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

Why is the Medicaid comparison limited to Kentucky 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. Kentucky (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.

Quality Care Case Management, LLC. (NPI 1346582343)

Field	Value
Entity Type	Organization
Organization	Quality Care Case Management, LLC.
Address	1746 Poosey Ridge Rd
City	Richmond
State	KY
ZIP	40475
Taxonomy	Case Management Agency
NPI Enumerated	March 18, 2013

Payer Source	Total Paid
Medicaid	$17.5M
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
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	39,620	$200	$8M
H0004	Behavioral health counseling and therapy, per 15 minutes	31,710	$170	$5.3M
T2022	Case management, per month	7,870	$310	$2.4M
H0023	Alcohol and/or drug outreach	31,930	$40	$1.4M
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	1,650	$80	$130.2K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	1,260	$90	$107.4K
S9129	Occupational therapy, in the home, per diem	390	$70	$27.4K
T2021	Day habilitation, waiver; per 15 minutes	770	$30	$25.2K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Quality Care Case Management, LLC. — 0 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2022	Case management, per month	39	80	7,120	$290	$4.1M
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	24	310	830	$120	$3.7M
H0004	Behavioral health counseling and therapy, per 15 minutes	17	180	1,320	$220	$1.9M
T2021	Day habilitation, waiver; per 15 minutes	138	150	16,130	$70	$1.7M
S9129	Occupational therapy, in the home, per diem	25	30	7,220	$70	$1.1M
H0023	Alcohol and/or drug outreach	2	20	1,570	$50	$454.8K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	218	340	2,730	$40	$328.2K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	294	540	1,500	$50	$235.7K

Nearby Providers

Other providers in the same ZIP code as Quality Care Case Management, LLC., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
American Health Management, Inc.	KY	Adult Day Care Clinic/Center	$0	$99.1M
Baptist Healthcare System, Inc.	KY	General Acute Care Hospital	$0	$58.5M
Fm Healing Center, LLC	KY	Addiction Medicine (Family Medicine) Physician	$0	$22M
Nathaniel House, Inc.	KY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$14.4M
Ethan Health LLC	KY	Substance Abuse Rehabilitation Facility	$0	$13.1M
Combined Physicians Lab LLC	KY	Clinical Medical Laboratory	$428.1K	$7.4M
Center For Behavioral Health Kentucky LLC	KY	Methadone Clinic	$198.1K	$7.2M
Bluegrass Pediatric Therapies, LLC	KY	Speech-Language Pathologist	$0	$4.5M
Madison Pediatric Assoc	KY	Pediatrics Physician	$0	$3.9M
Rose Bowling, LLC	KY	Rural Health Clinic/Center	$0	$3.9M

Quality Care Case Management, LLC. — Billing Profile & Reimbursement Data

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Quality Care Case Management, LLC. — Billing Profile & Reimbursement Data

Sign up for Quality Care Case Management, LLC. — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References