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.

Community Concepts, Inc. (NPI 1356772339)

Field	Value
Entity Type	Organization
Organization	Community Concepts, Inc.
Address	17932 Fraley Blvd Ste 300
City	Dumfries
State	VA
ZIP	22026
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	December 2, 2013

Payer Source	Total Paid
Medicaid	$63.6M
Medicare	$0

Key Findings

COMMUNITY CONCEPTS, INC. is effectively a Medicaid-focused provider: there is no Medicare billing on file and the provider reports $63.6M in lifetime Medicaid revenue, indicating Medicaid is the dominant and nearly exclusive payer for this entity’s billed services. This payer concentration implies the organization’s operations and financial performance are tightly linked to Medicaid policy and reimbursement for community behavioral health services.

Revenue is extremely concentrated in a single service line: the top 3 Medicaid codes by revenue account for 100.0% of this provider's total Medicaid revenue, with H2022 alone representing $62.3M (97.9% of Medicaid revenue). This concentration means most of the organization’s Medicaid income derives from community-based wrap-around services rather than a broad mix of fee-for-service clinical codes.

H2022 (Community-based wrap-around services, per diem) drives the business model in practice: it accounts for $62.3M in revenue, 27.7K claims, and an average paid/claim of $2248. The prominence of H2022 is consistent with an organizational focus on intensive, per-diem community behavioral health supports rather than episodic outpatient visits or primary-care procedures.

The provider’s market position for H2022 is notable but described as typical: H2022 ranks #18 of 136 providers in-state (87th percentile; typical, unremarkable volume for this code). In plain terms, COMMUNITY CONCEPTS is a meaningful in-state participant for wrap-around per-diem services but not an extreme outlier or monopoly provider of that service.

Secondary service lines are small in dollar impact but operationally present: 97530 (therapeutic activities, per 15 minutes) accounts for $1.2M (1.9% of Medicaid revenue) across 4.1K claims with an average paid/claim of $297, and 97139 (unlisted therapeutic procedures) contributes $112.3K (0.2% of Medicaid revenue) over 218 claims at $515 avg paid/claim. These volumes indicate ancillary therapy services are delivered alongside the dominant wrap-around program rather than serving as primary revenue drivers.

Competitive standing for the ancillary CPT codes is modest: 97530 ranks #149 of 401 providers in-state (63th percentile; typical, unremarkable volume for this code), while 97139 ranks #66 of 77 providers (14th percentile; typical, unremarkable volume for this code). This suggests COMMUNITY CONCEPTS provides some billed therapy minutes but is not a leading therapy provider statewide.

Tenure and operational history are established: the provider’s NPI was enumerated on 2013-12-02 (~13 years ago), indicating roughly a decade-plus of enrollment in federal provider registries and time to scale its Medicaid wrap-around service line. That tenure supports the observed large cumulative Medicaid revenue.

From a risk and strategic-analytics perspective, the provider’s heavy dependency on a single Medicaid per-diem code (H2022 at 97.9% of Medicaid revenue) creates sensitivity to changes in Medicaid coverage, per-diem rates, or program eligibility; analysts should treat changes to H2022 reimbursement or utilization policy as likely to have an outsized impact on COMMUNITY CONCEPTS’ financials.

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2022	Community-based wrap-around services, per diem	27,700	$2,250	$62.3M
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.	4,100	$300	$1.2M
97139	Use 97139 to report therapeutic procedures that do not have a specific code.	220	$520	$112.3K

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

Community Concepts, Inc. — 0 of 3 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

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2022	Community-based wrap-around services, per diem	18	140	4,450	$1,150	$15.3M
97139	Use 97139 to report therapeutic procedures that do not have a specific code.	66	80	750	$300	$802.7K
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.	149	400	2,060	$60	$407.3K

Nearby Providers

Other providers in the same ZIP code as Community Concepts, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eveready Home Care, LLC	VA	Home Health Agency	$0	$32.9M
Community Visions LLC	VA	Clinic/Center	$0	$27.3M
Perfect Home Health Care LLC	VA	Home Health Agency	$0	$22.1M
Msrc One, LLC	VA	Substance Abuse Rehabilitation Facility	$0	$10.6M
Authentic Home Healthcare And Nursing Solutions LLC	VA	Home Health Agency	$0	$7.7M
Ravinder Singh	VA	Internal Medicine Physician	$38K	$543.4K

Community Concepts, Inc. — Billing Profile & Reimbursement Data

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Community Concepts, 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