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.

St. Joseph Recovery Center, LLC (NPI 1174021406)

Field	Value
Entity Type	Organization
Organization	St. Joseph Recovery Center, LLC
Address	1824 Murdoch Ave Bldg C
City	Parkersburg
State	WV
ZIP	26101
Taxonomy	Substance Use Disorder Rehabilitation Clinic/Center
NPI Enumerated	February 1, 2018

Payer Source	Total Paid
Medicaid	$49.5M
Medicare	$0

Key Findings

This provider is effectively single‑payer: there is no Medicare billing on file and all reported lifetime federal claims are through Medicaid, which totals $49.5M in revenue. The absence of Medicare activity means analyses of clinical complexity or commercial diversification should focus on Medicaid-only patterns and program-level billing.

Revenue is highly concentrated in a small set of service lines: the precomputed top 3 Medicaid codes by revenue account for 94.9% of this provider's total Medicaid revenue. Those three codes are H2036 ($33.7M, 68.2% of Medicaid revenue), H0004 ($9M, 18.2%), and 99214 ($4.2M, 8.5%), indicating that nearly all Medicaid dollars come from per‑diem substance use treatment, behavioral counseling, and established-patient E/M visits.

H2036 dominates the provider’s Medicaid footprint: 155.5K claims generated $33.7M and represent 68.2% of this provider’s Medicaid revenue. The provider ranks #1 of 35 in-state for H2036 (100th percentile; described as an extreme outlier), which signals it is a dominant statewide source of per‑diem substance use treatment volume and likely operates a large-scale daily or residential substance use treatment program.

H0004 and 99214 together form the remainder of the primary revenue stream and point to how services are delivered: H0004 appears as intensive behavioral health counseling with 97.7K claims and $9M in revenue (rank #7 of 166, 96th percentile; notably above typical), while 99214 shows sustained E/M activity with 54.7K claims and $4.2M (rank #12 of 1031, 99th percentile; notably above typical). This mix suggests the operation pairs a high-volume per‑diem treatment platform with substantial visit-based clinical encounters and therapy delivered in 15‑minute increments.

Competitive standing by code varies but is strong at the state level: the provider is an extreme outlier for H2036 and ranks in very high percentiles for H0004 and 99214, indicating market leadership for Medicaid-funded substance use per‑diem services and above‑typical delivery of counseling and E/M care compared with in-state peers. For lower‑revenue codes (for example, H0038, H0031 and 80305) the provider’s ranks are more typical to modestly above typical, showing some breadth but not outsized market share outside its top three lines.

Operational throughput is evident from claims volumes: 155.5K H2036 claims and 97.7K H0004 claims reflect sustained daily and session-based service delivery, while ancillary testing and peer services appear as supporting lines (80305: 8.6K claims, $86.3K revenue; H0038: 14.5K claims, $449.6K revenue). These secondary codes generate meaningful activity but contribute only a small share of total Medicaid revenue relative to the top three codes.

The provider’s enrollment tenure is established but relatively recent: NPI enumerated 2018-02-01 (~8 years ago). Given the eight-year presence and the extreme concentration in a few Medicaid codes, the organization appears to have scaled a focused substance use disorder treatment operation rapidly within the state Medicaid market.

Medicaid: Complete Services Breakdown

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2036	Alcohol and/or other drug treatment program, per diem	155,480	$220	$33.7M
H0004	Behavioral health counseling and therapy, per 15 minutes	97,660	$90	$9M
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…	54,700	$80	$4.2M
H0038	Self‑help/peer services, per 15 minutes	14,500	$30	$449.6K
H0031	Mental health assessment, by non-physician	2,990	$150	$446.1K
99204	The provider sees a new 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 provider…	5,950	$70	$422.2K
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	680	$440	$294.3K
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…	5,120	$60	$292K
H0032	Mental health service plan development by non-physician	4,280	$60	$248.5K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	1,990	$100	$196.8K

Showing 1–10 of 19

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

St. Joseph Recovery Center, LLC — 4 of 19 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

19 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2036	Alcohol and/or other drug treatment program, per diem	1	40	29,190	$210	$7.8M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	17	20	2,650	$460	$2.9M
H0038	Self‑help/peer services, per 15 minutes	14	60	3,310	$110	$1.6M
H0004	Behavioral health counseling and therapy, per 15 minutes	7	170	8,500	$80	$1.5M
H0031	Mental health assessment, by non-physician	19	120	620	$160	$312.6K
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…	335	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…	12	1,030	890	$50	$221K
82075	The lab analyst performs the technical lab test to analyze the quantitative amount of alcohol in a patient’s breath and correlates the measurement to blood alcohol content.	19	40	900	$20	$214.7K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	148	310	740	$80	$178.2K
H0032	Mental health service plan development by non-physician	9	60	280	$80	$141.9K

Showing 1–10 of 19

Related Providers

Other providers that share a Tax Identification Number (TIN) with St. Joseph Recovery Center, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Donna Meadows	WV	Psychiatric/Mental Health Nurse Practitioner	$46.6K	$0

Nearby Providers

Other providers in the same ZIP code as St. Joseph Recovery Center, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rscr West Virginia, Inc.	WV	Developmental Disabilities Clinic/Center	$0	$153.6M
Camden Clark Memorial Hospital Corporation	WV	General Acute Care Hospital	$0	$56.2M
Westbrook Health Services, Inc	WV	Community/Behavioral Health Agency	$0	$42.5M
Westbrook Health Services, Inc.	WV	Community/Behavioral Health Agency	$0	$32.6M
Camden-clark Physician Corporation	WV	Surgery Physician	$0	$19.8M
Wv Family Support And Rehabilitation Services	WV	Community/Behavioral Health Agency	$0	$19.4M
Clean & Clear Advantage, LLC	WV	Addiction (Substance Use Disorder) Counselor	$0	$18.3M
Mjs Enterprises Inc	WV	Land Ambulance	$960.2K	$8.7M
Camden Clark Memorial Hospital Corporation	WV	Land Ambulance	$874.9K	$5.3M
Evergreen Therapeutic Treatment Centers LLC	WV	Adolescent and Children Mental Health Clinic/Center	$0	$3.3M

St. Joseph Recovery Center, LLC — Billing Profile & Reimbursement Data

Sign up for St. Joseph Recovery Center, LLC — Billing Profile & Reimbursement Data policy alerts

St. Joseph Recovery Center, LLC — Billing Profile & Reimbursement Data

Sign up for St. Joseph Recovery Center, LLC — Billing Profile & Reimbursement Data policy alerts

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