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.

Change, Incorporated (NPI 1245244367)

Field	Value
Entity Type	Organization
Organization	Change, Incorporated
Address	3136 West St
City	Weirton
State	WV
ZIP	26062
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	July 27, 2006

Payer Source	Total Paid
Medicaid	$21.2M
Medicare	$0

Key Findings

Medicaid revenue is overwhelmingly dominant for this entity: the provider reports $21.2M in Medicaid revenue and has no Medicare billing on file, making it effectively a single‑payer (Medicaid) operation at scale. This concentration means the organization’s financial performance is highly sensitive to Medicaid rate changes and policy shifts.

Revenue is highly concentrated in a very small set of codes: the precomputed top three Medicaid codes account for 91.6% of the provider’s total Medicaid revenue, with T1015 alone representing $17.3M (81.7% of Medicaid revenue). That level of concentration indicates the business model centers on the bundled clinic/encounter payment represented by T1015 rather than a broad mix of higher‑value, procedure-based billing.

T1015’s activity profile (141.8K claims, $122 avg paid/claim) and its statewide ranking (rank #3 of 385, 99th percentile — labeled an extreme outlier) identify this provider as one of the largest users of the all‑inclusive clinic encounter code in West Virginia. This suggests the provider functions as a high‑volume FQHC delivery site that relies on per‑encounter bundled payments as its primary revenue driver.

Primary care E/M codes show very large volumes but low average reimbursement, consistent with high throughput, low‑acuity visits: 99213 has 81.3K claims at $18 avg paid/claim generating $1.5M (6.9% of Medicaid revenue) and ranks #11 of 1273 in‑state (99th percentile, extreme outlier). The presence of substantial 99214 and 99212 volumes (31.2K and 8.2K claims respectively) indicates most visits are established‑patient encounters at low to moderate complexity rather than infrequent high‑complexity procedures.

Behavioral health care appears to be an important secondary service line: psychotherapy codes 90832 (24.5K claims, $489.5K, rank #4 of 204, 99th percentile) and 90834 (18.6K claims, $334.5K, rank #2 of 214, 100th percentile) are among the higher‑volume, high‑percentile codes. These rankings imply the provider is a major regional provider of Medicaid‑funded outpatient psychotherapy services, reinforcing a blended primary care plus behavioral health delivery model.

Competitive standing across top codes is consistently above typical state volumes: in addition to T1015 and 99213 being extreme outliers, ancillary high‑revenue codes such as D0999 ($639K, 2.9K claims) rank #4 of 20 (84th percentile) and 99214 ($592.2K, 31.2K claims) ranks in the 98th percentile. Taken together, these rank positions indicate this FQHC is a dominant in‑state participant for clinic encounters and several routine outpatient services, rather than a modest or fringe provider.

Operationally, the blend of very high claim counts with low average paid per claim (for example, T1015 $122 avg paid/claim and 99213 $18 avg paid/claim) signals a volume‑driven margin model that depends on sustaining patient throughput and encounter volumes. That structure can pressure margins and makes revenue sensitive to any limits on claim counts, bundling rules, or Medicaid fee changes.

The provider’s NPI tenure (enumerated 2006-07-27, ~20 years ago) indicates an established presence in the market and likely entrenched payer and referral relationships; combined with the extreme state rankings on several codes, this longevity supports the hypothesis that the organization operates multiple high‑volume access points or a large centralized clinic system within the state.

Medicaid: Complete Services Breakdown

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

79 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	141,770	$120	$17.3M
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…	81,330	$20	$1.5M
D0999	N/A	2,930	$220	$639K
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…	31,170	$20	$592.2K
90832	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…	24,480	$20	$489.5K
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…	18,580	$20	$334.5K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	8,150	$10	$65.2K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	2,490	$20	$47.3K
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…	2,090	$20	$39.7K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	1,320	$20	$30.4K

Showing 1–10 of 79

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

Change, Incorporated — 5 of 25 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

79 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	3	390	4,610	$130	$2.2M
D0999	N/A	4	20	500	$140	$317.9K
H0031	Mental health assessment, by non-physician	46	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…	11	1,270	1,240	$30	$245K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	136	190	660	$40	$226.4K
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…	26	1,030	890	$50	$221K
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…	144	310	740	$80	$178.2K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	48	50	730	$60	$126.6K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	77	110	170	$100	$103.9K
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…	129	340	140	$90	$97.5K

Showing 1–10 of 79

Related Providers

Other providers that share a Tax Identification Number (TIN) with Change, Incorporated, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Amy Spurrier	WV	Family Nurse Practitioner	$39.8K	$0
Roxanna Torres-santiago	WV	Obstetrics & Gynecology Physician	$10.4K	$0

Nearby Providers

Other providers in the same ZIP code as Change, Incorporated, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Healthways Inc	WV	Community/Behavioral Health Agency	$0	$40.8M
Weirton Medical Center, Inc	WV	General Acute Care Hospital	$0	$27.7M
Healthways Inc	WV	Community/Behavioral Health Agency	$0	$3M
First Steps Pediatrics & Adolescent Medicine PLLC	WV	Pediatrics Physician	$0	$2.5M
Hancock County Sheltered Workshop Inc.	WV	Community/Behavioral Health Agency	$0	$2.1M
Health Care Solutions At Home Inc.	WV	Durable Medical Equipment & Medical Supplies	$0	$1.8M
Family Connections	WV	Mental Health Counselor	$0	$818.8K
Tri State Medical	WV	Oxygen Equipment & Supplies (DME)	$0	$816K
Christopher Kolibash	WV	Clinical Cardiac Electrophysiology Physician	$425.8K	$48K
Maninder Bedi	WV	Cardiovascular Disease Physician	$416.1K	$53.8K

Change, Incorporated — Billing Profile & Reimbursement Data

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Change, Incorporated — 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