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.

Mental Health Centers Of Western Illinois (NPI 1558451716)

Field	Value
Entity Type	Organization
Organization	Mental Health Centers Of Western Illinois
Address	700 Se Cross St
City	Mt Sterling
State	IL
ZIP	62353
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	October 16, 2006

Payer Source	Total Paid
Medicaid	$4.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2015	Comprehensive community support services, per 15 minutes	50,090	$40	$2M
H0004	Behavioral health counseling and therapy, per 15 minutes	26,720	$60	$1.7M
H2000	Comprehensive multidisciplinary evaluation	4,770	$90	$419.7K
T1016	Case management, each 15 minutes	5,280	$30	$163.6K
H2010	Comprehensive medication services, per 15 minutes	2,380	$30	$68.9K
H2011	Crisis intervention service, per 15 minutes	480	$120	$56K
T1502	Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit	3,100	$20	$46.6K
H0032	Mental health service plan development by non-physician	150	$40	$5.8K
H0031	Mental health assessment, by non-physician	50	$70	$3.4K
T1019	Personal care services, per 15 minutes, 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…	20	$150	$2.9K

Showing 1–10 of 11

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

Mental Health Centers Of Western Illinois — 0 of 11 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

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2015	Comprehensive community support services, per 15 minutes	38	430	3,260	$80	$1.3M
H0004	Behavioral health counseling and therapy, per 15 minutes	80	800	2,480	$90	$962.2K
H2011	Crisis intervention service, per 15 minutes	92	160	1,060	$180	$959.9K
H2000	Comprehensive multidisciplinary evaluation	130	420	1,450	$100	$631.8K
T1016	Case management, each 15 minutes	139	470	1,830	$60	$475.9K
T1019	Personal care services, per 15 minutes, 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…	18	20	130	$110	$161.4K
H2010	Comprehensive medication services, per 15 minutes	75	250	690	$30	$145.6K
H0002	Behavioral health screening to determine eligibility for admission to treatment program	279	330	210	$110	$97.4K
T1502	Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit	104	230	2,330	$10	$66.5K
H0031	Mental health assessment, by non-physician	172	220	190	$90	$33.7K

Showing 1–10 of 11

Mental Health Centers Of Western Illinois — Billing Profile & Reimbursement Data

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Mental Health Centers Of Western Illinois — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Frequently Asked Questions

References