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

Why is the Medicaid comparison limited to Kentucky 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. Kentucky (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.

Theresa Rust (NPI 1093197089)

Field	Value
Entity Type	Individual
Organization	Theresa Rust
Address	80 Highway 2227
City	Somerset
State	KY
ZIP	42503
Taxonomy	Mental Health Counselor
NPI Enumerated	June 25, 2015

Payer Source	Total Paid
Medicaid	$4.9M
Medicare	$0

Medicaid: Complete Services Breakdown

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

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0038	Self‑help/peer services, per 15 minutes	7,000	$220	$1.5M
H2015	Comprehensive community support services, per 15 minutes	5,110	$240	$1.2M
H2020	Therapeutic behavioral services, per diem	7,820	$150	$1.1M
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…	4,410	$110	$462.5K
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…	3,770	$50	$177K
T2023	Targeted case management; per month	840	$200	$166.4K
H0049	Alcohol and/or drug screening	4,070	$10	$44.8K
H2027	Psychoeducational service, per 15 minutes	830	$40	$33.2K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	460	$70	$30.9K
H2019	Therapeutic behavioral services, per 15 minutes	310	$80	$25.6K

Showing 1–10 of 17

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Theresa Rust — 0 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

17 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2019	Therapeutic behavioral services, per 15 minutes	31	50	820	$190	$1.7M
H2020	Therapeutic behavioral services, per diem	26	130	1,730	$180	$1.2M
H2027	Psychoeducational service, per 15 minutes	117	220	970	$170	$1.1M
T2023	Targeted case management; per month	223	530	530	$300	$1.1M
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…	66	230	1,750	$110	$793.5K
H0038	Self‑help/peer services, per 15 minutes	108	320	3,070	$50	$678.3K
H2015	Comprehensive community support services, per 15 minutes	51	200	1,610	$80	$585.6K
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…	274	1,270	760	$80	$447.2K
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…	312	600	600	$40	$207.8K
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…	358	500	250	$60	$152.8K

Showing 1–10 of 17

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Protea Behavioral Health Counseling, PLLC	KY	Professional Counselor	$0	$24.4M

Nearby Providers

Other providers in the same ZIP code as Theresa Rust, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Morrland Healthcare LLC	KY	Community/Behavioral Health Agency	$0	$54.8M
Applied Behavioral Advancements, LLC	KY	Community/Behavioral Health Agency	$0	$29.2M
Lake Cumberland Regional Hospital, LLC	KY	Internal Medicine Physician	$0	$15.6M
Cumberland Behavior Group, LLC	KY	Community/Behavioral Health Agency	$0	$15.2M
Quest Counseling	KY	Mental Health Counselor	$0	$12.5M
Lake Cumberland Recovery, Inc	KY	Substance Use Disorder Rehabilitation Clinic/Center	$0	$11.8M
Achievements Through Actions	KY	Developmentally Disabled Services Day Training Agency	$0	$10M
Lake Cumberland Surgery Center LP	KY	Ambulatory Surgical Clinic/Center	$1M	$8.7M
Adult Day Health, Inc.	KY	Adult Day Care Clinic/Center	$0	$8.9M
Infinite Abilities & Supports, Inc.	KY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$8.9M

Theresa Rust — Billing Profile & Reimbursement Data

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Theresa Rust — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References