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

Why is the Medicaid comparison limited to South Dakota 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. South Dakota (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.

Northeastern Mental Health Center (NPI 1801964952)

Field	Value
Entity Type	Organization
Organization	Northeastern Mental Health Center
Address	14 S Main St
City	Aberdeen
State	SD
ZIP	57401
Taxonomy	Mental Health Counselor
NPI Enumerated	November 30, 2006

Payer Source	Total Paid
Medicaid	$10.1M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and reports total Medicaid revenue of $10.1M, making it effectively a single-payer (Medicaid-focused) operation in the available data. The NPI was enumerated on 2006-11-30 (~20 years ago), indicating long tenure and an established presence in the state Medicaid market.

Revenue is highly concentrated in a small set of services: the precomputed top three Medicaid codes account for 81.6% of the provider's Medicaid revenue. In particular H2021 accounts for $4.9M (48.2% of Medicaid revenue), H2016 accounts for $2.2M (21.4%), and 90832 accounts for $1.2M (12.1%).

The code mix points to a community-based behavioral health operation that emphasizes wrap-around and ongoing community support services plus short psychotherapy encounters. High revenue in H2021 (Community-based wrap-around services, per 15 minutes; $90 avg paid/claim) and H2016 (Comprehensive community support services, per diem; $74 avg paid/claim), together with 90832 (short psychotherapy sessions; $95 avg paid/claim), suggests staffing and workflows organized around frequent, time-unit-based community interventions and brief clinic-based therapy visits.

On the psychotherapy metric 90832 the provider is a clear statewide leader: 90832 generated $1.2M and the provider ranks #3 of 72 in-state (97th percentile; described as notably above typical state volume). This indicates the organization provides short psychotherapy sessions at a materially higher rate than most peers and likely captures a significant share of that segment in the state.

Despite the large share from H2021, the provider’s statewide position for that code is respectable but not dominant: H2021 generated $4.9M and ranks #3 of 11 (80th percentile; characterized as typical, unremarkable volume). H2016 generated $2.2M and ranks #6 of 11 (50th percentile; typical), indicating solid but middle-tier market share for per-diem community support services.

The provider appears to be a statewide leader in substance-use and behavioral counseling group services by volume even though those codes are smaller contributors to total revenue. H0005 (group counseling) generated $384.1K and ranks #1 of 20 (100th percentile; notably above typical), and H0004 (behavioral health counseling per 15 minutes) generated $264.4K and ranks #1 of 18 (100th percentile; notably above typical), signaling programmatic strength and potential referral pull in these service lines.

There are service lines where the provider is under-indexed relative to peers: H0039 (assertive community treatment, per 15 minutes) produced $754.7K but ranks #5 of 5 (0th percentile; notably below typical state volume), and H2012 (behavioral health day treatment, per hour) shows minimal activity with a rank of #5 of 5 (0th percentile). Those low percentiles suggest the organization does not run ACT teams or day-treatment programs at the scale other providers in the state do.

Medical management and standard evaluation-and-management codes appear in the billing mix but at modest levels relative to community services and psychotherapy. 90863 (medication management after psychotherapy) generated $238.5K and ranks #9 of 12 (27th percentile), 99214 generated $47.2K and ranks #83 of 260 (68th percentile), and 99213 generated $26.6K and ranks #144 of 344 (58th percentile), which together imply the practice focus is behavioral/psychotherapy-centered rather than primary-care-style or medication-management dominant.

Medicaid: Complete Services Breakdown

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2021	Community-based wrap-around services, per 15 minutes	54,080	$90	$4.9M
H2016	Comprehensive community support services, per diem	29,180	$70	$2.2M
90832	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…	12,830	$100	$1.2M
H0039	Assertive community treatment, face-to-face, per 15 minutes	10,340	$70	$754.7K
H0005	Alcohol and/or drug services; group counseling by a clinician	7,250	$50	$384.1K
H0004	Behavioral health counseling and therapy, per 15 minutes	3,110	$90	$264.4K
90863	The provider prescribes and reviews medications for pharmacological management after psychotherapy services at the same encounter.	2,620	$90	$238.5K
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…	1,890	$30	$47.2K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	540	$80	$42.4K
H0001	Alcohol and/or drug assessment	310	$140	$41.4K

Showing 1–10 of 16

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Dakota Distribution

Northeastern Mental Health Center — 3 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. South Dakota median

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2016	Comprehensive community support services, per diem	6	10	29,180	$80	$3.6M
H2021	Community-based wrap-around services, per 15 minutes	3	10	47,600	$90	$3.5M
H0039	Assertive community treatment, face-to-face, per 15 minutes	5	10	45,430	$80	$3.3M
90863	The provider prescribes and reviews medications for pharmacological management after psychotherapy services at the same encounter.	9	10	5,650	$90	$550.2K
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…	144	340	1,010	$100	$511K
H2012	Behavioral health day treatment, per hour	5	10	1,150	$180	$324.5K
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…	83	260	860	$80	$222.6K
90832	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…	3	70	200	$80	$176.7K
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…	107	190	430	$90	$154.1K
H0005	Alcohol and/or drug services; group counseling by a clinician	1	20	520	$80	$128.2K

Showing 1–10 of 16

Related Providers

Other providers that share a Tax Identification Number (TIN) with Northeastern Mental Health Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lauri Wolter	SD	Psychiatric/Mental Health Nurse Practitioner	$48.7K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Adjustment Training Center, Inc.	SD	Developmentally Disabled Services Day Training Agency	$0	$40.3M
Vision Care Associates, LLP	SD	Optometrist	$0	$6M
Sanford Health Network	SD	General Acute Care Hospital	$0	$4.4M
John Bormes	SD	Ophthalmology Physician	$2.6M	$0
Avera St. Luke's	SD	Family Medicine Physician	$0	$2.3M
Sanford Health Network	SD	General Acute Care Hospital	$0	$1.9M
Avera At Home	SD	Home Health Agency	$0	$1.6M
Avera St Lukes	SD	General Acute Care Hospital	$0	$1.5M
Ty Hanson	SD	Dermatology Physician	$1.2M	$0
Fettig And Drake Dds PC	SD	General Practice Dentistry	$0	$1M

Northeastern Mental Health Center — Billing Profile & Reimbursement Data

Sign up for Northeastern Mental Health Center — Billing Profile & Reimbursement Data policy alerts

Northeastern Mental Health Center — Billing Profile & Reimbursement Data

Sign up for Northeastern Mental Health Center — Billing Profile & Reimbursement Data policy alerts

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