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

Why is the Medicaid comparison limited to North Carolina 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. North Carolina (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.

Universal Mental Health Services, Inc. (NPI 1336361427)

Field	Value
Entity Type	Organization
Organization	Universal Mental Health Services, Inc.
Address	839 Wilkesboro Blvd Ne
City	Lenoir
State	NC
ZIP	28645
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	May 2, 2007

Payer Source	Total Paid
Medicaid	$158.1M
Medicare	$0

Key Findings

This provider is effectively single-payer in claims volume: there is no Medicare billing on file and the organization reports $158.1M in lifetime Medicaid revenue, so all observable fee-for-service scale comes from Medicaid programs. The absence of Medicare activity indicates the provider’s operations and contracting strategy are concentrated on state Medicaid waiver and community behavioral health financing rather than Medicare-covered medical services.

Revenue is highly concentrated in a small set of Medicaid habilitation and day-program codes: the top three Medicaid codes (T2013, T2012, T2020) account for 63.7% of the provider’s total Medicaid revenue. Specifically, T2013 generated $56.3M (35.6% of total Medicaid revenue), T2012 generated $26.4M (16.7%), and T2020 generated $17.9M (11.3%), showing that a majority of dollars flow through waiver habilitation and day habilitation services.

The code mix indicates an operational focus on waiver habilitation and community-based day services: large volumes in T2013 (habilitation, per hour), T2012 (habilitation, per diem), and T2020 (day habilitation, per diem) suggest the organization runs intensive day habilitation programs and direct habilitation staffing models rather than short clinical encounters. Substantial billing in H2016 and H2015 (comprehensive community support services, per diem and per 15 minutes) further signals integrated community support offerings and sustained client contact time, consistent with long-duration community behavioral and developmental services.

Competitive standing in the state is strong and an outlier for several core codes: T2013 ranks #5 of 185 providers in-state at the 98th percentile and is labeled an "extreme outlier, far above typical state volume for this code," while T2012 ranks #4 of 110 (97th percentile; notably above typical volume) and T2020 ranks #2 of 48 (98th percentile; notably above typical volume). These rank/percentile positions characterize the provider as a dominant regional operator for key waiver habilitation and day-services lines rather than a modest participant.

Beyond the top three, the provider shows breadth across complementary community services that support its core habilitation model: H2016 ($15.1M, 9.5% of Medicaid revenue), H2015 ($10.7M, 6.8%), S5150 respite ($5.9M, 3.7%), and employment-related codes H2025 and H2023 together contribute meaningful revenue. This mix of per-diem and per-15-minute codes implies a workforce model combining both long-shift/day programs and shorter, skills-focused interventions, as well as investment in respite and employment supports.

The provider’s high volume in heavily-utilized waiver codes creates operational and reimbursement sensitivity: with 63.7% of Medicaid dollars tied to three habilitation/day codes, changes in state waiver policy, rate-setting, or contract-level utilization expectations could materially affect revenue. The organization’s exposure is concentrated in services that are often governed by state waiver rules and utilization oversight, which is important context for payer negotiations and network management.

UNIVERSAL MENTAL HEALTH SERVICES, INC. has a long-tenured presence in the Medicaid market, with an NPI enumerated on 2007-05-02 (~19 years ago). That tenure, combined with its outsized rank positions on multiple waiver-related codes, supports the interpretation of a mature, established operator with significant footprint in North Carolina’s community habilitation and day-services ecosystem.

Medicaid: Complete Services Breakdown

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

21 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2013	Habilitation, educational, waiver; per hour	356,540	$160	$56.3M
T2012	Habilitation, educational; waiver, per diem	136,870	$190	$26.4M
T2020	Day habilitation, waiver; per diem	105,950	$170	$17.9M
H2016	Comprehensive community support services, per diem	78,000	$190	$15.1M
H2015	Comprehensive community support services, per 15 minutes	102,150	$110	$10.7M
T2014	Habilitation, prevocational, waiver; per diem	50,870	$150	$7.7M
S5150	Unskilled respite care, not hospice; per 15 minutes	65,540	$90	$5.9M
T2021	Day habilitation, waiver; per 15 minutes	45,960	$100	$4.7M
H2025	Ongoing support to maintain employment, per 15 minutes	30,880	$140	$4.3M
H2023	Supported employment, per 15 minutes	15,710	$210	$3.2M

Showing 1–10 of 21

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Carolina Distribution

Universal Mental Health Services, Inc. — 5 of 21 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. North Carolina median

21 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2013	Habilitation, educational, waiver; per hour	5	190	29,090	$150	$9.1M
H2016	Comprehensive community support services, per diem	9	70	28,040	$220	$8.2M
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	10	10	130	$90	$6.9M
T2020	Day habilitation, waiver; per diem	2	50	22,570	$180	$6.2M
T2012	Habilitation, educational; waiver, per diem	4	110	21,340	$180	$6.1M
T2021	Day habilitation, waiver; per 15 minutes	50	200	25,740	$130	$4.6M
T2014	Habilitation, prevocational, waiver; per diem	4	20	16,540	$150	$4.2M
S5125	Attendant care services; per 15 minutes	336	400	15,030	$100	$3M
H2015	Comprehensive community support services, per 15 minutes	4	250	10,060	$130	$2.4M
99509	A home health provider, such as a registered nurse, or a non nursing practitioner, visits a patient to provide help with activities of daily living, or ADLs, and self care.	1,223	1,450	23,320	$50	$2.3M

Showing 1–10 of 21

Nearby Providers

Other providers in the same ZIP code as Universal Mental Health Services, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Et Care Inc	NC	Durable Medical Equipment & Medical Supplies	$0	$35.6M
Caldwell Memorial Hospital, Inc.	NC	General Acute Care Hospital	$0	$28.8M
Rha Health Services, In	NC	Community/Behavioral Health Agency	$0	$10.9M
Comserv, Inc.	NC	Community/Behavioral Health Agency	$0	$9.8M
Mcleod Centers For Wellbeing	NC	Community/Behavioral Health Agency	$0	$8M
County Of Caldwell	NC	Ambulance	$764.2K	$2.3M
Johnny Dy	NC	Cardiovascular Disease Physician	$524.4K	$0
Meredith Dickson	NC	Foot & Ankle Surgery Podiatrist	$172.7K	$0
Kent Edwards	NC	Urology Physician	$136.3K	$0
Jenyung Chiu	NC	Interventional Cardiology Physician	$110.1K	$0

Universal Mental Health Services, Inc. — Billing Profile & Reimbursement Data

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Universal Mental Health Services, Inc. — 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