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 West Virginia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to West Virginia 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. West Virginia (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.

Russell Nesbitt Services Inc (NPI 1083017610)

Field	Value
Entity Type	Organization
Organization	Russell Nesbitt Services Inc
Address	431 Fulton St
City	Wheeling
State	WV
ZIP	26003
Taxonomy	Respite Care
NPI Enumerated	September 26, 2014

Payer Source	Total Paid
Medicaid	$29.5M
Medicare	$0

Key Findings

This provider is effectively single‑payer: there is no Medicare billing on file while total Medicaid revenue is $29.5M, so all reported fee‑for‑service scale and exposure sit with Medicaid rather than split across Medicare and Medicaid. That concentration means the provider’s financial and operational performance is tightly linked to state Medicaid policy and waiver program administration.

Revenue is highly concentrated in a small set of waiver/time‑based codes: the top three Medicaid codes together account for 92.2% of this provider's total Medicaid revenue, with S5125 alone contributing $21.9M (74.0% of Medicaid revenue). Such concentration indicates a reliance on a single service line for the bulk of top‑line revenue and heightens sensitivity to rate, utilization, or eligibility changes affecting those codes.

The code mix and descriptions indicate an operation focused on direct personal care and community habilitation: S5125 (attendant care services; per 15 minutes) and T2021 (day habilitation, waiver; per 15 minutes) are the dominant services, supplemented by clinical nursing visits billed under T1002 (Rn services, up to 15 minutes). Billing by 15‑minute units for S5125 and T2021 points to a high‑volume, time‑based direct care model delivering hands‑on attendant care and day habilitation services rather than episodic procedures or facility‑based care.

Competitive standing within West Virginia is mixed by service line: for S5125 the provider ranks #16 of 43 in‑state (64th percentile; typical, unremarkable volume for this code), indicating a modest but not dominant foothold in attendant care. By contrast T2021 activity is relatively strong—39K claims and $4.6M revenue—where the provider ranks #6 of 57 in‑state (91th percentile; typical, unremarkable volume for this code), suggesting a more prominent position among day habilitation providers. T1002 nursing services sit at $729.6K and rank #24 of 151 (85th percentile), implying above‑median engagement in short nursing visits compared with peers.

The provider’s secondary codes show limited but meaningful service diversification: G9002 (coordinated care fee, maintenance rate) accounts for $627.7K (2.1%), T1003 (Lpn/lvn services) $554.7K (1.9%), A0120 (non‑emergency transportation) $494.6K (1.7%), and T1016 (case management) $402.9K (1.4%). These smaller revenue streams indicate ancillary supports around the core attendant/habilitation services—transportation, coordination, and LPN care—but none approach the scale of S5125 or T2021.

Operational tenure is established but not long‑legacy: the provider’s NPI was enumerated on 2014-09-26 (~12 years ago), indicating roughly a decade of presence in the state Medicaid market and sufficient time to build recurring waiver relationships and claims patterns. This tenure supports the observed concentration in waiver/time‑based services and the higher percentile rankings in selected in‑state codes.

Many of the provider’s Medicaid codes are characterized in the data as “typical, unremarkable volume for this code” (for example S5125 at the 64th percentile, G9002 at the 50th percentile, and others), which suggests billing patterns that generally align with in‑state norms rather than representing extreme outlier behavior. Taken together with the percentile spread—some above median and some near the middle—the profile looks like a specialized, regionally competitive waiver services operator rather than an anomalous or statewide market leader across multiple service lines.

From a risk and strategic perspective, the business is highly exposed to Medicaid waiver policy and utilization dynamics: heavy dependence on time‑based attendant care and day habilitation (S5125 and T2021) concentrates payer risk and operational load into labor‑intensive services. Without a Medicare revenue stream to diversify payer mix, changes to state waiver reimbursement, documentation requirements, or audit focus on these specific codes could materially affect revenue and capacity for this provider.

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 Code	Description	Claims	Avg Paid	Revenue
S5125	Attendant care services; per 15 minutes	23,730	$920	$21.9M
T2021	Day habilitation, waiver; per 15 minutes	38,990	$120	$4.6M
T1002	Rn services, up to 15 minutes	8,480	$90	$729.6K
G9002	Coordinated care fee, maintenance rate	2,950	$210	$627.7K
T1003	Lpn/lvn services, up to 15 minutes	8,800	$60	$554.7K
A0120	Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems	8,240	$60	$494.6K
T1016	Case management, each 15 minutes	6,400	$60	$402.9K
A0160	Non-emergency transportation: per mile - case worker or social worker	2,230	$50	$102.7K
T2024	Service assessment/plan of care development, waiver	1,460	$60	$90.5K
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…	590	$60	$32.3K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. West Virginia Distribution

Russell Nesbitt Services Inc — 0 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — West Virginia

Full comparison — all codes billed, vs. West Virginia median

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5125	Attendant care services; per 15 minutes	16	40	14,820	$750	$30.5M
T2021	Day habilitation, waiver; per 15 minutes	6	60	6,490	$120	$2.2M
G9002	Coordinated care fee, maintenance rate	62	120	2,950	$150	$901.9K
T1003	Lpn/lvn services, up to 15 minutes	7	30	2,070	$90	$522.7K
T1016	Case management, each 15 minutes	30	100	2,790	$90	$496.2K
A0160	Non-emergency transportation: per mile - case worker or social worker	51	110	2,030	$50	$278.8K
T1002	Rn services, up to 15 minutes	24	150	1,980	$40	$232.6K
A0120	Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems	11	50	1,390	$30	$183.1K
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…	48	80	1,150	$40	$142.7K
T2024	Service assessment/plan of care development, waiver	17	50	760	$50	$95.5K

Nearby Providers

Other providers in the same ZIP code as Russell Nesbitt Services Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northwood Health Systems Inc	WV	Developmentally Disabled Services Day Training Agency	$0	$67.6M
Northwood Health Systems Inc	WV	Community/Behavioral Health Agency	$0	$52.5M
Wheeling Hospital Inc	WV	General Acute Care Hospital	$0	$40.1M
Lorraine Surgical Supply Of West Virginia Inc.	WV	Durable Medical Equipment & Medical Supplies	$0	$34.6M
Florence Crittenton Programs, Inc.	WV	Mental Health Counselor	$0	$14.4M
Wheeling Hospital Inc	WV	Family Medicine Physician	$0	$8.5M
Lifeline Addiction Specialists, PLLC	WV	Multi-Specialty Clinic/Center	$0	$7M
Radiology Associates, Inc	WV	Diagnostic Radiology Physician	$0	$6.7M
Serenity Hills Life Center	WV	Substance Use Disorder Rehabilitation Clinic/Center	$0	$6.1M
Alecto Healthcare Services Wheeling LLC	WV	General Acute Care Hospital	$0	$6M

Russell Nesbitt Services Inc — Billing Profile & Reimbursement Data

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Russell Nesbitt Services 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

Nearby Providers

Frequently Asked Questions

References