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.

Cumberland Mountain Community Services (NPI 1235125055)

Field	Value
Entity Type	Organization
Organization	Cumberland Mountain Community Services
Address	113 Cumberland Rd
City	Cedar Bluff
State	VA
ZIP	24609
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	September 27, 2005

Payer Source	Total Paid
Medicaid	$100.4M
Medicare	$0

Key Findings

CUMBERLAND MOUNTAIN COMMUNITY SERVICES is effectively a single-payer Medicaid provider: there is no Medicare billing on file while its lifetime Medicaid revenue is $100.4M. This concentration indicates the organization operates primarily within publicly funded behavioral health and social-support programs rather than Medicare-covered services for older adults.

Revenue is highly concentrated in a small set of behavioral-health service codes: the top three Medicaid codes (H0023, H2022, 97150) account for 62.6% of the provider's Medicaid revenue. Specifically, H0023 drives $28.6M (28.9%), H2022 drives $23.3M (23.5%), and 97150 drives $10.1M (10.2%), signaling that outreach, community wrap-around per diems, and supervised group therapeutic procedures are the primary revenue drivers.

The code mix and descriptions point to an operational model focused on community-based behavioral health interventions and group-oriented therapy: H0023 (behavioral health outreach), H2022 (community-based wrap-around, per diem), and 97150 (supervised group therapeutic procedures) together indicate a programmatic emphasis on outreach, intensive per-diem supports, and group treatment delivery rather than one-on-one, short outpatient visits. This suggests infrastructure for mobile/outreach teams, residential or wraparound program capacity, and group therapy supervision.

Despite large absolute Medicaid revenue, the provider’s market standing by code is mixed: its top codes generally sit in middle-to-upper state percentiles rather than dominating statewide markets. For example, H0023 ranks #10 of 50 providers in-state (82th percentile; typical, unremarkable volume for this code), H2022 ranks #33 of 136 (76th percentile; typical, unremarkable volume), and 97150 ranks #61 of 201 (70th percentile; typical, unremarkable volume), characterizing the organization as a solid but not exclusive regional participant for its main service lines.

The provider reports exceptionally high volume in non-emergency transportation (T2003): 139.1K claims, $14 avg paid/claim, $1.9M revenue (2.0% of Medicaid revenue) and it ranks #12 of 855 providers in-state (99th percentile; extreme outlier, far above typical state volume for this code). Although T2003 represents a modest share of revenue, this outsized claims count suggests extensive logistical operations or population served with high transportation needs, which is operationally significant for care coordination and program capacity.

There are above-typical strengths in several case-management and family-therapy areas: H0006 (case management) reports 6.1K claims and $1.4M revenue and ranks #4 of 79 in-state (96th percentile; notably above typical state volume), while 90847 (family psychotherapy with patient present) ranks #6 of 142 (96th percentile; notably above typical state volume). These placements imply relatively strong capacity in coordinated care and family-based psychotherapy relative to peers, supporting integrated behavioral-health models.

The provider also offers a broad mix of specialty behavioral-health services beyond its top three codes, including targeted case management (T1017), skills training (H2014), psychosocial rehabilitation (H2017), and detox (H0010), indicating a diversified service portfolio across outpatient, community, and residential supports. Many of these codes appear at typical state volumes (mid-percentiles), which suggests established service lines but not exclusive market dominance across those categories.

CUMBERLAND MOUNTAIN COMMUNITY SERVICES is a long-tenured entity with an NPI enumerated on 2005-09-27 (~21 years ago), indicating sustained participation in Medicaid programs and likely established relationships with state behavioral-health systems and payers. That longevity, combined with concentrated revenue in outreach, wrap-around, and group therapy codes, points to a mature community-behavioral health operator with operational strengths in case management and transportation logistics.

Medicaid: Complete Services Breakdown

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

49 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0023	Alcohol and/or drug outreach	86,260	$330	$28.6M
H2022	Community-based wrap-around services, per diem	9,600	$2,430	$23.3M
97150	In this procedure, the provider supervises and directs therapeutic procedures like exercise therapy for a group of patients.	6,020	$1,690	$10.1M
T1017	Targeted case management, each 15 minutes	23,630	$340	$8.1M
H2014	Skills training and development, per 15 minutes	2,060	$3,230	$6.7M
H2017	Psychosocial rehabilitation services, per 15 minutes	77,020	$70	$5M
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	3,180	$1,110	$3.5M
T2003	Non-emergency transportation; encounter/trip	139,060	$10	$1.9M
H2011	Crisis intervention service, per 15 minutes	2,050	$850	$1.7M
H2019	Therapeutic behavioral services, per 15 minutes	5,470	$270	$1.5M

Showing 1–10 of 49

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

Cumberland Mountain Community Services — 4 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

49 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2022	Community-based wrap-around services, per diem	33	140	4,450	$1,150	$15.3M
H0023	Alcohol and/or drug outreach	10	50	33,630	$320	$15M
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	19	30	7,090	$420	$11.5M
T1017	Targeted case management, each 15 minutes	24	50	23,860	$330	$9.4M
H2014	Skills training and development, per 15 minutes	39	70	2,500	$1,380	$7M
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…	697	760	17,620	$150	$5.5M
H0046	Mental health services, not otherwise specified	257	510	6,100	$190	$2.8M
H2036	Alcohol and/or other drug treatment program, per diem	9	10	480	$660	$2.6M
97150	In this procedure, the provider supervises and directs therapeutic procedures like exercise therapy for a group of patients.	61	200	2,840	$320	$2.4M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	54	150	5,420	$110	$1.9M

Showing 1–10 of 49

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Shelley Miller	VA	Family Nurse Practitioner	$63.5K	$2.8K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Galax Treatment Center, LLC	VA	Methadone Clinic	$389.3K	$18.7M
Kathy Cole	VA	Family Nurse Practitioner	$4.5K	$0

Cumberland Mountain Community Services — Billing Profile & Reimbursement Data

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Cumberland Mountain Community Services — 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