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

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

Cherokee Health Systems (NPI 1134128820)

Field	Value
Entity Type	Organization
Organization	Cherokee Health Systems
Address	6350 W Andrew Johnson Hwy
City	Talbott
State	TN
ZIP	37877
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	July 15, 2005

Payer Source	Total Paid
Medicaid	$97.7M
Medicare	$0

Key Findings

CHEROKEE HEALTH SYSTEMS is an FQHC (Federally Qualified Health Center) in TALBOTT, TN with an NPI enumerated 2005-07-15 (~21 years ago), indicating long-standing participation in publicly funded care delivery. Its billing footprint is overwhelmingly Medicaid-focused with Total Medicaid revenue reported as $97.7M and no Medicare billing on file, making it effectively a single‑payer Medicaid provider for the dataset shown.

Revenue concentration is high: the precomputed top 3 Medicaid codes account for 55.0% of this provider's total Medicaid revenue. Those top three contributors are T1015 ($31.1M, 32.8%), 99214 ($10.7M, 11.3%), and S0280 ($10.3M, 10.8%), so a small set of service categories drives the majority of clinical revenue.

The code mix shows an operational model centered on comprehensive primary care plus integrated behavioral health and care coordination. T1015 (Clinic visit/encounter, all-inclusive) is the single largest revenue source ($31.1M, 32.8%), while high volumes of E/M codes 99214 and 99213 and behavioral health codes 90832/90834/90791 indicate simultaneous emphasis on longitudinal primary care visits and psychotherapy/psychiatric services.

CHEROKEE’s competitive standing in Tennessee is dominant or extreme for several high-volume codes: T1015 ranks #1 of 10 providers in-state (100th percentile; notably above typical state volume), 99214 ranks #11 of 3759 (100th percentile; extreme outlier), and 99213 ranks #11 of 4050 (100th percentile; extreme outlier). These rankings suggest the organization is a major statewide provider for routine clinic visits and higher-complexity outpatient E/M services.

The provider also shows a strong role in care coordination and medical home activities: S0280 (Medical home program, initial plan) and G9002 (Coordinated care fee, maintenance rate) together contribute meaningful revenue ($10.3M and $5.8M respectively) and indicate billing for structured care management; S0280’s rank (#16 of 40, 62th percentile) is typical for the state while G9002 ranks #2 of 9 (88th percentile). This blend of codes supports an operational focus on medical-home style service delivery rather than episodic acute care alone.

Behavioral health and developmental screening are material service lines: psychotherapy codes 90832 and 90834 together produce more than $11M in revenue and rank highly (90832: #4 of 300, 99th percentile; 90834: #7 of 360, 98th percentile), and 96110 (developmental screening) is $3.1M and ranks #1 of 622 providers (100th percentile; extreme outlier). These patterns indicate a sizable behavioral health and pediatric screening footprint within the Medicaid population.

Preventive care and pediatric services are also visible: multiple preventive E/M codes (99391/99392/99393/99394) and vaccine administration codes (90460, 90471) appear in the top list with notable state-level ranks (many in the 96th–99th percentiles), supporting that the FQHC delivers routine well-child and immunization services at scale. This aligns with an FQHC mission of comprehensive primary care across age groups.

Concentration and payer risk should be noted: reliance on Medicaid ($97.7M) with no Medicare revenue on file creates exposure to Medicaid policy and rate changes, and the fact that 55.0% of revenue comes from the top three codes (T1015, 99214, S0280) means operational or reimbursement shifts for clinic-all‑inclusive, E/M, or medical-home payments could disproportionately affect total revenue. At the same time, the provider’s statewide leadership on several codes suggests it has scale and capacity to absorb some operational changes relative to smaller peers.

Medicaid: Complete Services Breakdown

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

209 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	129,690	$240	$31.1M
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	185,220	$60	$10.7M
S0280	Medical home program, comprehensive care coordination and planning, initial plan	69,850	$150	$10.3M
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…	202,370	$40	$8.1M
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…	150,480	$40	$6.6M
G9002	Coordinated care fee, maintenance rate	126,820	$50	$5.8M
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…	83,890	$60	$5M
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	130,670	$20	$3.1M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	26,900	$110	$2.9M
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	54,310	$40	$2.1M

Showing 1–10 of 209

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Cherokee Health Systems — 17 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

209 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S0280	Medical home program, comprehensive care coordination and planning, initial plan	16	40	22,180	$140	$21.3M
G9002	Coordinated care fee, maintenance rate	2	10	13,140	$80	$3.5M
T1015	Clinic visit/encounter, all-inclusive	1	10	40	$220	$3.1M
H2017	Psychosocial rehabilitation services, per 15 minutes	7	20	11,380	$70	$1.9M
H0016	Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting)	72	130	620	$200	$655.5K
J2315	Injection, naltrexone, depot form, 1 mg	4	10	190	$770	$474.5K
H0034	Medication training and support, per 15 minutes	3	20	610	$60	$421.5K
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…	7	360	350	$50	$414.4K
D2930	N/A	150	160	770	$110	$399.1K
H0038	Self‑help/peer services, per 15 minutes	6	30	1,450	$40	$310.3K

Showing 1–10 of 209

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cherokee Health Systems	TN	Federally Qualified Health Center (FQHC)	$0	$4.7M
Melody Stump	TN	Family Nurse Practitioner	$83K	$0
Ryan Roberts	TN	Gastroenterology Physician	$82.5K	$0
Guy Smoak	TN	Family Medicine Physician	$47.2K	$0
Wimberly Thompson	TN	Clinical Social Worker	$35.4K	$0
Marcella Dunaway	TN	Clinical Psychologist	$27.1K	$0

Nearby Providers

Other providers in the same ZIP code as Cherokee Health Systems, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jefferson Asc, LLC	TN	Ambulatory Surgical Clinic/Center	$293.5K	$0
Gary Harbin	TN	Certified Registered Nurse Anesthetist	$19.5K	$0

Cherokee Health Systems — Billing Profile & Reimbursement Data

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Cherokee Health Systems — 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