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.

Blue Ridge Behavioral Healthcare (NPI 1437137734)

Field	Value
Entity Type	Organization
Organization	Blue Ridge Behavioral Healthcare
Address	301 Elm Ave Sw
City	Roanoke
State	VA
ZIP	24016
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	January 6, 2006

Payer Source	Total Paid
Medicaid	$75.7M
Medicare	$0

Key Findings

BLUE RIDGE BEHAVIORAL HEALTHCARE reports $75.7M in lifetime Medicaid revenue and has no Medicare billing on file, so its commercial/Medicare exposure is effectively absent in this dataset. This makes the organization a Medicaid-dependent operator rather than a dual-payer provider in the Medicare/Medicaid mix presented here.

Revenue is highly concentrated in a small set of Medicaid codes: the precomputed top three codes (H0023, T1017, T2033) together account for 59.1% of the provider’s total Medicaid revenue. The individual contributions are H0023 ($19.6M, 26.1%), T1017 ($12.6M, 16.8%), and T2033 ($12.1M, 16.1%), indicating the bulk of Medicaid dollars flow through outreach, targeted case management, and residential per-diem services.

The code mix signals an operational model built around community outreach, case management, and residential behavioral health care. H0023 (behavioral health outreach), T1017 (targeted case management), and T2033 (residential care, waiver; per diem) together imply substantial investment in population outreach and ongoing care coordination plus material capacity for residential services.

Substance use disorder (SUD) treatment is a prominent service line: H0015 (intensive outpatient) generated $7.4M and ranks #1 of 107 providers in-state (100th percentile, labeled an extreme outlier), and H0010 (sub-acute detoxification) generated $3.2M. These figures show the provider is an unusually large statewide deliverer of intensive outpatient SUD care and carries material detoxification volume as well.

For several common outpatient evaluation and therapy services the provider reports above-typical volumes, reflecting a broad ambulatory behavioral-health footprint. Examples include 99213 (33.1K claims, $1.2M, 98th percentile; notably above typical) and 90834 (14.3K claims, $1.1M, 97th percentile; notably above typical), while 90791 (psychiatric evaluation) is also an extreme outlier (10.6K claims, $1.2M, 99th percentile), pointing to large-scale intake and ongoing outpatient clinical activity.

Competitive standing is mixed across codes: the provider is a clear statewide leader for H0015 (rank #1, extreme outlier) and for psychiatric evaluations (90791, rank #5, 99th percentile, extreme outlier), while its roles in H0023 (rank #15 of 50, 71st percentile) and T2033 (rank #30 of 43, 31st percentile) are more typical or modest relative to in-state peers. Overall this suggests dominant positions in some SUD and evaluation services, but only moderate standing in other case-management and residential-provider peer groups.

A small number of high-dollar per-diem services materially affect revenue composition: T2033 carries a high average paid-per-claim ($7322 avg paid/claim, $12.1M revenue), and H0039 shows a high per-15-minute average ($827 avg paid/claim, $1M revenue) despite lower rank. These high unit-value services mean a relatively small number of residential or intensive-treatment days account for a disproportionate share of dollars.

Operational and market implications tied to tenure and payer concentration: the NPI was enumerated on 2006-01-06 (~20 years ago), indicating an established presence in the state Medicaid system. That long tenure combined with heavy reliance on Medicaid (and the fact that the top three Medicaid codes account for 59.1% of Medicaid revenue) suggests the provider’s financial performance and capacity planning are particularly sensitive to state Medicaid policy, waiver rules, and SUD reimbursement changes.

Medicaid: Complete Services Breakdown

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

44 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0023	Alcohol and/or drug outreach	60,180	$330	$19.6M
T1017	Targeted case management, each 15 minutes	36,880	$340	$12.6M
T2033	Residential care, not otherwise specified (nos), waiver; per diem	1,650	$7,320	$12.1M
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	31,080	$240	$7.4M
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	7,090	$450	$3.2M
T2023	Targeted case management; per month	8,980	$300	$2.7M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	6,560	$340	$2.2M
H0046	Mental health services, not otherwise specified	19,190	$120	$2.2M
H2011	Crisis intervention service, per 15 minutes	2,540	$680	$1.7M
H0040	Assertive community treatment program, per diem	8,020	$180	$1.4M

Showing 1–10 of 44

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

Blue Ridge Behavioral Healthcare — 5 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

44 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2033	Residential care, not otherwise specified (nos), waiver; per diem	30	40	6,080	$1,660	$27.6M
H0023	Alcohol and/or drug outreach	15	50	33,630	$320	$15M
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	13	30	7,090	$420	$11.5M
T1017	Targeted case management, each 15 minutes	11	50	23,860	$330	$9.4M
S0201	Partial hospitalization services, less than 24 hours, per diem	44	80	1,870	$470	$2.9M
H0046	Mental health services, not otherwise specified	107	510	6,100	$190	$2.8M
H0040	Assertive community treatment program, per diem	25	40	10,830	$200	$2.7M
H2036	Alcohol and/or other drug treatment program, per diem	12	10	480	$660	$2.6M
H0039	Assertive community treatment, face-to-face, per 15 minutes	28	30	2,740	$530	$2M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	65	150	5,420	$110	$1.9M

Showing 1–10 of 44

Related Providers

Other providers that share a Tax Identification Number (TIN) with Blue Ridge Behavioral Healthcare, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Natalie Leonard	VA	Family Nurse Practitioner	$16.6K	$0
Sarah Hazelwood	VA	Psychiatry Physician	$11.9K	$0

Nearby Providers

Other providers in the same ZIP code as Blue Ridge Behavioral Healthcare, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mainstream Mental Health Services	VA	Community/Behavioral Health Agency	$0	$32.9M
Ehs Support Services, LLC	VA	Community/Behavioral Health Agency	$0	$28.4M
Anderson & Associates, LLC	VA	Substance Abuse Rehabilitation Facility	$0	$17.9M
Hall Community Services Inc	VA	Mental Health Counselor	$0	$16.6M
Vistar Eye Center, Inc	VA	Specialist	$0	$11.4M
Professional Therapies Of Roanoke, Inc.	VA	Rehabilitation Clinic/Center	$0	$10.5M
It's About Time, Inc	VA	Developmentally Disabled Services Day Training Agency	$0	$9.4M
Roanoke Resource LLC	VA	Community/Behavioral Health Agency	$0	$8.3M
Carilion Medical Center	VA	Home Health Agency	$0	$7.3M
City Of Roanoke	VA	Land Ambulance	$1.2M	$5.8M

Blue Ridge Behavioral Healthcare — Billing Profile & Reimbursement Data

Sign up for Blue Ridge Behavioral Healthcare — Billing Profile & Reimbursement Data policy alerts

Blue Ridge Behavioral Healthcare — Billing Profile & Reimbursement Data

Sign up for Blue Ridge Behavioral Healthcare — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References