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

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

Mindoula Health Inc. (NPI 1558843813)

Field	Value
Entity Type	Organization
Organization	Mindoula Health Inc.
Address	8040 Georgia Ave Ste 170
City	Silver Spring
State	MD
ZIP	20910
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	September 4, 2018

Payer Source	Total Paid
Medicaid	$29M
Medicare	$0

Key Findings

MINDOULA HEALTH INC. records no Medicare billing on file and is effectively a single-payer Medicaid operation with $29M in lifetime Medicaid revenue, indicating its business activity and revenue base are concentrated entirely in the Medicaid program. This payer mix means analyses should focus on Medicaid policy, rates, and state-level competitive dynamics rather than Medicare market behavior.

Revenue concentration is extreme: the precomputed top 3 Medicaid codes account for 100.0% of the provider’s total Medicaid revenue, indicating the organization’s income is highly dependent on a very narrow set of service lines. Such concentration elevates sensitivity to reimbursement changes or utilization shifts for those specific codes.

H0031 dominates the portfolio: 112K claims, $231 avg paid/claim, $25.9M revenue, representing 89.1% of this provider’s total Medicaid revenue. MINDOULA ranks #1 of 28 providers in-state for H0031 and is described as an extreme outlier, meaning its volume for non-physician mental health assessments is far above typical state activity and defines the provider’s operational footprint.

99490 is the second revenue driver with 17.1K claims, $185 avg paid/claim, $3.2M revenue, composing 10.9% of the provider’s Medicaid revenue. The provider ranks #1 of 113 in-state for 99490 and is likewise labeled an extreme outlier, signaling a substantial focus on provider-directed clinical staff care coordination and chronic care management services.

Service-line implications from the code mix point to a behavioral health–centered model built on high-volume, non-physician mental health assessments (H0031) combined with structured care coordination for patients with multiple chronic conditions (99490). This suggests operational emphasis on intake/assessment throughput and ongoing clinical-staff–led coordination rather than physician-delivered procedural care.

Competitive standing within Maryland is dominant for the specific codes reported: both H0031 and 99490 are at the 100th percentile statewide and rank #1 among peers, identifying MINDOULA as a major provider for these Medicaid services rather than a modest participant. Analysts should interpret statewide comparisons cautiously, as the provider’s dominance is code-specific rather than indicative of broad-service leadership across all behavioral health categories.

The provider’s NPI was enumerated on 2018-09-04 (~8 years ago), providing several years of operability in the Medicaid market for the volumes observed. This tenure supports the interpretation that the high volumes reflect established operational scale rather than a short-term reporting anomaly.

Given that two codes (H0031 and 99490) together account for essentially all reported Medicaid revenue and are both extreme outliers in state rankings, any change in state reimbursement policy, prior authorization, or behavioral-health program design for these services would likely have a material impact on MINDOULA’s financials. Monitoring state-level policy updates and utilization management activity for H0031 and 99490 should be a priority for payer/provider analysts assessing risk and sustainability.

Medicaid: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0031	Mental health assessment, by non-physician	111,960	$230	$25.9M
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	17,140	$190	$3.2M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Maryland Distribution

Mindoula Health Inc. — 2 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maryland

Full comparison — all codes billed, vs. Maryland median

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0031	Mental health assessment, by non-physician	1	30	120	$230	$1.1M
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	1	110	340	$50	$48.2K

Nearby Providers

Other providers in the same ZIP code as Mindoula Health Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Quality One Care Home Health Inc.	MD	Home Health Agency	$0	$61.8M
Project Redirect Inc	MD	Adult Mental Health Clinic/Center	$0	$48.4M
Automatic Nursing Care Services, Inc.	MD	Home Health Agency	$0	$43.8M
Symbral Foundation For Community Services Inc	MD	Intellectual Disabilities Intermediate Care Facility	$0	$17.3M
Mcs, PC	MD	Community/Behavioral Health Agency	$0	$14.5M
Vesta, Inc.	MD	Community/Behavioral Health Agency	$0	$9.9M
T S Trask Inc	MD	Community/Behavioral Health Agency	$0	$9.2M
Affiliated Sante Group	MD	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$8.6M
Consonant Healing Medical Associates	MD	Surgery Physician	$0	$7.2M
Community Clinic, Inc	MD	General Practice Dentistry	$0	$6.5M

Mindoula Health Inc. — Billing Profile & Reimbursement Data

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Mindoula Health Inc. — 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

Nearby Providers

Frequently Asked Questions

References