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.

Healthways Inc (NPI 1255545117)

Field	Value
Entity Type	Organization
Organization	Healthways Inc
Address	501 Colliers Way
City	Weirton
State	WV
ZIP	26062
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	May 10, 2007

Payer Source	Total Paid
Medicaid	$3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2036	Alcohol and/or other drug treatment program, per diem	18,720	$120	$2.3M
H0004	Behavioral health counseling and therapy, per 15 minutes	13,200	$40	$514.9K
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…	2,550	$50	$114.8K
H0031	Mental health assessment, by non-physician	340	$120	$41.6K
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…	840	$40	$29.5K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	70	$90	$5.9K
H0032	Mental health service plan development by non-physician	70	$30	$2.1K
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…	30	$20	$660

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

Healthways Inc — 0 of 8 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

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2036	Alcohol and/or other drug treatment program, per diem	22	40	29,190	$210	$7.8M
H0004	Behavioral health counseling and therapy, per 15 minutes	70	170	8,500	$80	$1.5M
H0031	Mental health assessment, by non-physician	70	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…	486	1,270	1,240	$30	$245K
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…	529	1,030	890	$50	$221K
H0032	Mental health service plan development by non-physician	46	60	280	$80	$141.9K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	55	100	120	$100	$69.6K
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…	189	210	280	$40	$59.2K

Nearby Providers

Other providers in the same ZIP code as Healthways Inc, 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
Change, Incorporated	WV	Federally Qualified Health Center (FQHC)	$0	$21.2M
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

Healthways Inc — Billing Profile & Reimbursement Data

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Healthways Inc — 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