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.

St Croix County (NPI 1932265105)

Field	Value
Entity Type	Organization
Organization	St Croix County
Address	1752 Dorset Ln
City	New Richmond
State	WI
ZIP	54017
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	December 29, 2006

Payer Source	Total Paid
Medicaid	$23.9M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-only billing entity: there is no Medicare revenue on file and total reported Medicaid revenue is $23.9M. The absence of Medicare billing indicates payer concentration in state Medicaid programs rather than a mixed Medicare/Medicaid practice footprint.

Revenue is highly concentrated in three codes: H2017 ($15.4M, 64.6%), T1016 ($4.3M, 18.1%), and 99199 ($2.3M, 9.8%), which together account for 92.5% of the provider's total Medicaid revenue. This concentration means a small set of service lines drives nearly all billed dollars and will dominate contracting and utilization discussions.

The code mix signals a community-based behavioral health operation focused on frequent, time-based interventions: H2017 (Psychosocial rehabilitation services, per 15 minutes) has 129.7K claims and is the single largest revenue driver, and T1016 (Case management, each 15 minutes) has 54.1K claims. High volumes of 15-minute units point to a programmatic delivery model (day/rehab services and case management) rather than episodic physician office care.

The provider’s competitive standing within the state is modest to regional for its top codes: H2017 ranks #20 of 58 providers (67th percentile) and 99199 ranks #20 of 57 providers (66th percentile), both described as typical, unremarkable volume for those codes, while T1016 ranks #29 of 224 providers (87th percentile), indicating a relatively strong presence among case management billers statewide. These rank/percentile positions suggest the organization is not dominant statewide in psychosocial rehab but is a notable participant in case management services.

There is one clear statistical outlier among ancillary services: S5161 (Emergency response system; service fee, per month) has 2.7K claims, $27K revenue and ranks #2 of 17 providers (94th percentile), described as notably above typical state volume for this code. This elevated rank for S5161 suggests the provider operates an emergency response or monitoring program at volumes higher than most peers, which could reflect a localized service offering or waiver-related activity.

Operationally, the billing pattern reflects a high-volume, low-unit-price, unitized care model: 129.7K claims for H2017 and 54.1K claims for T1016 show dependence on many short-duration encounters billed in 15-minute increments. That delivery and revenue model has implications for workforce (many clinicians or paraprofessionals delivering time-based services), capacity planning, and vendor/IRR contracting focused on per-unit reimbursement.

The frequent use of 99199 (30.1K claims, $2.3M, 9.8% of Medicaid revenue) indicates substantial billing under a catch-all ‘other medicine services’ code, which may reflect services that lack specific procedure codes or a need for broader service descriptors. While not inherently problematic, reliance on 99199 can complicate cross-provider comparisons, payor negotiations, and service-line costing because those claims are less granular than named procedure codes.

The provider has long tenure in the registry (NPI enumerated 2006-12-29, ~20 years ago), indicating sustained operation over time and an established presence in the state Medicaid market. Combined with the concentrated Medicaid revenue base, this tenure suggests a stable community behavioral health provider whose strategic considerations will center on Medicaid contracting and program-specific service lines rather than Medicare participation.

Medicaid: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2017	Psychosocial rehabilitation services, per 15 minutes	129,700	$120	$15.4M
T1016	Case management, each 15 minutes	54,090	$80	$4.3M
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	30,080	$80	$2.3M
H0039	Assertive community treatment, face-to-face, per 15 minutes	16,580	$30	$563.7K
S9484	Crisis intervention mental health services, per hour	9,680	$50	$483.8K
T1017	Targeted case management, each 15 minutes	4,910	$50	$245.6K
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…	5,470	$30	$175.1K
H0022	Alcohol and/or drug intervention service (planned facilitation)	1,910	$40	$66.9K
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…	3,510	$20	$59.6K
A9999	Miscellaneous dme supply or accessory, not otherwise specified	280	$180	$51K

Showing 1–10 of 20

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

St Croix County — 0 of 20 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

20 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2017	Psychosocial rehabilitation services, per 15 minutes	20	60	57,750	$100	$18.9M
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	20	60	16,890	$60	$2.9M
S9484	Crisis intervention mental health services, per hour	26	70	7,330	$60	$2.5M
H0039	Assertive community treatment, face-to-face, per 15 minutes	35	70	16,670	$30	$2.1M
T1017	Targeted case management, each 15 minutes	32	90	3,130	$100	$2M
T1016	Case management, each 15 minutes	29	220	7,110	$70	$1.7M
T2028	Specialized supply, not otherwise specified, waiver	42	40	340	$210	$188.6K
A9999	Miscellaneous dme supply or accessory, not otherwise specified	34	60	460	$170	$177.3K
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…	310	1,760	250	$40	$173.2K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	432	500	3,140	$20	$148.9K

Showing 1–10 of 20

Related Providers

Other providers that share a Tax Identification Number (TIN) with St Croix County, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
John Simon	MN	Psychiatry Physician	$24.9K	$0
Jonathan Hoistad	MN	Psychologist	$17.2K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Westfields Hospital, Inc.	WI	Critical Access Hospital	$0	$8.5M
Family Therapy Associates, LLC	WI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$4.4M
New Richmond Area Ambulance And Rescue Service Association	WI	Land Ambulance	$304.5K	$87.1K
Christine Rukamp	WI	Emergency Medicine Physician	$22.9K	$0

St Croix County — Billing Profile & Reimbursement Data

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St Croix County — 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