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.

Stepping Stones Cottages, LLC (NPI 1134126147)

Field	Value
Entity Type	Organization
Organization	Stepping Stones Cottages, LLC
Address	124 N Maple Ave
City	Martinsburg
State	WV
ZIP	25401
Taxonomy	Counseling Psychologist
NPI Enumerated	July 5, 2005

Payer Source	Total Paid
Medicaid	$26.6M
Medicare	$0

Key Findings

This provider is effectively single-payer: STEPPING STONES COTTAGES, LLC reports no Medicare billing on file and $26.6M in lifetime Medicaid revenue, indicating its operations and revenue are driven almost entirely by Medicaid-funded services rather than Medicare. The absence of Medicare claims suggests its patient mix or service authorizations are concentrated in Medicaid populations and programs.

Revenue is highly concentrated in a very small set of Medicaid codes: the precomputed top 3 Medicaid codes by revenue account for 95.9% of this provider's total Medicaid revenue, with S5125 alone representing $23.1M (87.1% of Medicaid revenue). That level of concentration implies that changes in authorization, rates, or utilization for those few codes would materially affect the provider’s financials.

The top revenue-driving codes define the service line: S5125 (Attendant care services; per 15 minutes), T1005 (Respite care services, up to 15 minutes), and A0160 (Non-emergency transportation: per mile - case worker or social worker) together make up the dominant mix, indicating the organization operates primarily in home- and community-based attendant care, respite support, and transportation services for Medicaid beneficiaries. These code descriptions point to an operational model focused on hands-on personal care and travel/caseworker support rather than clinic-based psychotherapy or medical specialty services.

Despite generating $23.1M from S5125, STEPPING STONES ranks in the middle of state peers on that code: S5125 shows 12.9K claims, $1798 avg paid/claim, $23.1M revenue and ranks #24 of 43 providers in-state (45th percentile; typical, unremarkable volume for this code). In other words, while S5125 is the provider’s dominant revenue line internally, its statewide market position on attendant care is modest and not unusually high relative to peers.

The provider shows relative strength on certain ancillary codes even where dollar contribution is smaller: A0160 produced $945.9K in revenue with 6K claims and $157 avg paid/claim and ranks #32 of 112 providers in-state (72th percentile; typical, unremarkable volume for this code), indicating a comparatively stronger role in non-emergency transportation than in several other service lines. By contrast, T1005 contributed $1.4M (1.2K claims, $1202 avg paid/claim) but ranks #20 of 29 (32th percentile; typical, unremarkable volume for this code), so respite services are a meaningful revenue line for the provider but not a leading state position.

There are pockets of above-average standing on non-dominant codes: T2024 (Service assessment/plan of care development, waiver) accounts for $177.4K (2.9K claims, $62 avg paid/claim) and ranks #8 of 45 providers in-state (84th percentile; typical, unremarkable volume for this code), suggesting the organization performs assessments and care planning at a higher relative rate than many peers even though this activity contributes a small share (0.7%) of total Medicaid revenue. This may reflect an operational capability in care coordination that complements the attendant-care delivery footprint.

Operational scale is evident in utilization metrics supporting the top lines: the largest code S5125 shows 12.9K claims at an avg paid/claim of $1798, and A0160 shows 6K claims at $157 avg paid/claim, indicating substantial per-claim volume and payment levels behind the Medicaid revenue totals. Those claim counts and payment averages underline that the provider’s Medicaid revenue is driven by frequent, billed service units consistent with time- or mileage-based billing models rather than infrequent high-dollar procedure codes.

STEPPING STONES has long tenure in the registry, with its NPI enumerated on 2005-07-05 (~21 years ago), which is consistent with an established local operator in Medicaid home- and community-based services; combined with the concentrated code mix, this suggests a stable, long-running business model centered on attendant/respite care and transportation for Medicaid enrollees.

Medicaid: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5125	Attendant care services; per 15 minutes	12,870	$1,800	$23.1M
T1005	Respite care services, up to 15 minutes	1,160	$1,200	$1.4M
A0160	Non-emergency transportation: per mile - case worker or social worker	6,030	$160	$945.9K
T1016	Case management, each 15 minutes	2,280	$210	$481.7K
T2021	Day habilitation, waiver; per 15 minutes	4,690	$80	$351.5K
T2024	Service assessment/plan of care development, waiver	2,860	$60	$177.4K
T1002	Rn services, up to 15 minutes	1,840	$30	$57.2K
A0120	Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems	820	$40	$32K
T1003	Lpn/lvn services, up to 15 minutes	20	$90	$2.2K

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

Stepping Stones Cottages, LLC — 0 of 9 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

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5125	Attendant care services; per 15 minutes	24	40	14,820	$750	$30.5M
T2021	Day habilitation, waiver; per 15 minutes	34	60	6,490	$120	$2.2M
T1005	Respite care services, up to 15 minutes	20	30	2,980	$250	$1.5M
T1003	Lpn/lvn services, up to 15 minutes	32	30	2,070	$90	$522.7K
T1016	Case management, each 15 minutes	52	100	2,790	$90	$496.2K
A0160	Non-emergency transportation: per mile - case worker or social worker	32	110	2,030	$50	$278.8K
T1002	Rn services, up to 15 minutes	79	150	1,980	$40	$232.6K
A0120	Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems	32	50	1,390	$30	$183.1K
T2024	Service assessment/plan of care development, waiver	8	50	760	$50	$95.5K

Nearby Providers

Other providers in the same ZIP code as Stepping Stones Cottages, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Shenandoah Valley Medical System, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$61M
City Hospital, Inc	WV	General Acute Care Hospital	$0	$41.1M
Eastern Panhandle Mental Health Center (waiver)	WV	Community/Behavioral Health Agency	$0	$28.8M
University Healthcare Physicians, Inc.	WV	Family Medicine Physician	$0	$17.5M
American Family Matters LLC	WV	Community/Behavioral Health Agency	$0	$16.9M
Berkeley County Emergency Ambulance Authority	WV	Land Ambulance	$864.6K	$5.6M
Eastern Panhandle Mental Health (rehab)	WV	Community/Behavioral Health Agency	$0	$5.7M
City Of Martinsburg	WV	Land Ambulance	$222.2K	$2.7M
Lance Pittman	WV	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$2.3M
Wv Pediatric Dentistry PLLC	WV	Pediatric Dentistry	$0	$2M

Stepping Stones Cottages, LLC — Billing Profile & Reimbursement Data

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Stepping Stones Cottages, LLC — 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