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

Why is the Medicaid comparison limited to North Dakota 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. North Dakota (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.

West Central Behavioral Health Clinic (NPI 1649226713)

Field	Value
Entity Type	Organization
Organization	West Central Behavioral Health Clinic
Address	1237 W Divide Ave
City	Bismarck
State	ND
ZIP	58501
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	May 26, 2006

Payer Source	Total Paid
Medicaid	$6.2M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-centric operation: Total Medicaid revenue is $6.2M and there is no Medicare billing on file (none). The absence of Medicare activity means payer exposure and growth opportunities are concentrated in the Medicaid market rather than split across federal Medicare flows.

Revenue is highly concentrated in a small set of codes: the top 3 Medicaid codes by revenue account for 57.3% of this provider's total Medicaid revenue, driven by 99214 ($2M, 32.1%), H2018 ($961.3K, 15.6%), and H0018 ($595.2K, 9.6%). This concentration indicates that a few high-volume, high-dollar service lines are the primary revenue engines.

The code mix indicates an operational focus on community behavioral health with a continuum of services: 99214 points to substantial outpatient E/M visits, H2018 signals psychosocial rehabilitation provided on a per‑diem basis, and H0018 shows significant short‑term residential behavioral health activity. Supporting services such as H0004 (behavioral health counseling) and T1016 (case management) further suggest integrated outpatient counseling and care coordination as core offerings rather than a narrow single-service practice.

99214 is the single largest revenue source at $2M (32.1%) and ranks #15 of 171 providers in‑state (92th percentile), reflecting relatively strong statewide volume for established-patient outpatient E/M. The dataset characterizes the volume for this code as "typical, unremarkable volume" despite its large absolute contribution to the clinic's Medicaid revenue, which underscores that high revenue can coexist with peer-comparable utilization patterns.

H2018 (psychosocial rehabilitation, per diem) contributes $961.3K (15.6%) but ranks #3 of 4 providers in-state (33th percentile), while H0018 (short-term residential) contributes $595.2K (9.6%) and ranks #2 of 5 providers in-state (75th percentile). These rank positions show the clinic operates among a small number of in‑state providers offering per‑diem rehab and residential services; H0018 places the clinic near the top of its small peer group, whereas H2018 is less dominant among the very small group reporting that code.

High placements on supportive-service codes reinforce a care-coordination orientation: H0004 generated $557.6K (9.0%) and ranks #5 of 36 providers in-state (89th percentile), while T1016 generated $518.8K (8.4%) and ranks #2 of 18 providers in-state (94th percentile). These positions and dollar amounts indicate above-average provision of counseling and case management relative to peers, consistent with a community mental health center model that emphasizes outpatient therapy plus active case coordination.

Dedicated psychotherapy codes are present but represent smaller revenue slices: 90837 produced $177.3K (2.9%), 90834 produced $93.8K (1.5%), and 90832 produced $20.9K (0.3%). This pattern suggests the organization leans more heavily on rehabilitation, residential, and E/M services for revenue than on high-volume individual psychotherapy as the principal billing driver.

The provider has an established tenure in the market, with NPI enumeration dated 2006-05-26 (~20 years ago), indicating long-standing operation in the state Medicaid market. Combined with the $6.2M in Medicaid revenue and the concentrated code mix, the clinic appears to be an established, Medicaid-focused behavioral health provider with a service portfolio oriented toward psychosocial rehabilitation, short‑term residential care, outpatient E/M, counseling, and case management.

Medicaid: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	6,100	$330	$2M
H2018	Psychosocial rehabilitation services, per diem	6,010	$160	$961.3K
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	1,160	$510	$595.2K
H0004	Behavioral health counseling and therapy, per 15 minutes	4,500	$120	$557.6K
T1016	Case management, each 15 minutes	3,990	$130	$518.8K
H0002	Behavioral health screening to determine eligibility for admission to treatment program	2,410	$170	$412.8K
H2014	Skills training and development, per 15 minutes	4,690	$70	$337.8K
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…	1,870	$140	$264.2K
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…	620	$290	$177.3K
H2017	Psychosocial rehabilitation services, per 15 minutes	3,540	$40	$124K

Showing 1–10 of 20

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Dakota Distribution

West Central Behavioral Health Clinic — 0 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Dakota

Full comparison — all codes billed, vs. North Dakota median

20 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2018	Psychosocial rehabilitation services, per diem	3	10	7,100	$130	$805.6K
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…	48	210	360	$100	$498.2K
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…	15	170	300	$100	$415.8K
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	2	10	230	$380	$250.3K
T1016	Case management, each 15 minutes	2	20	1,390	$100	$242.6K
H2035	Alcohol and/or other drug treatment program, per hour	12	20	590	$90	$206.4K
H0004	Behavioral health counseling and therapy, per 15 minutes	5	40	520	$80	$181.5K
H0002	Behavioral health screening to determine eligibility for admission to treatment program	3	10	900	$130	$178.3K
H2017	Psychosocial rehabilitation services, per 15 minutes	2	10	1,120	$80	$153.7K
H2011	Crisis intervention service, per 15 minutes	5	10	1,260	$80	$147.9K

Showing 1–10 of 20

Related Providers

Other providers that share a Tax Identification Number (TIN) with West Central Behavioral Health Clinic, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Michael Capan	ND	Psychiatry Physician	$38.1K	$0
Timothy Wilson	ND	Social Worker	$8K	$0
Nicole Erasmus	ND	Clinical Social Worker	$2.5K	$0
Joni Heine	ND	Clinical Social Worker	$1.4K	$0

Nearby Providers

Other providers in the same ZIP code as West Central Behavioral Health Clinic, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Enable, Inc.	ND	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$40.8M
Heartview Foundation	ND	Substance Use Disorder Rehabilitation Clinic/Center	$0	$13.6M
Sanford Bismarck	ND	General Acute Care Hospital	$0	$12.5M
Bismarck Public Schools Early Intervention	ND	Early Intervention Provider Agency	$0	$12M
D. Michael Goebel D.d.s., PC	ND	Pediatric Dentistry	$0	$5.8M
Poppy's Promise LLC	ND	Community/Behavioral Health Agency	$0	$5.6M
Sanford Bismarck	ND	Clinical Medical Laboratory	$726.9K	$4.3M
St. Alexius Medical Center	ND	Specialist	$0	$3.6M
Lasting Love Homecare	ND	In Home Supportive Care Agency	$0	$3.6M
St. Alexius Medical Center	ND	General Acute Care Hospital	$0	$3.5M

West Central Behavioral Health Clinic — Billing Profile & Reimbursement Data

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West Central Behavioral Health Clinic — 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