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

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

The Thresholds (NPI 1447407333)

Field	Value
Entity Type	Organization
Organization	The Thresholds
Address	4101 N Ravenswood Ave
City	Chicago
State	IL
ZIP	60613
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	August 21, 2008

Payer Source	Total Paid
Medicaid	$43.3M
Medicare	$0

Key Findings

THE THRESHOLDS is effectively a single-payer Medicaid provider: there is no Medicare billing on file and its reported lifetime Medicaid revenue is $43.3M. This places the organization squarely within Medicaid-funded behavioral health services rather than Medicare-focused care, concentrating its entire documented billing footprint on state Medicaid programs.

Revenue is highly concentrated in a very small set of service codes: the precomputed top three Medicaid codes account for 92.6% of this provider's total Medicaid revenue. The top contributors are H2016 ($21.9M, 50.5%), H0039 ($14.2M, 32.8%), and H2015 ($4M, 9.3%), which together drive virtually all reported Medicaid receipts for the entity.

The code mix indicates an operation built around intensive, community-based behavioral health services. Large volumes for H2016 (204.4K claims, $107 avg paid/claim) and H0039 (111.8K claims, $127 avg paid/claim) point to sustained, high-frequency delivery models such as comprehensive community supports and assertive community treatment teams, with per-diem and per-15-minute modalities dominant in the billing profile.

THE THRESHOLDS is a major in-state competitor for its top service lines: H2016 ranks #2 of 58 providers in Illinois (98th percentile; extreme outlier, far above typical state volume for this code) and H0039 ranks #3 of 47 providers in-state (96th percentile; notably above typical state volume for this code). These ranks signal market dominance in those specific community-based service categories rather than a broad-based statewide dominance across all behavioral health services.

While H2015 is in the top three revenue drivers, its relative standing is less exceptional: H2015 ($4M) ranks #47 of 431 providers in-state (89th percentile; typical, unremarkable volume for this code). This contrast suggests THE THRESHOLDS’ scale is concentrated in per-diem and ACT models rather than across all comprehensive community support billing modalities.

Case management and related supports are also material but secondary: T1016 appears with 51.7K claims and $2.1M revenue (4.8% of Medicaid revenue) and ranks #18 of 465 providers in-state (96th percentile; notably above typical state volume). The presence of high case-management volume reinforces the profile of an organization delivering coordinated, frequent-touch community services.

The provider’s claim-level volumes are substantial in absolute terms (e.g., 204.4K H2016 claims and 111.8K H0039 claims), which combined with an NPI enumeration date of 2008-08-21 (~18 years ago) indicate an established operation with sustained capacity to manage high-volume, ongoing community-based treatment programs. Tenure plus volume supports the inference of mature program infrastructure for Medicaid behavioral health delivery.

The very high concentration of Medicaid revenue in a handful of codes (92.6% from the top three) creates both operational leverage and exposure: dominance in H2016 and H0039 positions the provider strongly for contracts and referrals tied to community support and ACT services, but it also means the provider’s financial performance is highly sensitive to policy, rate, or utilization changes affecting those specific Medicaid service lines.

Medicaid: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2016	Comprehensive community support services, per diem	204,440	$110	$21.9M
H0039	Assertive community treatment, face-to-face, per 15 minutes	111,820	$130	$14.2M
H2015	Comprehensive community support services, per 15 minutes	42,400	$100	$4M
T1016	Case management, each 15 minutes	51,650	$40	$2.1M
H2000	Comprehensive multidisciplinary evaluation	7,410	$80	$600.1K
H0004	Behavioral health counseling and therapy, per 15 minutes	3,940	$80	$322.9K
H2010	Comprehensive medication services, per 15 minutes	1,470	$50	$76.2K
H2011	Crisis intervention service, per 15 minutes	420	$170	$69.5K
H0031	Mental health assessment, by non-physician	390	$100	$36.8K
H0032	Mental health service plan development by non-physician	340	$90	$28.9K

Showing 1–10 of 12

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Illinois Distribution

The Thresholds — 3 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Illinois

Full comparison — all codes billed, vs. Illinois median

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0039	Assertive community treatment, face-to-face, per 15 minutes	3	50	14,910	$140	$4.1M
H2016	Comprehensive community support services, per diem	2	60	11,700	$130	$3.5M
H2015	Comprehensive community support services, per 15 minutes	47	430	3,260	$80	$1.3M
H0004	Behavioral health counseling and therapy, per 15 minutes	318	800	2,480	$90	$962.2K
H2011	Crisis intervention service, per 15 minutes	95	160	1,060	$180	$959.9K
H2000	Comprehensive multidisciplinary evaluation	93	420	1,450	$100	$631.8K
T1016	Case management, each 15 minutes	18	470	1,830	$60	$475.9K
H0034	Medication training and support, per 15 minutes	73	110	1,030	$40	$179.2K
H2010	Comprehensive medication services, per 15 minutes	99	250	690	$30	$145.6K
H0002	Behavioral health screening to determine eligibility for admission to treatment program	126	330	210	$110	$97.4K

Showing 1–10 of 12

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Thresholds	IL	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$26.1M
The Thresholds	IL	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$12.4M
The Thresholds	IL	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$8M

Nearby Providers

Other providers in the same ZIP code as The Thresholds, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Howard Brown Health Center	IL	Federally Qualified Health Center (FQHC)	$0	$20.3M
Heartland Alliance Health	IL	Federally Qualified Health Center (FQHC)	$0	$17M
Raymond Bryant	IL	Psychiatric/Mental Health Nurse Practitioner	$104.1K	$3.1M
Manjeet Chawla	IL	Hematology & Oncology Physician	$275.2K	$1.3M
Venkata Buddharaju	IL	Critical Care Medicine (Internal Medicine) Physician	$184.2K	$612.2K
Ronald Hickombottom	IL	Internal Medicine Physician	$46K	$186.3K
Gregory Harms	IL	Clinical Psychologist	$41.8K	$1.4K

The Thresholds — Billing Profile & Reimbursement Data

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The Thresholds — 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