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NPI 1154740660 · Morgantown, WV · Community/Behavioral Health Agency
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Valley Comprehensive Community Mental Health Center is a community/behavioral health agency provider located in Morgantown, West Virginia. This profile covers 0 Medicare and 15 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Valley Comprehensive Community Mental Health Center |
| Address | 301 Scott Ave |
| City | Morgantown |
| State | WV |
| ZIP | 26508 |
| Taxonomy | Community/Behavioral Health Agency |
| NPI Enumerated | April 11, 2014 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $19.4M |
| Medicare | $0 |
VALLEY COMPREHENSIVE COMMUNITY MENTAL HEALTH CENTER reports no Medicare billing on file and is effectively a single-payer Medicaid provider, with lifetime Medicaid revenue of $19.4M. This concentration on Medicaid makes the organization highly sensitive to state Medicaid policy and reimbursement changes because there is no Medicare revenue to diversify payer risk.
Revenue is extremely concentrated: the top three Medicaid codes (H2036, H0040, H0038) account for 97.2% of the provider's total Medicaid revenue. In dollar terms those codes are H2036 $11.3M (58.3% of total), H0040 $5.9M (30.4% of total), and H0038 $1.7M (8.5% of total), indicating the organization’s finances are driven by a very narrow set of per-diem and peer-service billings.
The code mix (H2036 – Alcohol and/or other drug treatment program, per diem; H0040 – Assertive community treatment program, per diem; H0038 – Self-help/peer services, per 15 minutes) signals an operational focus on community-based behavioral health and substance-use treatment delivered largely through per-diem programs and peer support services. High claim volumes for those programs (H2036: 60.3K claims at $188 avg paid/claim; H0040: 71.2K claims at $83 avg paid/claim; H0038: 13.1K claims at $127 avg paid/claim) suggest day-to-day program delivery rather than episodic office-based specialty care.
On the largest revenue driver, H2036, the provider ranks #8 of 35 in-state (79th percentile), which places it as a relatively strong but not dominant participant in alcohol/other drug per-diem services; the dataset labels this as typical, unremarkable volume for this code. Despite H2036 producing the single largest revenue share (58.3%), the rank indicates there are several larger program operators in-state.
For H0040 and H0038 the competitive positions diverge: H0040 ranks #8 of 12 (36th percentile), marking the provider as a modest participant among assertive community treatment providers in West Virginia, while H0038 ranks #15 of 57 (75th percentile), indicating a stronger statewide position in self-help/peer services. Both codes are also described in the source as typical, unremarkable volume for those codes, so these standings reflect scale differences rather than extreme outlier behavior.
The provider’s NPI was enumerated 2014-04-11 (~12 years ago), indicating an established presence in the market. This tenure, combined with $19.4M in Medicaid lifetime revenue, suggests the organization has sustained its community behavioral health operations over multiple state Medicaid contracting cycles.
Average paid-per-claim differences across the top codes (H2036 $188 avg paid/claim; H0040 $83 avg paid/claim; H0038 $127 avg paid/claim) mean revenue per unit of service varies substantially by program type, so shifts in service mix or per-diem rates could materially affect total revenue even if claim volumes remain stable. Given that nearly all revenue is tied to per-diem and time-based behavioral health codes, changes in utilization patterns or reimbursement for those service types would disproportionately impact the bottom line.
Smaller ancillary codes make up a negligible share of revenue and point to limited diversification: examples include T1040 323 claims $98.5K revenue (ranks #6 of 6, 0th percentile), 99214 400 claims $26.4K revenue (ranks #652 of 1031, 37th percentile), and A0160 2.2K claims $17.2K revenue (ranks #53 of 112, 53rd percentile). These low-dollar streams indicate most clinical and non-clinical revenue is concentrated in the top per-diem behavioral health programs rather than E/M, transport, or clinic-based services.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
15 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| H2036 | Alcohol and/or other drug treatment program, per diem | 60,270 | $190 | $11.3M |
| H0040 | Assertive community treatment program, per diem | 71,230 | $80 | $5.9M |
| H0038 | Self‑help/peer services, per 15 minutes | 13,080 | $130 | $1.7M |
| H0036 | Community psychiatric supportive treatment, face-to-face, per 15 minutes | 420 | $470 | $198.6K |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 2,760 | $50 | $132.6K |
| T1040 | Medicaid certified community behavioral health clinic services, per diem | 320 | $310 | $98.5K |
| T1017 | Targeted case management, each 15 minutes | 800 | $50 | $41K |
| 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… | 400 | $70 | $26.4K |
| A0160 | Non-emergency transportation: per mile - case worker or social worker | 2,150 | $10 | $17.2K |
| H0031 | Mental health assessment, by non-physician | 160 | $80 | $13.7K |
Showing 1–10 of 15
How this provider's Medicaid billing volume and revenue compare to other West Virginia providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. West Virginia median
15 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| H2036 | Alcohol and/or other drug treatment program, per diem | 8 | 40 | 29,190 | $210 | $7.8M |
| H0040 | Assertive community treatment program, per diem | 8 | 10 | 71,630 | $80 | $6.8M |
| H0036 | Community psychiatric supportive treatment, face-to-face, per 15 minutes | 19 | 20 | 2,650 | $460 | $2.9M |
| H0038 | Self‑help/peer services, per 15 minutes | 15 | 60 | 3,310 | $110 | $1.6M |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 100 | 170 | 8,500 | $80 | $1.5M |
| T1040 | Medicaid certified community behavioral health clinic services, per diem | 6 | 10 | 3,100 | $270 | $790.4K |
| H0031 | Mental health assessment, by non-physician | 85 | 120 | 620 | $160 | $312.6K |
| A0160 | Non-emergency transportation: per mile - case worker or social worker | 53 | 110 | 2,030 | $50 | $278.8K |
| 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… | 979 | 1,270 | 1,240 | $30 | $245K |
| 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… | 652 | 1,030 | 890 | $50 | $221K |
Showing 1–10 of 15
Other providers in the same ZIP code as Valley Comprehensive Community Mental Health Center, ranked by combined Medicare and Medicaid revenue.
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