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.

Summit Pointe (NPI 1700833555)

Field	Value
Entity Type	Organization
Organization	Summit Pointe
Address	140 Michigan Ave W
City	Battle Creek
State	MI
ZIP	49017
Taxonomy	Psychiatry Physician
NPI Enumerated	May 27, 2006

Payer Source	Total Paid
Medicaid	$72.1M
Medicare	$0

Key Findings

SUMMIT POINTE reports $72.1M in lifetime Medicaid revenue and has no Medicare billing on file, making its footprint effectively single-payer Medicaid in scale. This concentration on Medicaid should frame any payer-mix analysis or network contracting discussions because there is no Medicare revenue to offset Medicaid exposure.

Revenue is highly concentrated in a few community- and case-management codes: T1017 generated $24.1M (34.2% of Medicaid revenue), H0039 generated $7.8M (11.0%), and T1016 generated $6.3M (8.9%); the top three Medicaid codes together account for 54.2% of the provider’s total Medicaid revenue. These three codes alone drive more than half of the Medicaid revenue base, so changes to reimbursement or utilization for these codes would disproportionately affect overall revenue.

The procedural mix points to a community-based behavioral health operation focused on case management and assertive community treatment rather than high-acuity hospital care. High volumes in T1017, T1016, H0039, H0038, and H2015 alongside frequent psychotherapy codes (90834, 90837) indicate an integrated model of frequent, time-based community contacts and ongoing outpatient psychotherapy.

On competitive standing, the provider’s ranks on its top revenue codes are generally above median but not dominant: T1017 ranks #25 of 175 (86th percentile) and is described as typical, unremarkable volume for that code; H0039 is #17 of 67 (76th percentile) and T1016 is #30 of 123 (76th percentile), both likewise characterized as typical, unremarkable volume. By contrast, the provider is an extreme outlier for psychotherapy codes 90834 and 90837 (both 99th percentile), and also notably above typical for 99213 (98th percentile), indicating unusual throughput in psychotherapy and office E/M compared with in-state peers.

Service delivery is skewed toward high-frequency, time-based encounters: massive claim counts for 15-minute units (e.g., 73.2K claims for T1017, 42.4K for H0039, 44.2K for H0038) suggest a care model that relies on many shorter or modular interactions rather than episodic, high-dollar procedures. The presence of both high-volume case management and high-volume psychotherapy implies mixed modalities of care—community outreach, peer/self-help services, and clinic-based psychotherapy.

The NPI enumeration date is 2006-05-27 (~20 years ago), indicating long-tenure billing activity in Medicaid. Sustained, multi-year presence combined with $72.1M in Medicaid revenue suggests an established operational footprint in Michigan behavioral health markets rather than a newly formed entrant.

Concentration in a small set of community-based codes creates both operational vulnerability and strategic opportunity: because T1017, H0039, and T1016 together comprise 54.2% of Medicaid revenue, payer policy changes or utilization management focused on targeted case management or assertive community treatment could materially affect the business. Conversely, the provider’s extreme psychotherapy volumes (90834, 90837) and high E/M volume (99213) position it to negotiate value-based arrangements that reward sustained outpatient behavioral-health engagement.

The mix of billed services implies a multidisciplinary workforce and potential for delegated treatment delivery: notable volumes for technician-delivered adaptive behavior codes (97153, 97155, 0365T), group therapy (90853), and procedure codes like 96372 indicate reliance on non-physician staff, structured therapy protocols, and group modalities. Staffing, supervision, and billing compliance for mixed clinician/technician models will be operational priorities given the service mix and claim volumes.

Medicaid: Complete Services Breakdown

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

48 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1017	Targeted case management, each 15 minutes	73,150	$330	$24.1M
H0039	Assertive community treatment, face-to-face, per 15 minutes	42,440	$180	$7.8M
T1016	Case management, each 15 minutes	21,020	$300	$6.3M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	8,750	$510	$4.5M
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	45,590	$80	$3.7M
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…	35,140	$100	$3.5M
H0038	Self‑help/peer services, per 15 minutes	44,240	$60	$2.7M
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	4,370	$600	$2.6M
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…	36,660	$70	$2.4M
H0031	Mental health assessment, by non-physician	11,520	$150	$1.7M

Showing 1–10 of 48

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

Summit Pointe — 9 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

48 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1017	Targeted case management, each 15 minutes	25	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…	76	130	11,590	$190	$7.6M
T1040	Medicaid certified community behavioral health clinic services, per diem	17	40	30,550	$80	$6.8M
H2015	Comprehensive community support services, per 15 minutes	295	610	14,740	$90	$6M
H0039	Assertive community treatment, face-to-face, per 15 minutes	17	70	20,710	$180	$5.1M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	46	90	8,750	$300	$4.7M
T1016	Case management, each 15 minutes	30	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…	74	130	3,170	$180	$2.2M
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	18	110	480	$530	$1.5M
H2023	Supported employment, per 15 minutes	74	110	5,150	$90	$1.5M

Showing 1–10 of 48

Nearby Providers

Other providers in the same ZIP code as Summit Pointe, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bronson Battle Creek Hospital	MI	General Acute Care Hospital	$0	$43.9M
Burnham Brook	MI	Case Management Agency	$0	$28.7M
Alternative Choices, LLC	MI	Home Health Agency	$0	$13.8M
Bronson Battle Creek Hospital	MI	Internal Medicine Physician	$0	$9.8M
Reza Tehrani	MI	Critical Care Medicine (Internal Medicine) Physician	$251K	$0
Chad Chambers	MI	Foot & Ankle Surgery Podiatrist	$136.7K	$0
Madhuri Gupta	MI	Anesthesiology Physician	$26.9K	$0
Margaret Enell	MI	Anesthesiology Physician	$26K	$0
Jessica Bagley	MI	Family Nurse Practitioner	$24.3K	$0
Steven Lins	MI	Anesthesiology Physician	$24K	$0

Summit Pointe — Billing Profile & Reimbursement Data

Sign up for Summit Pointe — Billing Profile & Reimbursement Data policy alerts

Summit Pointe — Billing Profile & Reimbursement Data

Sign up for Summit Pointe — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References