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

Why is the Medicaid comparison limited to North 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. North 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.

Southeast Behavioral Health Clinic (NPI 1932146941)

Field	Value
Entity Type	Organization
Organization	Southeast Behavioral Health Clinic
Address	2624 9th Ave S
City	Fargo
State	ND
ZIP	58103
Taxonomy	Substance Use Disorder Rehabilitation Clinic/Center
NPI Enumerated	May 31, 2006

Payer Source	Total Paid
Medicaid	$8.8M
Medicare	$0

Key Findings

SOUTHEAST BEHAVIORAL HEALTH CLINIC is effectively a Medicaid-focused facility with no Medicare billing on file; lifetime Medicare revenue is listed as none while lifetime Medicaid revenue totals $8.8M, indicating the provider's patient and revenue base is concentrated in Medicaid populations rather than fee-for-service Medicare. The NPI was enumerated ~20 years ago (2006-05-31), signaling long-standing operation in the market despite its narrow payer footprint.

Revenue concentration is very high: the precomputed top 3 Medicaid codes account for 66.9% of this provider's total Medicaid revenue. The largest single contributor is 99214 (office/outpatient E/M for established patients) at $3.3M (37.1% of Medicaid revenue), followed by T1016 (case management) at $1.7M (19.6%) and H2035 (AOD treatment program, per hour) at $910.6K (10.3%), which together define the financial backbone of the clinic.

The code mix suggests an outpatient behavioral health and substance use disorder treatment model focused on intensive case management and routine medical management visits. High volumes of T1016 (case management) and H2035 (AOD treatment per hour) alongside 99214 indicate the clinic provides ongoing structured addiction treatment services with substantial care coordination and regular established-patient evaluation visits rather than episodic, high-acuity medical care.

SOUTHEAST BHCLINIC is a market leader in several Medicaid service lines within North Dakota: T1016 ranks #1 of 18 providers in-state and is described as an "extreme outlier, far above typical state volume," and the clinic also ranks #1 for H0002 and top for S9485, indicating it is a dominant provider for case management and behavioral health admission screening services in-state. By contrast, 99214—while the largest revenue driver—ranks #9 of 171 providers (95th percentile), which reflects strong but not singular dominance for standard E/M outpatient visits.

Service mix shows both billable psychotherapy/group modalities and crisis/intervention services: 90853 (group psychotherapy) generated $845.3K and ranks #2 of 22 (95th percentile), while crisis codes like S9485 and H2011 appear with meaningful revenue and #1–#3 state rankings. This combination points to the clinic operating both structured group programming and crisis-oriented interventions, supporting a continuum of outpatient SUD care with supplemental crisis capacity.

Several codes show unusually high state-level standing that signal the provider’s operational emphasis rather than billing anomalies: T1016 is explicitly an "extreme outlier, far above typical state volume," and H0002 and S9485 both rank #1 of their peer counts, described as "notably above" or typical but top-volume; these descriptions indicate sustained, above-typical provision of case management and intake/screening services relative to in-state peers.

Although the clinic bills many standard behavioral health CPTs (99214, 99213, 90834, 90853), revenue is heavily skewed to a small set of service types; the top three codes alone make up 66.9% of Medicaid revenue, which implies business risk if reimbursement policies or utilization for those codes change. The presence of both high-volume E/M (99214) and high-volume non-E/M SUD services means operationally the clinic balances medical evaluation visits with programmatic treatment and coordination.

Medicaid: Complete Services Breakdown

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	11,960	$270	$3.3M
T1016	Case management, each 15 minutes	15,060	$120	$1.7M
H2035	Alcohol and/or other drug treatment program, per hour	7,590	$120	$910.6K
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…	13,860	$60	$845.3K
H0002	Behavioral health screening to determine eligibility for admission to treatment program	3,860	$120	$443.8K
S9485	Crisis intervention mental health services, per diem	1,860	$210	$394.3K
H2014	Skills training and development, per 15 minutes	4,130	$70	$297.4K
H0004	Behavioral health counseling and therapy, per 15 minutes	2,220	$110	$250.7K
H2011	Crisis intervention service, per 15 minutes	1,260	$140	$180.3K
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…	1,140	$130	$151K

Showing 1–10 of 22

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Dakota Distribution

Southeast Behavioral Health Clinic — 5 of 21 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Dakota

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

22 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	59	210	360	$100	$498.2K
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…	9	170	300	$100	$415.8K
T1016	Case management, each 15 minutes	1	20	1,390	$100	$242.6K
H2035	Alcohol and/or other drug treatment program, per hour	3	20	590	$90	$206.4K
S9485	Crisis intervention mental health services, per diem	1	10	990	$200	$203.1K
H0004	Behavioral health counseling and therapy, per 15 minutes	10	40	520	$80	$181.5K
H0002	Behavioral health screening to determine eligibility for admission to treatment program	1	10	900	$130	$178.3K
H2019	Therapeutic behavioral services, per 15 minutes	2	10	3,360	$50	$161.5K
H2017	Psychosocial rehabilitation services, per 15 minutes	7	10	1,120	$80	$153.7K
H2011	Crisis intervention service, per 15 minutes	3	10	1,260	$80	$147.9K

Showing 1–10 of 22

Related Providers

Other providers that share a Tax Identification Number (TIN) with Southeast Behavioral Health Clinic, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Michael Capan	ND	Psychiatry Physician	$38.1K	$0
Stacey Berger Johnson	ND	Professional Counselor	$0	$8.8K
Nicole Erasmus	ND	Clinical Social Worker	$2.5K	$0
Joni Heine	ND	Clinical Social Worker	$1.4K	$0

Nearby Providers

Other providers in the same ZIP code as Southeast Behavioral Health Clinic, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Living Services, Inc	ND	Community/Behavioral Health Agency	$0	$104.6M
Villa Nazareth	ND	Community/Behavioral Health Agency	$0	$84.2M
Psj Acquisition LLC	ND	Psychiatric Hospital	$0	$32.3M
Vocational Training Center, Inc.	ND	Community/Behavioral Health Agency	$0	$28.5M
Fm Ambulance Service, Inc	ND	Land Ambulance	$2M	$23.8M
Innovis Health, LLC	ND	General Acute Care Hospital	$0	$25.5M
Fraser, Ltd.	ND	Community/Behavioral Health Agency	$0	$13.9M
Community Medical Services Montana Private LLC	ND	Methadone Clinic	$214.7K	$8.9M
Village Family Service Center	ND	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$8.8M
Doyle's Yellow Checker Cab, Inc	ND	Taxi	$0	$7.8M

Southeast Behavioral Health Clinic — Billing Profile & Reimbursement Data

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Southeast Behavioral Health Clinic — 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