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.

Eastern Panhandle Mental Health (rehab) (NPI 1427197748)

Field	Value
Entity Type	Organization
Organization	Eastern Panhandle Mental Health (rehab)
Address	235 S Water St
City	Martinsburg
State	WV
ZIP	25401
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	February 5, 2007

Payer Source	Total Paid
Medicaid	$5.7M
Medicare	$0

Medicaid: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0004	Behavioral health counseling and therapy, per 15 minutes	37,170	$100	$3.8M
H0031	Mental health assessment, by non-physician	5,440	$160	$864.2K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	21,540	$30	$560.1K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	2,510	$100	$258.3K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	3,370	$30	$84.2K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	4,420	$10	$35.4K
H0038	Self‑help/peer services, per 15 minutes	440	$70	$31.5K
80306	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by instrument–assisted direct optical observation, often utilizing immunoassay, to screen for any number of…	1,980	$10	$25.7K
H0040	Assertive community treatment program, per diem	300	$80	$23.5K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	2,310	$10	$18.5K

Showing 1–10 of 13

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

Eastern Panhandle Mental Health (rehab) — 1 of 13 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

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0040	Assertive community treatment program, per diem	11	10	71,630	$80	$6.8M
H0038	Self‑help/peer services, per 15 minutes	45	60	3,310	$110	$1.6M
H0004	Behavioral health counseling and therapy, per 15 minutes	26	170	8,500	$80	$1.5M
H0031	Mental health assessment, by non-physician	9	120	620	$160	$312.6K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	58	310	740	$80	$178.2K
H0032	Mental health service plan development by non-physician	25	60	280	$80	$141.9K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	9	100	120	$100	$69.6K
80306	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by instrument–assisted direct optical observation, often utilizing immunoassay, to screen for any number of…	8	20	420	$30	$53K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	7	540	320	$20	$43.2K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	62	310	490	$20	$42K

Showing 1–10 of 13

Related Providers

Other providers that share a Tax Identification Number (TIN) with Eastern Panhandle Mental Health (rehab), ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Fezan Rizvi	WV	Psychiatry Physician	$43.8K	$0

Nearby Providers

Other providers in the same ZIP code as Eastern Panhandle Mental Health (rehab), ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Shenandoah Valley Medical System, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$61M
City Hospital, Inc	WV	General Acute Care Hospital	$0	$41.1M
Eastern Panhandle Mental Health Center (waiver)	WV	Community/Behavioral Health Agency	$0	$28.8M
Stepping Stones Cottages, LLC	WV	Counseling Psychologist	$0	$26.6M
University Healthcare Physicians, Inc.	WV	Family Medicine Physician	$0	$17.5M
American Family Matters LLC	WV	Community/Behavioral Health Agency	$0	$16.9M
Berkeley County Emergency Ambulance Authority	WV	Land Ambulance	$864.6K	$5.6M
City Of Martinsburg	WV	Land Ambulance	$222.2K	$2.7M
Lance Pittman	WV	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$2.3M
Wv Pediatric Dentistry PLLC	WV	Pediatric Dentistry	$0	$2M

Eastern Panhandle Mental Health (rehab) — Billing Profile & Reimbursement Data

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Eastern Panhandle Mental Health (rehab) — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References