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.

Ionia County Community Mental Health (NPI 1760452122)

Field	Value
Entity Type	Organization
Organization	Ionia County Community Mental Health
Address	375 Apple Tree Dr
City	Ionia
State	MI
ZIP	48846
Taxonomy	Public Health or Welfare Agency
NPI Enumerated	January 26, 2006

Payer Source	Total Paid
Medicaid	$93.9M
Medicare	$0

Key Findings

IONIA COUNTY COMMUNITY MENTAL HEALTH is effectively a single‑payer Medicaid provider: there is no Medicare billing on file while total Medicaid revenue is $93.9M, indicating the organization’s service footprint and reimbursement are concentrated in the Medicaid program. The provider’s NPI was enumerated on 2006-01-26 (~20 years ago), confirming long-standing operation in its market.

Revenue is highly concentrated in a few service lines: the top three Medicaid codes (T1040, T1017, H0036) together account for 51.6% of the provider’s total Medicaid revenue, signaling that a small set of program-level payments drives most of the financial activity. Specifically, T1040 represents 28.9% of Medicaid revenue, T1017 13.4%, and H0036 9.3%, so per‑diem community behavioral health clinic services and targeted case management are the dominant revenue streams.

The code mix (T1040, T1017, H0036) describes a community behavioral health center model: T1040 (Medicaid certified community behavioral health clinic services, per diem) as the single largest revenue source suggests a reliance on per‑diem clinic funding, while T1017 (targeted case management) and H0036 (community psychiatric supportive treatment, per 15 minutes) indicate heavy investment in care coordination, outreach, and community‑based psychiatric supports. This combination is consistent with a public health or welfare agency operating broad services across outpatient, case management, and community support.

Competitive standing by statewide ranking is mixed: for its largest code T1040 the provider ranks #13 of 42 (71st percentile) which the data characterizes as a typical, unremarkable volume within the in‑state peer group, and for T1017 it ranks #41 of 175 (77th percentile) likewise described as typical. These ranks indicate the provider is a meaningful regional participant in core community‑behavioral‑health lines but not a statewide dominant outlier for those per‑diem and case‑management payments.

The provider shows above‑typical intensity in psychotherapy delivery: 90837 (long psychotherapy sessions) generates $4.1M and ranks in the 97th percentile for the state, described as notably above typical state volume. This suggests a substantive clinical psychotherapy capacity relative to in‑state peers and a service mix that includes frequent long-session psychotherapy encounters.

Operational breadth extends beyond core per‑diem and case management: the provider bills substantial amounts for ABA/adaptive behavior treatment (97153, 97155, 0365T), psychiatric evaluation codes (90791, 90792), and evaluation/management office visits (99214, 99213). These entries indicate the organization provides both behavioral/ABA services and medical/psychiatric evaluation and E/M visits, supporting a multidisciplinary service model that serves children and adults with behavioral health and developmental needs.

Several codes show high statewide percentiles but are labeled in the data as typical, which points to consistent high activity rather than isolated spikes: examples include 99214 (95th percentile, labeled typical), 90791 (94th percentile, labeled typical), and 90792 (70th percentile, labeled typical). Taken together with the revenue concentration in the top three codes, this pattern suggests a stable, high‑volume Medicaid provider with concentrated dependencies on a few programmatic payment streams rather than wide dispersion across many low‑revenue codes.

From a risk/strategic perspective for payers and partners, the provider’s heavy reliance on T1040 per‑diem funding and T1017 case management (which together drive over 40% of Medicaid revenue) means changes in Medicaid clinic certification rules, per‑diem rates, or case management policy could disproportionately affect its revenue base. Conversely, the above‑typical volume in psychotherapy (90837) and comprehensive mix of behavioral, case management, and medical evaluation codes indicates operational capacity that could be leveraged in value‑based contracting focused on community behavioral health outcomes.

Medicaid: Complete Services Breakdown

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

45 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1040	Medicaid certified community behavioral health clinic services, per diem	87,900	$300	$26.5M
T1017	Targeted case management, each 15 minutes	49,870	$250	$12.3M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	27,120	$310	$8.5M
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…	18,340	$340	$6.2M
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…	16,810	$340	$5.8M
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…	23,460	$180	$4.1M
H0038	Self‑help/peer services, per 15 minutes	15,520	$210	$3.3M
T1016	Case management, each 15 minutes	16,770	$190	$3.2M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	4,640	$630	$2.9M
H0002	Behavioral health screening to determine eligibility for admission to treatment program	6,130	$360	$2.2M

Showing 1–10 of 45

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

Ionia County Community Mental Health — 2 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

45 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1017	Targeted case management, each 15 minutes	41	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…	56	130	11,590	$190	$7.6M
T1040	Medicaid certified community behavioral health clinic services, per diem	13	40	30,550	$80	$6.8M
H2015	Comprehensive community support services, per 15 minutes	563	610	14,740	$90	$6M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	15	90	8,750	$300	$4.7M
T1016	Case management, each 15 minutes	38	120	8,060	$210	$3.4M
T2025	Waiver services; not otherwise specified (nos)	31	30	2,980	$100	$2.3M
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…	41	130	3,170	$180	$2.2M
T1005	Respite care services, up to 15 minutes	92	110	4,910	$80	$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	29	110	480	$530	$1.5M

Showing 1–10 of 45

Nearby Providers

Other providers in the same ZIP code as Ionia County Community Mental Health, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sparrow Ionia Hospital	MI	Critical Access Hospital	$0	$13.7M
Life Ems Of Ionia Co Inc	MI	Land Ambulance	$1.9M	$10.8M
John Birgiolas	MI	Interventional Pain Medicine Physician	$172.8K	$0

Ionia County Community Mental Health — Billing Profile & Reimbursement Data

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Ionia County Community Mental Health — 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

Nearby Providers

Frequently Asked Questions

References