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.

Wayne Halfway House Inc. (NPI 1174818702)

Field	Value
Entity Type	Organization
Organization	Wayne Halfway House Inc.
Address	942 Andrew Jackson Dr
City	Waynesboro
State	TN
ZIP	38485
Taxonomy	Psychiatric Residential Treatment Facility
NPI Enumerated	June 11, 2011

Payer Source	Total Paid
Medicaid	$62.8M
Medicare	$0

Key Findings

This entity reports no Medicare billing on file and $62.8M in lifetime Medicaid revenue, making it effectively a single-payer (Medicaid) operation in the available claims data. The absence of Medicare billing indicates the organization’s clinical and reimbursement footprint is concentrated in state Medicaid programs rather than federal Medicare markets.

Revenue is highly concentrated in three per-diem residential and therapeutic codes: H0019 accounts for $43.9M (69.8% of Medicaid revenue), T2048 accounts for $13.6M (21.7%), and H2020 accounts for $5.1M (8.2%); these three codes together represent 99.7% of the provider’s Medicaid revenue. This level of concentration signals a focused business model that depends on long-term residential behavioral health reimbursements.

The code mix (H0019, T2048, H2020) is consistent with a Psychiatric Residential Treatment Facility model that bills high-value per-diem residential services both without and with room and board and supplements those stays with therapeutic behavioral services. The prominence of T2048 ($13.6M at $6387 avg paid/claim, 2.1K claims) alongside H0019 ($43.9M at $4513 avg paid/claim, 9.7K claims) implies operations that combine room-and-board residential placements and non-room per-diem residential programming.

State-level competitive standing for the two largest codes is above average but not dominant: the provider ranks #4 of 15 for H0019 (79th percentile; typical, unremarkable volume for this code) and #4 of 13 for T2048 (75th percentile; typical, unremarkable volume for this code). Those placements indicate the organization is a meaningful regional participant in long-term residential behavioral health but not the top payer-contracted provider in Tennessee.

H2020 (therapeutic behavioral services) is a smaller but material contributor and shows more modest standing: it generated $5.1M from 2.2K claims at $2320 avg paid/claim and ranks #12 of 36 in-state (69th percentile; typical, unremarkable volume for this code). This suggests therapeutic per-diem programming is part of the service mix but not the primary revenue engine.

Smaller ancillary mental-health codes produce negligible revenue relative to the per-diem residential services: S9485 produced $170.4K (193 claims, $883 avg paid/claim; ranks #11 of 15, 29th percentile), 90853 produced $10.1K (917 claims, $11 avg paid/claim; ranks #42 of 106, 61th percentile), and 90834 produced $9.6K (310 claims, $31 avg paid/claim; ranks #192 of 360, 47th percentile). The very low average paid per claim for psychotherapy codes indicates the facility’s revenue profile is driven almost entirely by residential per-diem reimbursement rather than by fee-for-service psychotherapy.

Operational scale signals: high claim volumes in H0019 (9.7K claims) and H2020 (2.2K claims) combined with notably higher per-claim payments for T2048 ($6387) and H0019 ($4513) reflect a capital- and facility-intensive service model where per-diem rates, rather than high-frequency low-dollar visits, drive revenue. Payers evaluating network value should weigh capacity for long-term placements and associated room-and-board reimbursement against relatively limited outpatient/psychotherapy billing.

The provider has an NPI enumeration date of 2011-06-11 (~15 years ago), indicating long-tenure in the market; paired with the concentrated Medicaid revenue base, this longevity suggests established relationships with Medicaid payers for long-term residential services but also a business exposure concentrated on a narrow set of Medicaid rate schedules and program authorizations.

Medicaid: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	9,720	$4,510	$43.9M
T2048	Behavioral health; long-term care residential (non-acute care in a residential treatment program where stay is typically longer than 30 days), with room and board, per diem	2,130	$6,390	$13.6M
H2020	Therapeutic behavioral services, per diem	2,210	$2,320	$5.1M
S9485	Crisis intervention mental health services, per diem	190	$880	$170.4K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	920	$10	$10.1K
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…	310	$30	$9.6K

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

Wayne Halfway House Inc. — 0 of 6 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

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2048	Behavioral health; long-term care residential (non-acute care in a residential treatment program where stay is typically longer than 30 days), with room and board, per diem	4	10	770	$9,920	$22M
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	4	20	1,590	$1,740	$16.5M
H2020	Therapeutic behavioral services, per diem	12	40	880	$1,910	$5.9M
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…	192	360	350	$50	$414.4K
S9485	Crisis intervention mental health services, per diem	11	20	1,410	$60	$291.9K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	42	110	510	$20	$43.4K

Nearby Providers

Other providers in the same ZIP code as Wayne Halfway House Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Buffalo River Services, Inc.	TN	Developmentally Disabled Services Day Training Agency	$0	$2.2M
Air Evac Ems Inc.	TN	Air Ambulance	$436.6K	$37.5K
Brian Coggins	TN	Physical Therapist	$428.5K	$0

Wayne Halfway House Inc. — Billing Profile & Reimbursement Data

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Wayne Halfway House 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