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.

Highlands Community Services (NPI 1396774147)

Field	Value
Entity Type	Organization
Organization	Highlands Community Services
Address	610 Campus Dr
City	Abingdon
State	VA
ZIP	24210
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	July 2, 2006

Payer Source	Total Paid
Medicaid	$106.4M
Medicare	$0

Key Findings

HIGHLANDS COMMUNITY SERVICES is effectively a Medicaid-centric provider: there is no Medicare billing on file and the organization reports $106.4M in total Medicaid revenue, indicating that Medicaid is the dominant — and for Medicare absent — payer driving its financial footprint. The provider’s NPI was enumerated on 2006-07-02 (~20 years ago), showing a long-tenured presence in the state market.

Revenue concentration is high: the precomputed top three Medicaid codes account for 65.5% of this provider’s total Medicaid revenue. Those top three are H0023 ($39.7M, 37.8%), T2033 ($20.7M, 19.7%), and H0035 ($8.3M, 7.9%), demonstrating that a majority of dollars flow through a small set of service lines.

The code mix for the top revenue drivers points to a community behavioral health model with outreach, residential, and structured day/partial-hospitalization programs. H0023 is billed as Behavioral health outreach service, T2033 is Residential care, waiver per diem, and H0035 is Mental health partial hospitalization (less than 24 hours), together suggesting coordinated outreach plus residential and intensive day-treatment capacity.

On competitive standing, the provider ranks well above typical state volume for several high-revenue codes: H0023 ranks #5 of 50 in-state (92th percentile; notably above typical state volume for this code), T2033 ranks #3 of 43 (95th percentile; notably above typical state volume for this code), and H0035 ranks #7 of 145 (96th percentile; notably above typical state volume for this code). These placements indicate HIGHLANDS is a major in-state provider for outreach, residential waiver, and partial-hospitalization services.

Several service lines are statistical outliers or top-ranked in the state beyond the top three revenue drivers, pointing to niche strengths. T2021 (Day habilitation, waiver; per 15 minutes) is ranked #1 of 108 providers in-state (100th percentile; extreme outlier) and T1024 (Evaluation and treatment by an integrated, specialty team) is ranked #1 of 30 providers in-state (100th percentile; notably above typical state volume for this code), while 90834 and 90791 are both described as extreme outliers in statewide volume — together these rankings signal unusually large-scale delivery of day habilitation, integrated specialty-team encounters, and high-volume diagnostic/evaluation services.

The provider shows strong outpatient psychotherapy and evaluation throughput based on claim counts and ranking: 90837 has 18.4K claims ($1.6M revenue), 90834 has 17.1K claims ($1.1M revenue) and 90832 has 18K claims ($900.3K revenue), while 90791 has 7.9K claims ($761.7K revenue) and ranks #8 of 612 providers in-state (99th percentile; extreme outlier). This pattern indicates substantial capacity for individual psychotherapy and diagnostic evaluations within the Medicaid population.

Several relatively high-dollar-per-claim services suggest capacity for crisis and intensive behavioral support: H2019 shows $3.3M revenue at $546 avg paid/claim (6K claims), and H2011 shows $2.1M revenue at $1048 avg paid/claim (2K claims). Combined with targeted case management codes such as T1017 ($5.4M revenue, $330 avg paid/claim, 16.5K claims), the dataset indicates both high-intensity episodic services and ongoing case-management activity.

Operational and market risk: because 65.5% of Medicaid revenue is concentrated in the top three codes, the provider’s financial performance is sensitive to payment or authorization changes affecting H0023, T2033, and H0035. At the same time, multiple top-percentile and #1-in-state rankings suggest the organization is well-positioned regionally across several specialized Medicaid service lines, which could mitigate some concentration risk through diversified behavioral-health offerings.

Medicaid: Complete Services Breakdown

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

51 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0023	Alcohol and/or drug outreach	133,200	$300	$39.7M
T2033	Residential care, not otherwise specified (nos), waiver; per diem	73,130	$280	$20.7M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	92,170	$90	$8.3M
T1017	Targeted case management, each 15 minutes	16,490	$330	$5.4M
H2017	Psychosocial rehabilitation services, per 15 minutes	67,630	$60	$3.9M
T2021	Day habilitation, waiver; per 15 minutes	39,110	$100	$3.8M
H2019	Therapeutic behavioral services, per 15 minutes	6,030	$550	$3.3M
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…	40,190	$60	$2.3M
H2011	Crisis intervention service, per 15 minutes	2,000	$1,050	$2.1M
H2012	Behavioral health day treatment, per hour	22,180	$90	$1.9M

Showing 1–10 of 51

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

Highlands Community Services — 10 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

51 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2033	Residential care, not otherwise specified (nos), waiver; per diem	3	40	6,080	$1,660	$27.6M
H0023	Alcohol and/or drug outreach	5	50	33,630	$320	$15M
T1017	Targeted case management, each 15 minutes	31	50	23,860	$330	$9.4M
H0046	Mental health services, not otherwise specified	338	510	6,100	$190	$2.8M
S9123	Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)	19	30	1,000	$500	$2.6M
97150	In this procedure, the provider supervises and directs therapeutic procedures like exercise therapy for a group of patients.	78	200	2,840	$320	$2.4M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	7	150	5,420	$110	$1.9M
H2017	Psychosocial rehabilitation services, per 15 minutes	10	100	15,920	$60	$1.9M
H2012	Behavioral health day treatment, per hour	37	360	3,770	$200	$1.8M
S9482	Family stabilization services, per 15 minutes	141	180	650	$1,070	$1.7M

Showing 1–10 of 51

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Revida Recovery Centers, PC	VA	Addiction Medicine (Family Medicine) Physician	$0	$40.6M
Starting Point Of Virginia, P.C.	VA	Multi-Specialty Clinic/Center	$0	$29M
Maxim Healthcare Services, Inc.	VA	Home Health Agency	$0	$23.4M
Blue Mountain Therapy, LLC	VA	Early Intervention Provider Agency	$0	$7M
Abingdon Convalescent Ambulance Service Incorporated	VA	Ambulance	$397.8K	$6.5M
Team Nurse Inc	VA	Personal Care Attendant	$0	$6M
Matthew Hubbard	VA	Otolaryngology/Facial Plastic Surgery Physician	$240.8K	$26.8K
Jeffrey Neal	VA	Plastic Surgery within the Head & Neck (Otolaryngology) Physician	$219.7K	$23.1K
Clinton Sutherland	VA	Internal Medicine Physician	$230.8K	$0
James Dick	VA	Physical Therapist	$220.7K	$0

Highlands Community Services — Billing Profile & Reimbursement Data

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Highlands 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