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.

Mount Rogers Community Services (NPI 1255365599)

Field	Value
Entity Type	Organization
Organization	Mount Rogers Community Services
Address	770 W Ridge Rd
City	Wytheville
State	VA
ZIP	24382
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	July 11, 2006

Payer Source	Total Paid
Medicaid	$210.4M
Medicare	$0

Key Findings

MOUNT ROGERS COMMUNITY SERVICES is effectively a Medicaid-focused provider: it has no Medicare billing on file and reports $210.4M in lifetime Medicaid revenue, making Medicaid the sole material payer in the dataset for this entity. This single-payer concentration means all observed volume and revenue patterns reflect state Medicaid programs and waiver arrangements rather than Medicare business lines.

Revenue is highly concentrated in a few service lines: the precomputed top three Medicaid codes account for 50.7% of the provider's total Medicaid revenue. The largest contributors are H0023 ($55.6M, 27.1%), H2022 ($24.8M, 12.1%), and T2033 ($23.6M, 11.5%), indicating that a small set of codes drives half of reported Medicaid receipts.

The top revenue-driving codes map to community-based and residential operations rather than traditional office-based medical visits: H0023 is behavioral health outreach, H2022 is community-based wrap-around per diem, and T2033 is residential waiver per diem. This code mix suggests the provider operates large outreach, wrap-around, and residential programs that rely on per-diem and high-volume encounter models rather than episodic procedure billing.

Competitive standing in-state is strong across multiple community mental health codes. H0023 ranks #3 of 50 (96th percentile), H2022 ranks #5 of 136 (97th percentile), and T2033 ranks #2 of 43 (98th percentile), and several other lines are extreme outliers or at very high percentiles (for example, H0035 ranks #2 of 145 at the 99th percentile; H0046 ranks #7 of 509 and is labeled an extreme outlier; 90837 ranks #3 of 1337 at the 100th percentile). These ranks indicate MOUNT ROGERS is a major statewide provider for multiple community mental health services.

The provider delivers a broad mix of service intensity levels, from psychotherapy and outpatient visits to intensive day and residential programs. High-volume lines include psychotherapy 90837 ($7.8M, 3.8%), mental health partial hospitalization H0035 ($12.1M, 5.9%), psychosocial rehabilitation H2018 ($7.1M, 3.5%, rank #1 of 35, 100th percentile), and crisis intervention H2011 ($4M, 2.0%), showing simultaneous capacity for individual therapy, partial hospitalization, structured day programs, and crisis services.

Operational model appears to combine per-diem and time-based case management: large per-diem revenues are reported for H2022 and T2033, while time/15-minute codes such as T1017 (35K claims, $12.1M) and H2019 (14.4K claims, $6.7M) indicate substantial targeted case management and therapeutic behavioral services. This mix implies staffing and infrastructure oriented to longitudinal, team-based care delivery rather than short ambulatory encounters.

The organization's tenure is long-standing: the NPI was enumerated on 2006-07-11 (~20 years ago). This longevity aligns with the high state ranks and extreme-volume designations and suggests an established role in regional behavioral health service delivery and Medicaid waiver programs.

Concentration risk is material within Medicaid because a handful of codes produce the majority of revenue—top three codes alone are 50.7% of Medicaid revenue. While that concentration reflects deliberate service specialization in outreach, wrap-around, and residential care, changes to Medicaid reimbursement or waiver structures for those specific codes could have outsized effects on the provider's revenue base.

Medicaid: Complete Services Breakdown

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

55 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0023	Alcohol and/or drug outreach	164,890	$340	$55.6M
H2022	Community-based wrap-around services, per diem	80,260	$310	$24.8M
T2033	Residential care, not otherwise specified (nos), waiver; per diem	83,910	$280	$23.6M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	126,420	$100	$12.1M
T1017	Targeted case management, each 15 minutes	34,980	$350	$12.1M
H0046	Mental health services, not otherwise specified	122,190	$90	$11.2M
97150	In this procedure, the provider supervises and directs therapeutic procedures like exercise therapy for a group of patients.	12,540	$800	$10M
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…	72,080	$110	$7.8M
H2018	Psychosocial rehabilitation services, per diem	9,540	$750	$7.1M
H2019	Therapeutic behavioral services, per 15 minutes	14,400	$470	$6.7M

Showing 1–10 of 55

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

Mount Rogers Community Services — 14 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

55 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2033	Residential care, not otherwise specified (nos), waiver; per diem	2	40	6,080	$1,660	$27.6M
H2022	Community-based wrap-around services, per diem	5	140	4,450	$1,150	$15.3M
H0023	Alcohol and/or drug outreach	3	50	33,630	$320	$15M
T1017	Targeted case management, each 15 minutes	14	50	23,860	$330	$9.4M
H2033	Multisystemic therapy for juveniles, per 15 minutes	70	80	5,390	$210	$3.8M
H0046	Mental health services, not otherwise specified	7	510	6,100	$190	$2.8M
H0040	Assertive community treatment program, per diem	5	40	10,830	$200	$2.7M
97150	In this procedure, the provider supervises and directs therapeutic procedures like exercise therapy for a group of patients.	31	200	2,840	$320	$2.4M
H0039	Assertive community treatment, face-to-face, per 15 minutes	15	30	2,740	$530	$2M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	2	150	5,420	$110	$1.9M

Showing 1–10 of 55

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wythe County Community Hospital LLC	VA	Rural Acute Care Hospital	$0	$18.3M
Intercept Youth Services, Inc	VA	Community/Behavioral Health Agency	$0	$6M
Team Nurse, Inc.	VA	Personal Care Attendant	$0	$5.7M
Brett Burton	VA	Foot & Ankle Surgery Podiatrist	$1.5M	$0
Heather Pearman	VA	Foot & Ankle Surgery Podiatrist	$182.7K	$0
Thomas Tran	VA	Podiatrist	$122.7K	$510
Richard Happel	VA	Cardiovascular Disease Physician	$89.1K	$0
Wal-mart Stores East LP	VA	Community/Retail Pharmacy	$70.7K	$0
Elizabeth Fox	VA	Obstetrics & Gynecology Physician	$15.4K	$14.7K

Mount Rogers Community Services — Billing Profile & Reimbursement Data

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Mount Rogers 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

Nearby Providers

Frequently Asked Questions

References