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.

The Arc Of Harrison County (NPI 1093844037)

Field	Value
Entity Type	Organization
Organization	The Arc Of Harrison County
Address	100 N 1st St
City	Clarksburg
State	WV
ZIP	26301
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	March 5, 2007

Payer Source	Total Paid
Medicaid	$32.8M
Medicare	$0

Key Findings

THE ARC OF HARRISON COUNTY is effectively a Medicaid-centric operation with no Medicare billing on file and $32.8M in lifetime Medicaid revenue. The absence of Medicare activity makes the provider functionally single-payer in the claims data, concentrating financial exposure and strategic emphasis on Medicaid program rules and waiver services.

Revenue is extremely concentrated in a very small set of services: the precomputed top 3 Medicaid codes account for 95.6% of the provider's total Medicaid revenue, driven overwhelmingly by S5125 which alone represents $30.2M (92.3% of Medicaid revenue). This concentration indicates the organization’s financial performance is heavily dependent on a single service line and reimbursement stream.

S5125 (Attendant care services; per 15 minutes) dominates the provider’s billed activity with 163.4K claims at $185 avg paid/claim and $30.2M revenue, and the provider ranks #4 of 43 in-state (93th percentile), described as notably above typical state volume. That combination of high volume, high share of revenue, and a top-state rank signals that attendant/personal care delivery is the core business model and the most important operational focus.

A0160 (Non-emergency transportation: per mile - case worker or social worker) and T1003 (Lpn/lvn services, up to 15 minutes) are both state-level outliers: A0160 has 34.9K claims, $488.5K revenue and ranks #2 of 112 (99th percentile; extreme outlier), while T1003 shows 29.1K claims, $378.7K revenue and ranks #1 of 33 (100th percentile; extreme outlier). These rankings indicate unusually large volumes of transportation and LPN/LVN-delivered services relative to peers, suggesting substantial logistics and frontline nursing capacity embedded in the provider’s operations.

Other waiver and care-coordination codes in the top mix—T2021 (Day habilitation, waiver; $609.3K, rank #22 of 57, 63th percentile) and G9002 (Coordinated care fee, $464.3K, rank #76 of 123, 39th percentile)—add modest, typical-state-level revenue and point to a mix of day habilitation and care coordination activities alongside dominant attendant care. The presence of T1016 (case management) and T1002 (RN services) at measurable volumes further supports an integrated waiver-service footprint that combines hands-on care, nursing oversight, and case-management.

Given the provider’s NPI tenure (enumerated 2007-03-05 (~19 years ago)), this is an established entity in the West Virginia market with a long-running Medicaid billing history. The longevity combined with the concentration in attendant care suggests institutional specialization rather than a new entrant testing multiple lines of business.

Competitive implications are mixed: the provider is a major player for attendant care and certain ancillary services—S5125’s rank and share make it a dominant Medicaid attendant-care provider statewide—while for several other codes (G9002, T2024) the provider sits in more ordinary percentile positions and does not lead the market. Analysts should treat the entity as a market leader in attendant/personal care and a high-volume outlier in transportation and LPN services, but not as broadly dominant across all waiver or coordination codes.

Operational risk and strategic attention should focus on the concentrated revenue stream: because S5125 comprises 92.3% of Medicaid revenue and the top three codes together make up 95.6%, any policy, rate, or utilization changes affecting attendant care, transportation mileage reimbursement, or LPN visit billing could have outsized financial impact. Monitoring state waiver rules, attendant-care reimbursement policy, and non-emergency-transportation rates will be critical for payers and partners evaluating contract or utilization-management approaches.

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5125	Attendant care services; per 15 minutes	163,440	$190	$30.2M
T2021	Day habilitation, waiver; per 15 minutes	10,880	$60	$609.3K
A0160	Non-emergency transportation: per mile - case worker or social worker	34,890	$10	$488.5K
G9002	Coordinated care fee, maintenance rate	2,100	$220	$464.3K
T1003	Lpn/lvn services, up to 15 minutes	29,130	$10	$378.7K
T1016	Case management, each 15 minutes	11,210	$30	$302.7K
T1002	Rn services, up to 15 minutes	6,690	$40	$247.6K
T2024	Service assessment/plan of care development, waiver	650	$60	$40.9K

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

The Arc Of Harrison County — 2 of 8 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

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5125	Attendant care services; per 15 minutes	4	40	14,820	$750	$30.5M
T2021	Day habilitation, waiver; per 15 minutes	22	60	6,490	$120	$2.2M
G9002	Coordinated care fee, maintenance rate	76	120	2,950	$150	$901.9K
T1003	Lpn/lvn services, up to 15 minutes	1	30	2,070	$90	$522.7K
T1016	Case management, each 15 minutes	12	100	2,790	$90	$496.2K
A0160	Non-emergency transportation: per mile - case worker or social worker	2	110	2,030	$50	$278.8K
T1002	Rn services, up to 15 minutes	30	150	1,980	$40	$232.6K
T2024	Service assessment/plan of care development, waiver	26	50	760	$50	$95.5K

Nearby Providers

Other providers in the same ZIP code as The Arc Of Harrison County, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
United Summit Center Inc- Rehab	WV	Community/Behavioral Health Agency	$0	$32.8M
United Summit Center Inc-wavier	WV	Developmental Disabilities Clinic/Center	$0	$25.6M
Community Care Of West Virginia, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$11M
Harrison County Emergency Squad	WV	Ambulance	$839K	$8M
Genesis Youth Crisis Center	WV	Community/Behavioral Health Agency	$0	$7.4M
Clarksburg Treatment Center, LLC	WV	Methadone Clinic	$67.1K	$6.3M
Dr. Robert Martino, PLLC	WV	Dentist	$0	$5.8M
Clarksburg Treatment Center, LLC	WV	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$2.7M
Genesis Youth Crisis Center, Inc.	WV	Community/Behavioral Health Agency	$0	$2.4M
Pressley Ridge	WV	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$2.2M

The Arc Of Harrison County — Billing Profile & Reimbursement Data

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The Arc Of Harrison 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

Nearby Providers

Frequently Asked Questions

References