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.

Cumberland Behavior Group, LLC (NPI 1184944100)

Field	Value
Entity Type	Organization
Organization	Cumberland Behavior Group, LLC
Address	889 Hideaway Dr
City	Somerset
State	KY
ZIP	42503
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	June 2, 2010

Payer Source	Total Paid
Medicaid	$15.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	73,480	$180	$13.2M
T2021	Day habilitation, waiver; per 15 minutes	16,530	$60	$1M
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…	1,270	$360	$451.6K
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	3,190	$120	$388.6K
H0004	Behavioral health counseling and therapy, per 15 minutes	880	$130	$116.2K

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

Cumberland Behavior Group, LLC — 0 of 5 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

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	39	150	42,680	$190	$11.3M
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…	45	50	13,600	$140	$11.1M
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	94	310	830	$120	$3.7M
H0004	Behavioral health counseling and therapy, per 15 minutes	101	180	1,320	$220	$1.9M
T2021	Day habilitation, waiver; per 15 minutes	74	150	16,130	$70	$1.7M

Nearby Providers

Other providers in the same ZIP code as Cumberland Behavior Group, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Morrland Healthcare LLC	KY	Community/Behavioral Health Agency	$0	$54.8M
Applied Behavioral Advancements, LLC	KY	Community/Behavioral Health Agency	$0	$29.2M
Protea Behavioral Health Counseling, PLLC	KY	Professional Counselor	$0	$24.4M
Lake Cumberland Regional Hospital, LLC	KY	Internal Medicine Physician	$0	$15.6M
Quest Counseling	KY	Mental Health Counselor	$0	$12.5M
Lake Cumberland Recovery, Inc	KY	Substance Use Disorder Rehabilitation Clinic/Center	$0	$11.8M
Achievements Through Actions	KY	Developmentally Disabled Services Day Training Agency	$0	$10M
Lake Cumberland Surgery Center LP	KY	Ambulatory Surgical Clinic/Center	$1M	$8.7M
Adult Day Health, Inc.	KY	Adult Day Care Clinic/Center	$0	$8.9M
Infinite Abilities & Supports, Inc.	KY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$8.9M

Cumberland Behavior Group, LLC — Billing Profile & Reimbursement Data

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Cumberland Behavior Group, LLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References