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NPI 1518068071 · Traverse City, MI · Community/Behavioral Health Agency
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Northern Lakes Community Mental Health Authority is a community/behavioral health agency provider located in Traverse City, Michigan. This profile covers 0 Medicare and 57 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 | Northern Lakes Community Mental Health Authority |
| Address | 105 Hall Street |
| City | Traverse City |
| State | MI |
| ZIP | 49684 |
| Taxonomy | Community/Behavioral Health Agency |
| NPI Enumerated | September 26, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $148.6M |
| Medicare | $0 |
This provider is effectively single-payer on file: there is no Medicare billing on file and lifetime Medicaid revenue totals $148.6M, so the organization’s operating footprint and reimbursement depend almost entirely on Medicaid rather than Medicare. Analysts should treat Medicare benchmarks as inapplicable for this entity and focus competitive comparisons to Michigan Medicaid peers.
Revenue is concentrated in a small set of community behavioral-health services: the precomputed top 3 Medicaid codes by revenue account for 37.5% of this provider's total Medicaid revenue, with T1017 ($21.9M, 15.4%), H2016 ($18.5M, 13.0%), and T1020 ($13M, 9.1%) driving the largest shares. This concentration indicates a reliance on targeted case management, per‑diem comprehensive community support, and personal care per‑diem as core business lines.
The claims and code mix point to a broad community‑based behavioral health operation that delivers both time‑based team services and individual clinical care: high volumes of H0039 (51K claims, $10.5M), H2011 (23K claims, $7.4M), H0036 (21.4K claims, $6.9M) and clubhouse and peer supports such as H2030 (79K claims, $5.5M) and H0038 (8.4K claims, $1.5M) reflect a service model built on frequent, short-interval contacts and multidisciplinary supports. This suggests staffing and scheduling oriented to case managers, community teams, and frequent face‑to‑face encounters.
On statewide competitive standing, the provider is a major participant in several service lines: examples include 99214 (28K claims, $6.5M) which ranks #98 of 4380 providers in-state (98th percentile; notably above typical state volume), 90847 (23.7K claims, $4.1M) which ranks #5 of 174 (98th percentile; extreme outlier, far above typical state volume), and H2011 which ranks #3 of 76 (97th percentile; notably above typical state volume). These high ranks show the organization is a leading Medicaid provider in multiple high‑volume outpatient and crisis codes within Michigan.
Several codes are explicitly flagged as statistical outliers or notably above typical state volume and merit attention for service capacity and referral patterns: 90847 is labeled an "extreme outlier, far above typical state volume," H2011 is "notably above typical state volume," and other codes such as T1023 (ranks #8 of 107, 93th percentile; notably above typical state volume) and S0280 (ranks #7 of 88, 93th percentile; notably above typical state volume) also appear well above typical state volumes. These distinctions indicate areas where this provider outperforms most in-state peers and where demand and resource allocation diverge from typical community mental health centers.
The provider’s mix of per‑15‑minute and per‑diem codes (e.g., H0039 per 15 minutes, H2016 per diem, T2022 per month) plus high volumes of assessment and care‑planning codes (T1017, H0032, H0031, 90791) imply substantial ongoing case management and administrative overhead; this translates operationally into sustained needs for case managers, community support staff, and non‑physician clinical personnel to support long‑term care plans and frequent contacts. Revenue figures such as T2022 ($9.5M) and T1017 ($21.9M) underscore the financial importance of recurring management services to the organization’s model.
The provider has a long-standing enrollment history that supports continuity of operations: NPI enumerated 2006-09-26 (~20 years ago). Combined with $148.6M in lifetime Medicaid revenue and strong statewide ranks on multiple codes, this tenure suggests a stable, established community behavioral health authority with deep ties to Michigan’s Medicaid system rather than a new or transient market entrant.
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.
57 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| T1017 | Targeted case management, each 15 minutes | 103,120 | $210 | $21.9M |
| H2016 | Comprehensive community support services, per diem | 80,150 | $230 | $18.5M |
| 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… | 80,110 | $160 | $13M |
| H0039 | Assertive community treatment, face-to-face, per 15 minutes | 51,020 | $210 | $10.5M |
| T2022 | Case management, per month | 18,110 | $530 | $9.5M |
| H2011 | Crisis intervention service, per 15 minutes | 22,960 | $320 | $7.4M |
| H0036 | Community psychiatric supportive treatment, face-to-face, per 15 minutes | 21,440 | $320 | $6.9M |
| T1023 | Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter | 12,630 | $540 | $6.9M |
| 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… | 27,980 | $230 | $6.5M |
| H0032 | Mental health service plan development by non-physician | 14,600 | $370 | $5.5M |
Showing 1–10 of 57
How this provider's Medicaid billing volume and revenue compare to other Michigan providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Michigan median
57 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| T2022 | Case management, per month | 16 | 40 | 3,310 | $490 | $9.4M |
| H2016 | Comprehensive community support services, per diem | 24 | 300 | 6,660 | $310 | $8.7M |
| T1017 | Targeted case management, each 15 minutes | 17 | 180 | 10,890 | $210 | $8.1M |
| H2015 | Comprehensive community support services, per 15 minutes | 319 | 610 | 14,740 | $90 | $6M |
| H0039 | Assertive community treatment, face-to-face, per 15 minutes | 14 | 70 | 20,710 | $180 | $5.1M |
| H0036 | Community psychiatric supportive treatment, face-to-face, per 15 minutes | 22 | 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… | 17 | 220 | 7,030 | $170 | $4.6M |
| H2014 | Skills training and development, per 15 minutes | 107 | 130 | 20,660 | $50 | $3.8M |
| T1016 | Case management, each 15 minutes | 46 | 120 | 8,060 | $210 | $3.4M |
| H2030 | Mental health clubhouse services, per 15 minutes | 4 | 60 | 22,740 | $80 | $2.3M |
Showing 1–10 of 57
Other providers in the same ZIP code as Northern Lakes Community Mental Health Authority, ranked by combined Medicare and Medicaid revenue.
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