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

Why is the Medicaid comparison limited to Michigan 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. Michigan (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 Guidance Center (NPI 1609947027)

Field	Value
Entity Type	Organization
Organization	The Guidance Center
Address	13101 Allen Rd
City	Southgate
State	MI
ZIP	48195
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	November 10, 2006

Payer Source	Total Paid
Medicaid	$91.1M
Medicare	$0

Key Findings

This provider has no Medicare billing on file (Medicare revenue: none) and reports $91.1M in lifetime Medicaid revenue, indicating it operates effectively as a Medicaid-focused organization rather than a dual-payer practice. The absence of Medicare volume means performance and financial exposure will be driven almost entirely by Medicaid reimbursement and policy changes.

Revenue is highly concentrated: the precomputed top three Medicaid codes (H0036, T1017, 90837) account for 51.3% of this provider’s total Medicaid revenue. Individually those codes are H0036 $21.5M (23.9%), T1017 $15.3M (17.0%), and 90837 $9.3M (10.3%), so a small set of service lines drive the majority of dollars.

The code mix and high-revenue items point to a community behavioral health model centered on intensive community treatment, case management, and long psychotherapy sessions. Heavy revenue from H0036 (community psychiatric supportive treatment), T1017 (targeted case management), 90837 (long psychotherapy), plus a material H2021 presence ($8.2M) indicate a programmatic focus on time-based, face-to-face community supports and wrap-around care rather than primarily clinic-based or procedural medicine.

Several individual codes place the provider among the state’s leaders: 90837 ranks #8 of 1956 providers in-state (100th percentile) and H2021 ranks #1 of 49 providers in-state (100th percentile), while H0031 ranks #3 of 183 (99th percentile) and H0036 ranks #4 of 93 (97th percentile). These rank/percentile positions denote dominant statewide standing for multiple high-revenue service lines and imply meaningful market share in community mental health delivery.

Operational scale is substantial: the provider billed 91.5K claims for T1017, 74.1K claims for 90837, and 72K claims for H0036, demonstrating very high throughput for both psychotherapy and case-management encounters. Average paid-per-claim figures (for example $298 for H0036 and $167 for T1017) show these high volumes translate into large absolute Medicaid revenue streams that underpin the $91.1M lifetime total.

The provider’s reliance on time-based, per-15-minute codes (e.g., H0036, T1017, H2021, T1016) and on both assessment/plan-development codes (H0031, H0032) suggests contracting and utilization management will need to be tailored to per-unit activity and care coordination metrics. Payers negotiating with this entity should expect the majority of services to be delivered as frequent, shorter time increments and by non-physician clinicians.

Concentration risk is material because there is effectively single-payer exposure: with Medicare revenue recorded as none and $91.1M from Medicaid, changes to Medicaid rates, authorization, or service definitions for top codes could disproportionately affect this provider’s revenue. The organization’s top codes already carry high rank-percentiles in-state, so any policy shifts for those specific services would have outsized operational impact.

The provider has a long tenure in the NPI file (enumerated 2006-11-10 (~20 years ago)), which aligns with its mature billing footprint and its high state rankings on multiple behavioral-health codes. Long-standing presence combined with dominant rank positions suggests established referral and program infrastructure in its service area.

Medicaid: Complete Services Breakdown

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

46 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	72,010	$300	$21.5M
T1017	Targeted case management, each 15 minutes	91,540	$170	$15.3M
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	74,060	$130	$9.3M
H2021	Community-based wrap-around services, per 15 minutes	15,670	$520	$8.2M
T1016	Case management, each 15 minutes	27,220	$230	$6.3M
H0031	Mental health assessment, by non-physician	31,280	$140	$4.4M
H0032	Mental health service plan development by non-physician	30,290	$130	$3.9M
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…	37,130	$80	$3M
H0039	Assertive community treatment, face-to-face, per 15 minutes	16,040	$170	$2.7M
H2019	Therapeutic behavioral services, per 15 minutes	14,360	$150	$2.1M

Showing 1–10 of 46

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Michigan Distribution

The Guidance Center — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

46 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1017	Targeted case management, each 15 minutes	19	180	10,890	$210	$8.1M
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	92	130	11,590	$190	$7.6M
T1040	Medicaid certified community behavioral health clinic services, per diem	7	40	30,550	$80	$6.8M
H0039	Assertive community treatment, face-to-face, per 15 minutes	41	70	20,710	$180	$5.1M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	4	90	8,750	$300	$4.7M
T1016	Case management, each 15 minutes	24	120	8,060	$210	$3.4M
97155	The provider, a physician or other qualified healthcare professional, administers adaptive behavior treatment face–to–face with one patient and makes modifications in the protocol targets and…	92	130	3,170	$180	$2.2M
H2019	Therapeutic behavioral services, per 15 minutes	3	30	3,330	$200	$1.6M
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	48	110	480	$530	$1.5M
H2023	Supported employment, per 15 minutes	60	110	5,150	$90	$1.5M

Showing 1–10 of 46

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Aqeel Khan	IL	Psychiatry Physician	$2.2M	$3.5M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Arkay Incorporated	MI	Developmentally Disabled Services Day Training Agency	$0	$20.9M
Dr. Dinesh Nayak, Md, P.C.	MI	Pediatrics Physician	$0	$8M
City Medical P C	MI	General Practice Physician	$0	$6.8M
Castleman Surgery Center, LLC	MI	Ambulatory Surgical Clinic/Center	$1.2M	$794.2K
Mustafa Hashem	MI	Interventional Cardiology Physician	$749.9K	$0
Ghassan Atto	MI	Family Medicine Physician	$526.7K	$0
Dennis Vollman	MI	Diagnostic Radiology Physician	$297.6K	$0
Qaiser Shafiq	MI	Interventional Cardiology Physician	$289K	$0
Kempaiah Gowda	MI	Cardiovascular Disease Physician	$262.5K	$0
Zoe Deol	MI	Surgery Physician	$163K	$0

The Guidance Center — Billing Profile & Reimbursement Data

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The Guidance Center — 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