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NPI 1912639576 · Lawrence, KS · Community/Behavioral Health Agency
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Bert Nash Community Mental Health Center Inc is a community/behavioral health agency provider located in Lawrence, Kansas. This profile covers 0 Medicare and 25 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Bert Nash Community Mental Health Center Inc |
| Address | 200 Maine St Ste A |
| City | Lawrence |
| State | KS |
| ZIP | 66044 |
| Taxonomy | Community/Behavioral Health Agency |
| NPI Enumerated | June 30, 2022 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $28.8M |
| Medicare | $0 |
Medicaid revenue is highly concentrated: the precomputed top-3 Medicaid codes account for 100.0% of this provider’s total Medicaid revenue, and that concentration is entirely driven by T1040, which is listed at $28.8M in revenue with 82.2K claims and a $350 avg paid/claim. This single per‑diem code dominates the financial picture for the organization.
This provider effectively operates as a Medicaid-focused entity: there is no Medicare billing on file while Medicaid revenue totals $28.8M, so the organization is practically single‑payer (Medicaid) in the available claims data. Analysts should treat Medicaid performance as the primary indicator of scale and market impact.
The code mix and dominant revenue source indicate a CCBHC-style operating model: T1040 is described as Medicaid certified community behavioral health clinic services, per diem, and the provider’s taxonomy is Community/Behavioral Health Agency. The presence of many psychotherapy, case management, and crisis codes alongside a large per‑diem payment stream is consistent with bundled, clinic‑level reimbursement for comprehensive community behavioral health services.
Many high-volume CPT/HCPCS lines show $0 avg paid/claim and $0 revenue (for example H0036: 42.1K claims, 90837: 6.9K claims, T1017: 11.3K claims), which is consistent with those services being billed or paid under the T1040 per‑diem or otherwise bundled payment arrangements. This pattern means that encounter counts are informative about service mix and utilization even when line‑level Medicaid payments are not separately reported.
Competitive standing for the primary revenue driver is modest within the state: T1040 ranks #8 of 33 providers in-state (78th percentile; typical, unremarkable volume for this code), so while T1040 generates almost all revenue, the provider is not the top state payer for that code and sits in a typical to slightly above‑median position among peers.
The provider is a clear statewide leader on group psychotherapy volume: 90853 ranks #1 of 46 providers in-state (100th percentile; extreme outlier), indicating an outsized role in delivering group therapy compared with peers. In addition, 90837 ranks #34 of 731 (95th percentile; notably above typical state volume), showing substantial delivery of long individual psychotherapy sessions as well.
Beyond psychotherapy, the provider reports substantial volumes in community and case‑management services—examples include T1017 (11.3K claims, ranks #68 of 218, 69th percentile), H2017 (11.1K claims, ranks #35 of 63, 45th percentile) and H0038 (5.4K claims, ranks #18 of 64, 73th percentile). Together these claim counts paint a picture of high‑frequency outpatient and community‑based services across multiple modalities even when those lines do not show separate Medicaid revenue.
The organization’s enrollment timeline is relatively recent for a major Medicaid billing entity: NPI enumerated 2022-06-30 (~4 years ago). Achieving $28.8M in Medicaid revenue and high claim volumes within this timeframe suggests rapid operational scale-up in the Medicaid community behavioral health space rather than a long‑standing slow build.
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
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 |
|---|---|---|---|---|
| T1040 | Medicaid certified community behavioral health clinic services, per diem | 82,190 | $350 | $28.8M |
| 90791 | In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. | 870 | $0 | $0 |
| 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… | 310 | $0 | $0 |
| 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… | 1,870 | $0 | $0 |
| 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… | 4,500 | $0 | $0 |
| 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… | 6,850 | $0 | $0 |
| 90839 | In this service, the provider performs psychotherapy for a crisis situation when the patient is in a life–threatening state and needs immediate attention. The treatment session typically lasts… | 50 | $0 | $0 |
| 90846 | A provider meets with the patient’s family without the patient present to counsel the family on the psychological issues affecting the patient and the family. | 30 | $0 | $0 |
| 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… | 850 | $0 | $0 |
| 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… | 2,850 | $0 | $0 |
Showing 1–10 of 25
How this provider's Medicaid billing volume and revenue compare to other Kansas providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Kansas median
25 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| T1040 | Medicaid certified community behavioral health clinic services, per diem | 8 | 30 | 34,540 | $260 | $13.9M |
| T1019 | Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify… | 51 | 60 | 21,510 | $90 | $8.5M |
| H0036 | Community psychiatric supportive treatment, face-to-face, per 15 minutes | 25 | 60 | 35,080 | $100 | $4.1M |
| H2017 | Psychosocial rehabilitation services, per 15 minutes | 35 | 60 | 12,570 | $60 | $1.5M |
| H2011 | Crisis intervention service, per 15 minutes | 19 | 50 | 1,840 | $270 | $1.1M |
| T1017 | Targeted case management, each 15 minutes | 68 | 220 | 5,390 | $40 | $599.4K |
| H2021 | Community-based wrap-around services, per 15 minutes | 29 | 30 | 3,140 | $60 | $441K |
| 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… | 650 | 1,050 | 560 | $80 | $266.8K |
| H0038 | Self‑help/peer services, per 15 minutes | 18 | 60 | 2,130 | $50 | $223.2K |
| S5110 | Home care training, family; per 15 minutes | 31 | 30 | 2,000 | $30 | $139.3K |
Showing 1–10 of 25
Other providers in the same ZIP code as Bert Nash Community Mental Health Center Inc, ranked by combined Medicare and Medicaid revenue.
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