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 1710994835)

Field	Value
Entity Type	Organization
Organization	Grand Lake Mental Health Center, Inc.
Address	405 E Excelsior Ave
City	Vinita
State	OK
ZIP	74301
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	August 2, 2006

Payer Source	Total Paid
Medicaid	$15.9M
Medicare	$0

Key Findings

GRAND LAKE MENTAL HEALTH CENTER, INC. is effectively a single-payer Medicaid provider: there is no Medicare billing on file while its lifetime Medicaid revenue is reported as $15.9M, indicating the organization’s operations and reimbursement exposure are concentrated in the Medicaid program rather than Medicare. This payer concentration suggests payer contracting, care delivery, and financial risk are driven by state Medicaid policies and rates.

Medicaid revenue is highly concentrated in one service line: T1041 (Medicaid certified community behavioral health clinic services, per month) accounts for $15.3M and represents 96.7% of the provider’s total Medicaid revenue. This dominance implies the center primarily operates as a certified community behavioral health clinic with bundled monthly payments forming the bulk of its income rather than fee-for-service outpatient E/M or per-15-minute behavioral codes.

The top-3 Medicaid codes together account for 99.4% of the provider’s Medicaid revenue, signaling an extreme revenue concentration in a very small set of service codes. That level of concentration indicates the business model is centered on a small number of high-value billing lines—primarily the monthly certified community behavioral health clinic payment—making the provider financially sensitive to any policy or rate changes that affect those codes.

Within the state competitive landscape for T1041, the provider ranks #17 of 97 in volume, placing it in the 83rd percentile; this reflects a solid but not dominant position among in-state peers for community behavioral health clinic monthly billing. For the coordinated care fee codes G9010 and G9009, the provider sits at the 72nd and 57th percentiles respectively, which are typical, unremarkable volumes; collectively this suggests the center is a meaningful regional participant for its specialty but not a statewide market leader across all managed-care related payments.

Operationally, the code mix—dominated by T1041 and supplemented by coordinated care fees G9010 and G9009—indicates the center’s services emphasize comprehensive, ongoing behavioral health management and care coordination rather than brief office-based E/M visits. The presence of numerous per-15-minute and case-management codes with zero reported payment (e.g., T1016, H2015, H0034, H2019) suggests either these services are billed but not yielding reimbursement in the dataset or they are part of bundled arrangements captured under the main clinic monthly payment.

The provider has a long tenure in the NPI file, enumerated on 2006-08-02 (~20 years ago), which supports an established presence in the community and likely long-standing participation in state Medicaid programs and behavioral health networks. This longevity, combined with the high reliance on certified community behavioral health clinic payments, points to a stable specialized operation focused on Medicaid behavioral health services.

Several commonly billed behavioral and case-management codes show nonzero claim counts but $0 avg paid/claim in the dataset (for example, T1016, H2015, H0034, H2019 and others), which may reflect bundling into the dominant T1041 monthly rate or reporting artifacts. Analysts should treat those zero-paid lines cautiously and investigate whether they represent services included in bundled payments, unpaid claims, alternative payment arrangements, or data reporting limitations.

Medicaid: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1041	Medicaid certified community behavioral health clinic services, per month	14,370	$1,070	$15.3M
G9010	Coordinated care fee, risk adjusted maintenance, level 4	250	$1,010	$252.5K
G9009	Coordinated care fee, risk adjusted maintenance, level 3	490	$350	$168.7K
G9002	Coordinated care fee, maintenance rate	700	$150	$101.1K
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…	110	$0	$0
G8431	Screening for depression is documented as being positive and a follow-up plan is documented	60	$0	$0
H0004	Behavioral health counseling and therapy, per 15 minutes	7,810	$0	$0
H0031	Mental health assessment, by non-physician	60	$0	$0
H0032	Mental health service plan development by non-physician	10	$0	$0
H0034	Medication training and support, per 15 minutes	140	$0	$0

Showing 1–10 of 15

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 4 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

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1041	Medicaid certified community behavioral health clinic services, per month	17	100	4,790	$880	$8.3M
T1016	Case management, each 15 minutes	100	140	3,200	$60	$2.3M
H0004	Behavioral health counseling and therapy, per 15 minutes	289	620	6,640	$70	$1.2M
G9009	Coordinated care fee, risk adjusted maintenance, level 3	32	70	320	$320	$317.4K
G9010	Coordinated care fee, risk adjusted maintenance, level 4	13	40	140	$970	$285.1K
H2017	Psychosocial rehabilitation services, per 15 minutes	170	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…	1,348	1,750	870	$70	$254.4K
G9002	Coordinated care fee, maintenance rate	32	70	630	$140	$216.3K
H2015	Comprehensive community support services, per 15 minutes	99	150	770	$40	$73.8K
H2019	Therapeutic behavioral services, per 15 minutes	22	50	480	$20	$31.5K

Showing 1–10 of 15

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	$22.5M
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
Saint Francis Hospital Vinita, Inc	OK	General Acute Care Hospital	$0	$6.4M
Creoks Mental Health Services	OK	Community/Behavioral Health Agency	$0	$2.4M
Curtis Phillips	OK	Surgery Physician	$167.6K	$115.7K
James Butner	OK	Optometrist	$81.7K	$119.4K
Terry Horton	OK	Family Medicine Physician	$164.8K	$0
Mickey Tyrrell	OK	Family Medicine Physician	$126K	$0
Kim Kennedy-mcdonald	OK	Speech-Language Pathologist	$68.1K	$0
Austin Mcardle	OK	Foot & Ankle Surgery Podiatrist	$53.2K	$0

Grand Lake Mental Health Center, Inc. — Billing Profile & Reimbursement Data

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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