Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerNPI Medicare & MedicaidGuild
    Ask Trek AI about this page

    Guild — Billing Profile & Reimbursement Data

    NPI 1861514945 · Saint Paul, MN · Community/Behavioral Health Agency

    Customize your policy alerts

    Sign up for Guild — Billing Profile & Reimbursement Data policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Guild is a community/behavioral health agency provider located in Saint Paul, Minnesota. This profile covers 0 Medicare and 10 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

    Table of contents

    Progress1 / 8

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationGuild
    Address122 Wabasha St S Ste 400
    CitySaint Paul
    StateMN
    ZIP55107
    TaxonomyCommunity/Behavioral Health Agency
    NPI EnumeratedApril 6, 2007

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$44.6M
    Medicare$0

    Key Findings

    GUILD is effectively a Medicaid-focused provider with no Medicare billing on file and $44.6M in lifetime Medicaid revenue, indicating the organization operates predominantly within Medicaid-funded behavioral health services rather than serving a Medicare population. Its NPI was enumerated on 2007-04-06 (~19 years ago), signalling long-term presence in the market and likely established referral and payer relationships within the state. The provider’s revenue is highly concentrated: the top three Medicaid codes (H0040, T2023, H0019) account for 89.1% of total Medicaid revenue, showing reliance on a small set of service lines for the vast majority of billing. H0040 (Assertive community treatment program, per diem) is the single largest revenue driver with $19.7M (44.3% of Medicaid revenue), and GUILD ranks #1 of 38 providers in-state for this code (100th percentile), making it an extreme statewide outlier and a dominant provider of intensive community treatment services. T2023 (Targeted case management; per month) contributes $15.2M (34.2% of Medicaid revenue) and ranks #12 of 192 providers in-state (94th percentile), indicating the organization is a major regional player in case management with volumes well above typical statewide peers. H0019 (long-term residential behavioral health, per diem without room and board) adds $4.7M (10.6% of Medicaid revenue) and sits at #12 of 55 providers in-state (80th percentile), consistent with a meaningful but more typical role in long-term residential services compared with its dominance in H0040. Secondary codes such as S0281 and G9002 provide modest additional revenue ($2.7M and $1.3M respectively) and rank notably above typical volumes for their categories (S0281 at the 93rd percentile), which supports that GUILD’s business model combines intensive community treatment, ongoing case management, and care coordination services rather than a wide breadth of low-volume procedures. Overall, the profile suggests a specialized behavioral health agency heavily focused on intensive community-based treatment and targeted case management, occupying a dominant statewide position for Assertive Community Treatment while maintaining strong standing in case management and residential behavioral health services.

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    10 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    H0040Assertive community treatment program, per diem118,950$170$19.7M
    T2023Targeted case management; per month39,890$380$15.2M
    H0019Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem9,230$510$4.7M
    S0281Medical home program, comprehensive care coordination and planning, maintenance of plan12,640$210$2.7M
    G9002Coordinated care fee, maintenance rate14,240$90$1.3M
    H0018Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem820$530$439.5K
    S0280Medical home program, comprehensive care coordination and planning, initial plan820$300$244.4K
    H2015Comprehensive community support services, per 15 minutes1,740$50$79.9K
    H0046Mental health services, not otherwise specified6,290$10$62.9K
    H0043Supported housing, per diem10,130$0$0

    Medicaid: Competitive Analysis & Benchmarks

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

    Full comparison — all codes billed, vs. Minnesota median

    10 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    H0040Assertive community treatment program, per diem14025,290$200$5.8M
    T2023Targeted case management; per month121902,820$480$4.2M
    H0018Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem14202,550$570$2.7M
    H0019Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem12604,380$450$2.6M
    G9002Coordinated care fee, maintenance rate7206,640$150$2.4M
    H2015Comprehensive community support services, per 15 minutes761402,300$110$700.1K
    S0281Medical home program, comprehensive care coordination and planning, maintenance of plan7801,070$90$341.2K
    S0280Medical home program, comprehensive care coordination and planning, initial plan1640450$240$253K
    H0046Mental health services, not otherwise specified842102,990$10$213.5K
    H0043Supported housing, per diem2201,970$0$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Tapestry Treatment Center LLCMNSubstance Abuse Rehabilitation Facility$0$18.6M
    West Side Community Health Services, IncMNFederally Qualified Health Center (FQHC)$0$17.3M
    Midtling Oral & Maxillofacial Surgery, PAMNOral and Maxillofacial Surgery Clinic/Center$0$16M
    Cerenity Senior CareMNSkilled Nursing Facility$0$11.2M
    Group Health, Inc.MNPediatric Dentistry$0$5.6M
    Chokchai ChareandeeMNNephrology Physician$100.6K$0
    Islam KhanMNNephrology Physician$67.5K$0
    Andrew KummerMNNephrology Physician$49.3K$0
    Nadar AliMNFamily Medicine Physician$35.1K$0
    Leslie McguireMNCertified Registered Nurse Anesthetist$31.6K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Minnesota Providers
    7 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Minnesota Distribution
    Guild — 1 of 9 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Minnesota