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 Virginia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to 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. 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.

Northwestern Community Services Board (NPI 1215930573)

Field	Value
Entity Type	Organization
Organization	Northwestern Community Services Board
Address	209 W Criser Rd
City	Front Royal
State	VA
ZIP	22630
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	May 31, 2005

Payer Source	Total Paid
Medicaid	$53.5M
Medicare	$0

Key Findings

This provider is effectively a single-payer Medicaid operation: there is no Medicare billing on file and lifetime Medicaid revenue is $53.5M. The absence of Medicare revenue means the organization’s financial performance and payer negotiations are concentrated entirely in the Medicaid market.

Revenue concentration is high: the precomputed top three Medicaid codes account for 70.5% of the provider’s total Medicaid revenue. In particular, H0023 generates $23.7M (44.3% of Medicaid revenue) and T1017 generates $12M (22.4%), while H2017 contributes $2M (3.7%), indicating a narrow set of services drive most dollars.

The code mix points to a community behavioral health model focused on outreach, case management, and intensive community-based supports. High volumes and revenue for H0023 (Behavioral health outreach service), T1017 (Targeted case management, each 15 minutes), and H2017 (Psychosocial rehabilitation per 15 minutes) — together with presence of H0039, H0015, H0006 and H0040 — suggest operations emphasize mobile/community outreach, targeted case management, psychosocial rehabilitation, and substance-use treatment.

Operational scale is demonstrated by large claim counts and high E/M volume: H0023 has 74.2K claims and T1017 has 35.1K claims, while 99214 and 99213 have 28.1K and 27.9K claims respectively. Those E/M volumes sit high in-state (99213 ranks #100 of 4012, 98th percentile) and 99214 also ranks at the 98th percentile (#80 of 3523), reflecting a substantial outpatient visit footprint alongside community services.

Competitive standing is mixed across codes: for core outreach and targeted case management the provider ranks in the mid-to-upper state percentiles but is described as having typical, unremarkable volume (H0023: #12 of 50, 78th percentile; T1017: #13 of 46, 73th percentile; H2017: #20 of 97, 80th percentile). Conversely, the provider is a relative state leader in several discrete services — H0006 (Alcohol and/or drug services; case management) ranks #3 of 79 at the 97th percentile and 90791 (psychiatric evaluation) ranks #19 of 612 at the 97th percentile, both described as notably above typical state volume — indicating pockets of outsized specialization.

Several service lines show materially above-typical state volume even as overall Medicaid activity centers on a few codes. In addition to H0006 and 90791, 99213 is flagged as notably above typical state volume (98th percentile) which, combined with high telehealth originating-site activity (Q3014 ranks #8 of 87, 92th percentile), suggests this provider has both high in-person E/M throughput and an active telehealth footprint.

The provider’s payment mix and per-claim economics reinforce the operational focus: H0023 averages $319 paid/claim and T1017 averages $341 paid/claim, while H2017 averages $41 paid/claim. Those per-claim values, coupled with the heavy claim volumes for outreach and case management, imply revenue is driven by frequent, shorter-interval community-based contacts rather than a smaller number of high-dollar inpatient or specialty procedures.

Tenure and market durability are notable: the NPI was enumerated on 2005-05-31 (~21 years ago), indicating an established presence in the state Medicaid landscape. Given long tenure, concentrated Medicaid reliance (no Medicare billing on file), and the fact that top three codes represent 70.5% of Medicaid revenue, the organization should be viewed as a mature community behavioral health provider whose financial exposure is sensitive to Medicaid policy or rate changes affecting H0023 and T1017.

Medicaid: Complete Services Breakdown

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

34 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0023	Alcohol and/or drug outreach	74,190	$320	$23.7M
T1017	Targeted case management, each 15 minutes	35,140	$340	$12M
H2017	Psychosocial rehabilitation services, per 15 minutes	48,770	$40	$2M
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…	28,090	$60	$1.8M
T2023	Targeted case management; per month	6,970	$260	$1.8M
H2011	Crisis intervention service, per 15 minutes	1,340	$1,310	$1.7M
H0039	Assertive community treatment, face-to-face, per 15 minutes	5,870	$250	$1.5M
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	7,730	$190	$1.5M
H0006	Alcohol and/or drug services; case management	6,490	$200	$1.3M
H0040	Assertive community treatment program, per diem	7,780	$160	$1.3M

Showing 1–10 of 34

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Virginia providers billing the same CPT/HCPCS codes.

Claims Volume vs. Virginia Distribution

Northwestern Community Services Board — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

34 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0023	Alcohol and/or drug outreach	12	50	33,630	$320	$15M
T1017	Targeted case management, each 15 minutes	13	50	23,860	$330	$9.4M
H0040	Assertive community treatment program, per diem	26	40	10,830	$200	$2.7M
H0039	Assertive community treatment, face-to-face, per 15 minutes	9	30	2,740	$530	$2M
H2017	Psychosocial rehabilitation services, per 15 minutes	20	100	15,920	$60	$1.9M
T2023	Targeted case management; per month	9	40	3,000	$300	$1.3M
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	20	110	1,830	$220	$1.1M
H2011	Crisis intervention service, per 15 minutes	43	230	360	$1,290	$1.1M
H0004	Behavioral health counseling and therapy, per 15 minutes	56	100	3,280	$40	$455.8K
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	15	50	1,510	$180	$364.4K

Showing 1–10 of 34

Related Providers

Other providers that share a Tax Identification Number (TIN) with Northwestern Community Services Board, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Patricia Gray	VA	Clinical Social Worker	$50.3K	$0
Jagadamba Pandit	VA	Psychiatry Physician	$23.2K	$0
Lakuma Mogili	VA	Psychiatry Physician	$22.9K	$0
Glenn Mcclaugherty	VA	Psychiatry Physician	$20.9K	$0

Nearby Providers

Other providers in the same ZIP code as Northwestern Community Services Board, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Warren Memorial Hospital, Inc.	VA	General Acute Care Hospital	$0	$23.5M
Keri Ayres-coutts	VA	Case Manager/Care Coordinator	$0	$18.2M
Moms In Motion, Inc.	VA	Case Management Agency	$0	$17.6M
Warren Co Board Of Supervisors	VA	Ambulance	$594K	$698.9K
Yevgeny Kats	VA	Foot & Ankle Surgery Podiatrist	$169.2K	$56.1K
Virginia Cvs Pharmacy LLC	VA	Pharmacy	$134.4K	$0
Abigail Scheerschmidt	VA	Speech-Language Pathologist	$81.3K	$0
Sona Kalra	VA	Optometrist	$60.9K	$2.1K
Edward Schrank	VA	Physical Therapist	$29.2K	$0

Northwestern Community Services Board — Billing Profile & Reimbursement Data

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Northwestern Community Services Board — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References