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.

Montcalm Care Network (NPI 1710074448)

Field	Value
Entity Type	Organization
Organization	Montcalm Care Network
Address	611 N State Street
City	Stanton
State	MI
ZIP	48888
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	October 6, 2006

Payer Source	Total Paid
Medicaid	$62.1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

34 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1017	Targeted case management, each 15 minutes	65,460	$210	$13.8M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	37,310	$270	$10.2M
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…	19,780	$350	$7M
H2030	Mental health clubhouse services, per 15 minutes	23,990	$230	$5.6M
H0038	Self‑help/peer services, per 15 minutes	19,930	$170	$3.3M
T1002	Rn services, up to 15 minutes	6,880	$390	$2.6M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	4,410	$550	$2.4M
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…	9,520	$230	$2.2M
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…	9,320	$170	$1.6M
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…	5,630	$240	$1.3M

Showing 1–10 of 34

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

Montcalm Care Network — 1 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

34 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1017	Targeted case management, each 15 minutes	29	180	10,890	$210	$8.1M
H2015	Comprehensive community support services, per 15 minutes	352	610	14,740	$90	$6M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	7	90	8,750	$300	$4.7M
T1016	Case management, each 15 minutes	88	120	8,060	$210	$3.4M
H2030	Mental health clubhouse services, per 15 minutes	28	60	22,740	$80	$2.3M
H2019	Therapeutic behavioral services, per 15 minutes	12	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	30	110	480	$530	$1.5M
H2023	Supported employment, per 15 minutes	54	110	5,150	$90	$1.5M
H2011	Crisis intervention service, per 15 minutes	40	80	1,470	$310	$1.4M
H0032	Mental health service plan development by non-physician	50	180	2,030	$170	$1.2M

Showing 1–10 of 34

Nearby Providers

Other providers in the same ZIP code as Montcalm Care Network, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dawn Phenix-stoll	MI	In Home Supportive Care Agency	$0	$14.4M
County Of Montcalm	MI	Land Ambulance	$891.8K	$4.1M

Montcalm Care Network — Billing Profile & Reimbursement Data

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Montcalm Care Network — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References