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.

Northwood Health Systems Inc (NPI 1417173444)

Field	Value
Entity Type	Organization
Organization	Northwood Health Systems Inc
Address	111 19th St
City	Wheeling
State	WV
ZIP	26003
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	April 18, 2007

Payer Source	Total Paid
Medicaid	$67.6M
Medicare	$0

Key Findings

NORTHWOOD HEALTH SYSTEMS INC is effectively a Medicaid-focused provider: it has no Medicare billing on file and reports $67.6M in lifetime Medicaid revenue. The absence of Medicare activity paired with substantial Medicaid receipts indicates the organization operates almost exclusively within Medicaid-funded programs rather than dual-payer clinical lines.

Revenue is highly concentrated in a small set of direct-support service codes: the top three Medicaid codes (S5125, T2021, T1005) together account for 91.8% of the provider’s total Medicaid revenue. This concentration implies the business model centers on a narrow set of service offerings rather than a broad mix of procedures or medical services.

S5125 (Attendant care services; per 15 minutes) is the dominant revenue driver with $43.5M (64.4% of Medicaid revenue), 332.2K claims, and an average paid/claim of $131; this code ranks #1 of 43 providers in-state and is labeled an “extreme outlier.” The scale and rank for S5125 indicate NORTHWOOD is a statewide leader in attendant care volume and likely delivers very large amounts of hands-on support hours compared with peers.

T2021 (Day habilitation, waiver; per 15 minutes) contributes $15.8M (23.3% of Medicaid revenue) from 113.3K claims at $139 avg paid/claim and ranks #3 of 57 providers in-state (96th percentile, extreme outlier). The combination of high volume and high rank on habilitation services suggests a major focus on day habilitation programming and capacity to serve many waiver-enrolled beneficiaries.

T1005 (Respite care services, up to 15 minutes) generates $2.8M (4.1% of Medicaid revenue) from 44.7K claims at $62 avg paid/claim and ranks #1 of 29 providers in-state (100th percentile, extreme outlier). Strong leadership on respite care alongside attendant care and habilitation signals a service mix oriented toward continuous caregiver support and temporary relief services for families and guardians.

Beyond the top three, several ancillary codes show meaningful but much smaller contributions: G9002 ($1.9M, 2.9%) and T1016 ($1.5M, 2.2%) reflect coordinated care fees and case management at typical, unremarkable state volumes, while transportation codes A0120 ($579K, 0.9%) and A0160 ($339.5K, 0.5%) are notably above typical state volume. These secondary lines indicate NORTHWOOD supplements direct care with care coordination and transportation capacity, supporting a comprehensive community-based program.

Competitive standing in-state is concentrated and dominant for its primary services: S5125 and T1005 both rank #1 in their respective peer sets (100th percentile, extreme outlier) and T2021 ranks #3 (96th percentile, extreme outlier), positioning NORTHWOOD as a major provider in West Virginia’s IDD/day habilitation market. For codes outside the top three, ranks and percentiles (for example G9002 at the 84th percentile) portray the organization as a solid but not uniformly dominant participant across all service lines.

The provider has longstanding presence given its NPI enumeration date of 2007-04-18 (~19 years ago), which, combined with high volumes on per-15-minute Medicaid waiver codes, suggests operational maturity in delivering time-based attendant, habilitation, and respite services. The combination of long tenure and extreme-volume rankings on core codes supports the view that NORTHWOOD’s scale is built on sustained Medicaid waiver program participation rather than recent expansion into Medicare or other payer markets.

Medicaid: Complete Services Breakdown

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5125	Attendant care services; per 15 minutes	332,200	$130	$43.5M
T2021	Day habilitation, waiver; per 15 minutes	113,350	$140	$15.8M
T1005	Respite care services, up to 15 minutes	44,660	$60	$2.8M
G9002	Coordinated care fee, maintenance rate	9,020	$220	$1.9M
T1016	Case management, each 15 minutes	6,270	$230	$1.5M
T1002	Rn services, up to 15 minutes	3,800	$230	$877.6K
A0120	Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems	48,250	$10	$579K
A0160	Non-emergency transportation: per mile - case worker or social worker	21,220	$20	$339.5K
T2024	Service assessment/plan of care development, waiver	3,730	$60	$223.9K
T1003	Lpn/lvn services, up to 15 minutes	2,500	$50	$119.9K

Showing 1–10 of 11

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

Northwood Health Systems Inc — 4 of 11 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

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5125	Attendant care services; per 15 minutes	1	40	14,820	$750	$30.5M
T2021	Day habilitation, waiver; per 15 minutes	3	60	6,490	$120	$2.2M
T1005	Respite care services, up to 15 minutes	1	30	2,980	$250	$1.5M
G9002	Coordinated care fee, maintenance rate	20	120	2,950	$150	$901.9K
T1003	Lpn/lvn services, up to 15 minutes	15	30	2,070	$90	$522.7K
T1016	Case management, each 15 minutes	33	100	2,790	$90	$496.2K
T2019	Habilitation, supported employment, waiver; per 15 minutes	6	10	420	$130	$445.4K
A0160	Non-emergency transportation: per mile - case worker or social worker	8	110	2,030	$50	$278.8K
T1002	Rn services, up to 15 minutes	46	150	1,980	$40	$232.6K
A0120	Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems	2	50	1,390	$30	$183.1K

Showing 1–10 of 11

Nearby Providers

Other providers in the same ZIP code as Northwood Health Systems Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northwood Health Systems Inc	WV	Community/Behavioral Health Agency	$0	$52.5M
Wheeling Hospital Inc	WV	General Acute Care Hospital	$0	$40.1M
Lorraine Surgical Supply Of West Virginia Inc.	WV	Durable Medical Equipment & Medical Supplies	$0	$34.6M
Russell Nesbitt Services Inc	WV	Respite Care	$0	$29.5M
Florence Crittenton Programs, Inc.	WV	Mental Health Counselor	$0	$14.4M
Wheeling Hospital Inc	WV	Family Medicine Physician	$0	$8.5M
Lifeline Addiction Specialists, PLLC	WV	Multi-Specialty Clinic/Center	$0	$7M
Radiology Associates, Inc	WV	Diagnostic Radiology Physician	$0	$6.7M
Serenity Hills Life Center	WV	Substance Use Disorder Rehabilitation Clinic/Center	$0	$6.1M
Alecto Healthcare Services Wheeling LLC	WV	General Acute Care Hospital	$0	$6M

Northwood Health Systems 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