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

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

Grand Lake Mental Health Center, Inc. (NPI 1598213977)

Field	Value
Entity Type	Organization
Organization	Grand Lake Mental Health Center, Inc.
Address	604 S Walnut St
City	Stillwater
State	OK
ZIP	74074
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	September 14, 2016

Payer Source	Total Paid
Medicaid	$22.5M
Medicare	$0

Key Findings

This provider reports no Medicare billing on file and $22.5M in lifetime Medicaid revenue, so the entity is effectively a single-payer (Medicaid) operation in the claims dataset. Analysts should therefore prioritize Medicaid policy, network participation, and state-level reimbursement dynamics when evaluating its financial and operational profile.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 98.7% of this provider's total Medicaid revenue, with T1041 alone representing $21.1M (93.7%). Such concentration means the provider's financial performance is tightly linked to continued enrollment, certification, and reimbursement of the T1041 monthly community behavioral health clinic payment.

The code mix points to a certified community behavioral health clinic model of care: T1041 (20K claims, $1053 avg paid/claim) is the dominant line and H0004 (behavioral health counseling and therapy) and coordinated-care fees (G9009) are the next-largest contributors. This pattern suggests the organization delivers bundled monthly clinic services supplemented by time-based therapy and care-coordination activity rather than a fee-for-service medical model.

Competitive standing by code is moderate-to-solid within Oklahoma: for its main revenue driver T1041 the provider ranks #13 of 97 providers in-state (88th percentile; typical, unremarkable volume for this code), indicating a meaningful regional presence but not an outlier leader. H0004 ranks #160 of 621 providers in-state (74th percentile; typical, unremarkable volume for this code) while G9009 ranks #13 of 73 providers in-state (83th percentile; typical, unremarkable volume for this code), showing consistent mid-to-upper percentile positioning across its primary services.

There is at least one notable documentation outlier: G8431 (Screening for depression is documented as being positive and a follow-up plan is documented) shows 191 claims with $0 avg paid/claim and $0 revenue and ranks #1 of 12 providers in-state (100th percentile; notably above typical state volume for this code). This suggests unusually high capture or reporting of positive depression screens and follow-up plans relative to peers, even though it does not generate separate Medicaid revenue on file.

Several billed codes report nonzero claim counts but $0 avg paid/claim and $0 revenue (examples include T1016 with 1.3K claims, $0 avg paid/claim, $0 revenue, plus H0034, H2017, and others in the list). That pattern is consistent with many services being recorded for encounter, quality, or programmatic reporting or being reimbursed as part of the T1041 bundle rather than as standalone paid line items.

The provider's NPI was enumerated on 2016-09-14 (~10 years ago), indicating an established presence in the market and suggesting operational experience with Oklahoma Medicaid behavioral health billing. Given the heavy reliance on the T1041 per-month reimbursement, the provider's revenue profile is sensitive to any changes in clinic certification rules, bundled payment rates, or state-level care coordination policies.

Medicaid: Complete Services Breakdown

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1041	Medicaid certified community behavioral health clinic services, per month	19,990	$1,050	$21.1M
H0004	Behavioral health counseling and therapy, per 15 minutes	19,730	$40	$690.7K
G9009	Coordinated care fee, risk adjusted maintenance, level 3	1,260	$350	$434K
G9010	Coordinated care fee, risk adjusted maintenance, level 4	210	$1,010	$212.1K
G9002	Coordinated care fee, maintenance rate	290	$150	$42.9K
H0031	Mental health assessment, by non-physician	460	$40	$16.1K
H0032	Mental health service plan development by non-physician	260	$60	$14.8K
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…	710	$10	$6.4K
H0002	Behavioral health screening to determine eligibility for admission to treatment program	480	$10	$5.7K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	450	$1	$1.4K

Showing 1–10 of 19

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Oklahoma Distribution

Grand Lake Mental Health Center, Inc. — 0 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oklahoma

Full comparison — all codes billed, vs. Oklahoma median

19 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1041	Medicaid certified community behavioral health clinic services, per month	13	100	4,790	$880	$8.3M
T1016	Case management, each 15 minutes	80	140	3,200	$60	$2.3M
H0004	Behavioral health counseling and therapy, per 15 minutes	160	620	6,640	$70	$1.2M
G9009	Coordinated care fee, risk adjusted maintenance, level 3	13	70	320	$320	$317.4K
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…	886	1,680	820	$90	$307K
G9010	Coordinated care fee, risk adjusted maintenance, level 4	16	40	140	$970	$285.1K
H2017	Psychosocial rehabilitation services, per 15 minutes	214	240	1,280	$50	$259.4K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	1,054	1,750	870	$70	$254.4K
G9002	Coordinated care fee, maintenance rate	45	70	630	$140	$216.3K
H2015	Comprehensive community support services, per 15 minutes	127	150	770	$40	$73.8K

Showing 1–10 of 19

Related Providers

Other providers that share a Tax Identification Number (TIN) with Grand Lake Mental Health Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Grand Lake Mental Health Center, Inc.	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$47.2M
Grand Lake Mental Health Center, Inc.	OK	Community/Behavioral Health Agency	$0	$38.5M
Grand Lake Mental Health Center, Inc.	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$38.3M
Grand Lake Mental Health Center, Inc.	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$24.8M
Grand Lake Mental Health Center, Inc.	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$23M
Grand Lake Mental Health Center, Inc.	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$15.9M
Grand Lake Mental Health Center Inc	OK	Community/Behavioral Health Agency	$0	$15.4M
Grand Lake Mental Health Center Inc	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$11.7M
Grand Lake Mental Health Center, Inc.	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$11M
Grand Lake Mental Health Center, Inc.	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$9.8M

Nearby Providers

Other providers in the same ZIP code as Grand Lake Mental Health Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Stillwater Medical Center Authority	OK	General Acute Care Hospital	$0	$15.7M
Stillwater Medical Center Authority	OK	Family Medicine Physician	$0	$13.2M
South Central Emergency Services PC	OK	Emergency Medicine Physician	$0	$12.6M
Dysphagia Specialists, PLLC	OK	Speech-Language Pathologist	$0	$5.1M
Knight Medical Supply L.L.C.	OK	Durable Medical Equipment & Medical Supplies	$0	$4.3M
Stewart & Schuessler Orthodontics, PC	OK	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$3.2M
Osu Center For Health Sciences	OK	Clinic/Center	$0	$2.9M
Ocean Dental, PC	OK	General Practice Dentistry	$0	$2.1M
Cockrell Eyecare Center PLLC	OK	Optometrist	$0	$1.9M
Matthew Flood	OK	Ophthalmology Physician	$1.1M	$0

Grand Lake Mental Health Center, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References