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

Why is the Medicaid comparison limited to Wisconsin 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. Wisconsin (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.

Washington County Mental Health Center (NPI 1801043385)

Field	Value
Entity Type	Organization
Organization	Washington County Mental Health Center
Address	333 E Washington St
City	West Bend
State	WI
ZIP	53095
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	August 26, 2008

Payer Source	Total Paid
Medicaid	$22.1M
Medicare	$0

Key Findings

This provider is effectively single‑payer: there is no Medicare billing on file while total Medicaid revenue is $22.1M, so Medicaid is the sole recorded source of Medicare/Medicaid revenue for this entity. Analysts should treat performance and risk as concentrated in the Medicaid program rather than split across federal payers.

Revenue is highly concentrated in a very small set of codes: the precomputed top 3 codes account for 100.0% of the provider's Medicaid revenue, with a single code, H2017, making up 89.6% ($19.8M) of the $22.1M total. That level of concentration implies operational and reimbursement exposure tied to the continued authorization and payment rates for psychosocial rehabilitation services.

H2017 (Psychosocial rehabilitation services, per 15 minutes) dominates activity with 200K claims and a $99 avg paid/claim, generating $19.8M in revenue. This code mix indicates the organization operates primarily as a behavioral health/psychosocial rehabilitation provider delivering high-volume, time-based services (likely frequent, recurring outpatient visits or program units).

The second material code, 99199 (other medicine services), accounts for $2.3M in revenue (10.4% of Medicaid revenue) from 39.1K claims at $59 avg paid/claim. Its presence at meaningful volume suggests routine use of a catch-all code for services that lack a specific CPT/HCPCS descriptor, which warrants review of service documentation and alignment with program models.

On competitive standing within the state, the provider ranks in the upper-middle tier for its top codes: H2017 is #13 of 58 providers (79th percentile) and 99199 is #14 of 57 providers (77th percentile). These ranks and the supplied characterization of "typical, unremarkable volume for this code" indicate the center is a solid, above-average participant in state Medicaid behavioral health markets but not a statewide dominant provider.

The provider has an established operational tenure, with NPI enumeration on 2008-08-26 (~18 years ago), which supports interpretation of these billing patterns as sustained rather than newly emergent. Longevity paired with high concentration in a programmatic code like H2017 suggests mature service lines rather than transient billing spikes.

Statistically, neither of the listed codes is flagged as an extreme outlier; both are described as "typical, unremarkable volume for this code" at their respective percentiles. From a surveillance perspective this reduces the likelihood that the observed billing mix is anomalous relative to in‑state peers, but the concentration itself remains a material business risk.

Operational and analytic implications: because $22.1M in Medicaid revenue hinges on H2017 (89.6%, $19.8M) and 99199 (10.4%, $2.3M), payers and provider analysts should prioritize program-level reviews of psychosocial rehabilitation delivery, validate appropriate use of 99199, and benchmark unit/session intensity against similarly ranked in‑state peers to assess utilization and payment sustainability.

Medicaid: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2017	Psychosocial rehabilitation services, per 15 minutes	199,990	$100	$19.8M
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	39,100	$60	$2.3M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wisconsin Distribution

Washington County Mental Health Center — 0 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2017	Psychosocial rehabilitation services, per 15 minutes	13	60	57,750	$100	$18.9M
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	14	60	16,890	$60	$2.9M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. Josephs Community Hospital Of West Bend Inc.	WI	General Acute Care Hospital	$0	$5.8M
Lifestar Emergency Medical Services, LLC	WI	Land Ambulance	$1.5M	$2.9M
Washington County Wisconsin	WI	Community/Behavioral Health Agency	$0	$4M
West Bend Joint School District #1	WI	Local Education Agency (LEA)	$0	$2M
City Of West Bend	WI	Land Ambulance	$312.6K	$810K
Spine Solutions Of West Bend LLC	WI	Ambulatory Surgical Clinic/Center	$543.2K	$0
Nausheen Abbas	WI	Ophthalmology Physician	$355.7K	$0
West Bend Surgery Center LLC	WI	Ambulatory Surgical Clinic/Center	$261K	$3.3K
Mark Nunag	WI	Nephrology Physician	$241.7K	$0
Abdel Hai Alqwasmi	WI	Hematology & Oncology Physician	$181.6K	$0

Washington County Mental Health Center — Billing Profile & Reimbursement Data

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Washington County Mental Health Center — 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