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.

Aurora Psychiatric Hospital, Inc. (NPI 1881627438)

Key Findings

Field	Value
Entity Type	Organization
Organization	Aurora Psychiatric Hospital, Inc.
Address	1220 Dewey Ave
City	Wauwatosa
State	WI
ZIP	53213
Taxonomy	Psychiatric Hospital
NPI Enumerated	July 8, 2006

Payer Source	Total Paid
Medicaid	$28.2M
Medicare	$0

AURORA PSYCHIATRIC HOSPITAL, INC. is effectively a single‑payer Medicaid provider with no Medicare billing on file; total Medicaid revenue is $28.2M and there is explicitly none reported for Medicare, which means Medicaid drives the entire documented payer revenue base for this facility. This concentration implies operational focus and contractual dependence on Medicaid programs rather than fee‑for‑service Medicare reimbursement.

Revenue concentration is extremely high: the top three Medicaid codes account for 96.8% of the provider’s total Medicaid revenue, indicating a narrow set of service lines dominate billing. H2012 alone represents $21.8M (77.4% of total Medicaid revenue) with 127.4K claims, while 90853 contributes $4.8M (17.1%) and S9480 adds $635.5K (2.3%), together showing near-total reliance on intensive behavioral health and group therapy services.

The code mix and descriptions point to an operation built around structured, high‑volume behavioral health programming: H2012 (behavioral health day treatment, per hour) is the primary revenue driver, supported by very large volumes of group psychotherapy (90853) and intensive outpatient per diem services (S9480). These codes suggest the facility runs day treatment and group‑based psychiatric programs at scale rather than predominantly individual outpatient or medical inpatient services.

Competitive standing in Wisconsin is strong for key Medicaid service lines. The provider ranks #2 of 52 for H2012 (98th percentile) and is a statewide leader for 90853, ranking #1 of 110 (100th percentile) and described as an extreme outlier — these ranks indicate AURORA PSYCHIATRIC HOSPITAL is a dominant provider of day‑treatment and group psychotherapy in‑state. S9480 and several inpatient consultation codes (e.g., 99253, 99252) also show top state rankings (many at #1) that reinforce its leadership in intensive outpatient and inpatient consult services for Medicaid.

Several codes are noted explicitly as statistical outliers or notably above typical state volume. 90853 is an extreme outlier (100th percentile) and H2012 is notably above typical state volume (98th percentile), which together signal unusually large program scale relative to peers and a likely specialization in group and day‑treatment modalities. Other codes such as 99252, 82075 and select consultation codes rank at or near #1 and are characterized as notably above typical state volume, highlighting pockets of state‑level dominance beyond the top two codes.

The provider has long operational tenure: its NPI was enumerated on 2006‑07‑08 (~20 years ago). This extended presence in the market aligns with the high volumes reported for recurring service codes and suggests established program infrastructure supporting sustained Medicaid billing.

While the top three codes dominate revenue, many additional CPT/HCPCS entries appear at modest dollar contributions and typical statewide percentiles, indicating that ancillary services (e.g., psychiatric evaluations 90791/90792, E/M inpatient visit codes 99232/99233, and laboratory/drug testing codes 80305/82075) supplement the core behavioral health day and group services rather than constitute major revenue streams. These ancillary lines likely support the clinical operations required by the high‑volume day‑treatment and group therapy programs.

From a payer/provider analyst perspective, the combination of no Medicare activity, high Medicaid concentration ($28.2M), and top‑percentile rankings on H2012 and 90853 identifies AURORA PSYCHIATRIC HOSPITAL as a specialized, Medicaid‑focused psychiatric hospital with programmatic scale in day treatment and group psychotherapy. This profile implies that reimbursement changes or policy shifts in Medicaid behavioral health coverage would disproportionately affect this provider relative to institutions with more diversified payer mixes.

Medicaid: Complete Services Breakdown

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

25 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2012	Behavioral health day treatment, per hour	127,430	$170	$21.8M
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…	29,770	$160	$4.8M
S9480	Intensive outpatient psychiatric services, per diem	6,000	$110	$635.5K
99253	The provider sees a patient for an inpatient or observation consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	11,460	$50	$573.2K
99254	The provider sees a patient for an inpatient or observation consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider spends…	1,820	$50	$82K
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	480	$150	$73.6K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	400	$100	$39.1K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	1,560	$20	$28.1K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	290	$90	$27.2K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	340	$60	$20.3K

Showing 1–10 of 25

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

Aurora Psychiatric Hospital, Inc. — 6 of 24 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

25 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2012	Behavioral health day treatment, per hour	2	50	8,810	$110	$2.2M
S9480	Intensive outpatient psychiatric services, per diem	1	10	2,990	$110	$418.1K
G0176	Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more)	41	50	670	$120	$361.8K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	148	170	720	$70	$272.7K
90834	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…	347	790	400	$40	$109.6K
99253	The provider sees a patient for an inpatient or observation consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	1	10	160	$40	$94.4K
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…	1	110	270	$50	$87.4K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	53	170	240	$20	$68.9K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	49	170	110	$80	$62.4K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	80	240	420	$10	$58.8K

Showing 1–10 of 25

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Aurora Health Care Metro, Inc.	WI	General Acute Care Hospital	$0	$181.9M
Aurora Medical Group, Inc.	WI	Certified Registered Nurse Anesthetist	$2.2K	$139.2M
Bergen County Improvement Authority	NJ	General Acute Care Hospital	$0	$37.5M
Aurora Medical Center Of Oshkosh, Inc	WI	General Acute Care Hospital	$0	$16.4M
Aurora Health Care Central, Inc.	WI	General Acute Care Hospital	$0	$12.4M
Jeffrey Bahr	WI	Internal Medicine Physician	$3.1M	$356.4K
Aurora Medical Group, Inc.	WI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$3.2M
Douglas Long	WI	Ophthalmology Physician	$164.3K	$0
Kari Kluessendorf	WI	Diagnostic Radiology Physician	$130K	$0
Christopher Canitz	WI	Diagnostic Radiology Physician	$112.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mid America Healthcare Corp Of Wisconsin	WI	Home Health Agency	$0	$16.2M
Visiting Nurse Association Of Wisconsin, Inc.	WI	Community Based Hospice Care Agency	$0	$9.8M
Family Care Fiscal Agent	WI	Supports Brokerage Agency	$0	$2.1M
Supportive Homecare Options, Inc	WI	Homemaker	$0	$2.1M
Neeraj Agrawal	WI	Professional Counselor	$0	$1.7M
City Of Wauwatosa	WI	Land Ambulance	$267.6K	$1.1M
Milos Tomich	WI	Podiatrist	$81.4K	$109.8K
Solomon Demby	WI	Psychiatric/Mental Health Nurse Practitioner	$66.2K	$0
Joseph Burgarino	WI	Psychiatry Physician	$33.2K	$90
Charles Grade	WI	Psychiatry Physician	$20.6K	$9.5K

Aurora Psychiatric Hospital, Inc. — Billing Profile & Reimbursement Data

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Aurora Psychiatric Hospital, 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