signaling a substantial investment in medication training and support services as well.
The extreme reliance on a small set of Medicaid codes creates operational and reimbursement risk: with 91.0% of Medicaid revenue concentrated in the top three codes, changes to state Medicaid policy, rate setting for H2015, or utilization management for comprehensive community support services could materially affect total revenue. This concentration also means payer negotiations and contract design should prioritize those dominant service lines.
Competitive standing is mixed by payer: the provider is a modest participant in Medicare overall given the $8.4K total, but it is a dominant, high-volume statewide provider of at least some Medicaid services — most prominently H2015 where it is an extreme outlier and ranked #1. Analysts should treat the entity as a major local supply source for community support services while recognizing its negligible scale in traditional Medicare clinical billing.
The organization has a long operational history: the NPI was enumerated on 2006-03-09 (~20 years ago), indicating an established presence in the Rockford community that aligns with the sustained high volumes reported for Medicaid behavioral health and support services. That tenure supports the interpretation that large H2015 volumes reflect ongoing programmatic capacity rather than a short-term billing spike.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| Q3014 | Telehealth originating site facility fee | 430 | $20 | $8.2K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 1 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
1 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| Q3014 | 3 | 30 | 50 | $20 | $2.4K |
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
15 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| H2015 | Comprehensive community support services, per 15 minutes | 311,890 | $100 | $30.6M |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 21,560 | $110 | $2.5M |
| T1016 | Case management, each 15 minutes | 34,260 | $50 | $1.7M |
| H2000 | Comprehensive multidisciplinary evaluation | 12,350 | $120 | $1.4M |
| H0034 | Medication training and support, per 15 minutes | 32,280 | $40 | $1.4M |
| H2010 | Comprehensive medication services, per 15 minutes | 9,610 | $30 | $288.1K |
| H2017 | Psychosocial rehabilitation services, per 15 minutes | 5,400 | $30 | $167.5K |
| Q3014 | Telehealth originating site facility fee | 2,850 | $20 | $62.6K |
| T1502 | Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit | 3,120 | $20 | $46.8K |
| H0032 | Mental health service plan development by non-physician | 340 | $70 | $24.6K |
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How this provider's Medicaid billing volume and revenue compare to other Illinois providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Illinois median
15 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| H2015 | Comprehensive community support services, per 15 minutes | 1 | 430 | 3,260 | $80 | $1.3M |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 105 | 800 | 2,480 | $90 | $962.2K |
| H2000 | Comprehensive multidisciplinary evaluation | 59 | 420 | 1,450 | $100 | $631.8K |
| H2017 | Psychosocial rehabilitation services, per 15 minutes | 31 | 60 | 5,920 | $50 | $621.3K |
| T1016 | Case management, each 15 minutes | 28 | 470 | 1,830 | $60 | $475.9K |
| H0034 | Medication training and support, per 15 minutes | 4 | 110 | 1,030 | $40 | $179.2K |
| H2010 | Comprehensive medication services, per 15 minutes | 27 | 250 | 690 | $30 | $145.6K |
| H0002 | Behavioral health screening to determine eligibility for admission to treatment program | 181 | 330 | 210 | $110 | $97.4K |
| 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… | 709 | 760 | 140 | $110 | $67.3K |
| T1502 | Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit | 102 | 230 | 2,330 | $10 | $66.5K |
Showing 1–10 of 15
Other providers in the same ZIP code as Stepping Stones Of Rockford, Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Rosecrance Inc | IL | Mental Health Clinic/Center (Including Community Mental Health Center) | $0 | $43.5M |
| Rosecrance Inc | IL | Mental Health Clinic/Center (Including Community Mental Health Center) | $0 | $3.4M |
| Julie Kafka | IL | Family Medicine Physician | $223.1K | $384.1K |
| Walid Abdallah | IL | Ophthalmology Physician | $547.9K | $0 |
| Gregory Nowak | IL | Cardiovascular Disease Physician | $206K | $152K |
| Rose Stocker | IL | Family Medicine Physician | $71.5K | $245.3K |
| Faisal Raja | IL | Neurology Physician | $29.5K | $194.3K |
| Abdullah Altayeh | IL | Pulmonary Disease Physician | $92.6K | $81.1K |
| Diane Boone | IL | Ophthalmology Physician | $166.7K | $0 |
| Jeffrey Smith | IL | Cardiovascular Disease Physician | $32K | $28K |
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