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.

Seven Counties Services, Inc. (NPI 1144349150)

Field	Value
Entity Type	Organization
Organization	Seven Counties Services, Inc.
Address	10401 Linn Station Rd Ste 100
City	Louisville
State	KY
ZIP	40223
Taxonomy	Developmental Disabilities Clinic/Center
NPI Enumerated	March 29, 2007

Payer Source	Total Paid
Medicaid	$375.2M
Medicare	$0

Key Findings

SEVEN COUNTIES SERVICES, INC. shows no Medicare billing on file and is effectively a single-payer Medicaid provider, reporting $375.2M in lifetime Medicaid revenue; its NPI was enumerated on 2007-03-29 (~19 years ago), indicating a long-tenured presence in the market.

Revenue is highly concentrated: the top three Medicaid codes (97535, T1019, T2022) together account for 85.3% of the provider's Medicaid revenue. Those individual contributions are 97535 = $214.4M (57.1%), T1019 = $69.5M (18.5%), and T2022 = $36M (9.6%), showing the business is driven by a narrow set of services.

The code mix points to a core operational focus on hands-on therapeutic instruction and long-duration support services consistent with a developmental disabilities clinic/center: 97535 (therapeutic instruction) dominates revenue, while T1019 (personal care services) and T2022 (case management, per month) reflect heavy investment in personal care and care coordination. Supplemental codes such as S5108 (home care training), T2040 (financial management, self-directed waiver), and T1005 (respite care) further indicate a portfolio of home- and waiver-based supports.

SEVEN COUNTIES is a dominant state-level provider for several codes: it ranks #1 of 305 providers for 97535 at the 100th percentile (labeled an "extreme outlier"), #1 of 81 for T2022 at the 100th percentile (also an "extreme outlier"), and ranks #2 of 51 for T1019 at the 98th percentile ("notably above typical"). These rank/percentile positions indicate the organization holds major, outsized market share in key Medicaid service lines within Kentucky.

Operational scale is substantial in time-based services: the provider reported 1.7M claims for 97535, 404.1K claims for T1019, and 127.7K claims for T2022, implying a large recurring-service footprint and significant delivery capacity for intensive, repeatable supports. High claim counts combined with large per-claim average payments (for example, $129 avg paid/claim for 97535 and $172 avg paid/claim for T1019) explain the large revenue totals tied to these volumes.

Beyond the three revenue leaders, SEVEN COUNTIES also bills meaningfully for S5108 (245.7K claims, $30.5M) and maintains top statewide positions for other waiver-related services such as T2040 ($12.6M, rank #1 of 43, 100th percentile; labeled an "extreme outlier") and T1005 ($11M, rank #1 of 81, 100th percentile; labeled an "extreme outlier"), demonstrating breadth across habilitation, financial management, and respite within waiver programs.

The extreme concentration of Medicaid revenue in a few codes (top three = 85.3%) creates operational and reimbursement risk: material payment-policy, rate, or coverage changes to 97535, T1019, or T2022 would disproportionately affect the provider's financials, and the absence of Medicare billing means there is little revenue diversification to offset Medicaid-specific shifts.

Given its long tenure (NPI enumerated 2007-03-29) and repeated top-state rankings on multiple waiver and personal-care codes, SEVEN COUNTIES should be viewed as a large, established provider of community-based developmental disability services in Kentucky, with dominant capacity in instruction/therapy and personal care/case-management delivery models.

Medicaid: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	1,662,110	$130	$214.4M
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	404,100	$170	$69.5M
T2022	Case management, per month	127,690	$280	$36M
S5108	Home care training to home care client, per 15 minutes	245,670	$120	$30.5M
T2040	Financial management, self-directed, waiver; per 15 minutes	116,900	$110	$12.6M
T1005	Respite care services, up to 15 minutes	137,740	$80	$11M
T2021	Day habilitation, waiver; per 15 minutes	7,680	$50	$407.3K
T2019	Habilitation, supported employment, waiver; per 15 minutes	5,440	$60	$299.4K
T1999	Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks"	1,170	$220	$254.8K
E1399	Durable medical equipment, miscellaneous	280	$530	$148.2K

Showing 1–10 of 12

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

Seven Counties Services, Inc. — 5 of 12 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

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5108	Home care training to home care client, per 15 minutes	17	100	43,820	$140	$16.6M
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	2	50	13,600	$140	$11.1M
T2022	Case management, per month	1	80	7,120	$290	$4.1M
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	1	310	830	$120	$3.7M
T2040	Financial management, self-directed, waiver; per 15 minutes	1	40	14,910	$160	$3.5M
T2021	Day habilitation, waiver; per 15 minutes	107	150	16,130	$70	$1.7M
E1399	Durable medical equipment, miscellaneous	11	30	170	$600	$996.7K
T1005	Respite care services, up to 15 minutes	1	80	2,880	$70	$799.2K
H2015	Comprehensive community support services, per 15 minutes	144	200	1,610	$80	$585.6K
T1999	Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks"	21	40	1,370	$160	$315.4K

Showing 1–10 of 12

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Seven Counties Services, Inc.	KY	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$194.4M
Psf PLLC	KY	Allergy & Immunology Physician	$0	$41.4M
Maryhurst, Inc.	KY	Community/Behavioral Health Agency	$0	$29.7M
Therapeutic Intervention Services	KY	Community/Behavioral Health Agency	$0	$24.9M
Seven Counties Services, Inc.	KY	Clinic/Center	$0	$11.2M
Southern Home Care Services, Inc.	KY	Intellectual Disabilities Intermediate Care Facility	$0	$11.1M
Help At Home, LLC	KY	Home Health Agency	$0	$10.3M
Caretenders Vs Of Louisville, LLC	KY	Home Health Agency	$0	$8.9M
Abi-alternative Intervention Dba Abi Behavioral Health	KY	Professional Counselor	$0	$7.6M
Seven Counties Services, Inc.	KY	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$2.9M

Seven Counties Services, Inc. — Billing Profile & Reimbursement Data

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Seven Counties 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