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.

Psychological Assessment & Intervention Services, LLC (NPI 1477955235)

Field	Value
Entity Type	Organization
Organization	Psychological Assessment & Intervention Services, LLC
Address	1 Dunbar Plz Ste 100a
City	Dunbar
State	WV
ZIP	25064
Taxonomy	Respite Care
NPI Enumerated	September 23, 2014

Payer Source	Total Paid
Medicaid	$43.5M
Medicare	$0

Key Findings

PSYCHOLOGICAL ASSESSMENT & INTERVENTION SERVICES, LLC is effectively a single‑payer provider: there is no Medicare billing on file and the organization reports $43.5M in lifetime Medicaid revenue, indicating its operations and scale are driven almost entirely by state Medicaid programs. This payer concentration means Medicaid policy and rate changes will disproportionately affect the business.

Revenue is extremely concentrated in a very small set of Medicaid codes: the precomputed top three codes account for 97.3% of the provider’s total Medicaid revenue. This concentration signals operational reliance on a narrow set of services and creates exposure if reimbursement rates, coverage rules, or utilization management for these codes change.

S5125 is by far the dominant revenue driver: the provider reported 15.2K claims for S5125 with $2697 avg paid/claim and $41.1M revenue, representing 94.5% of its Medicaid revenue. The code description (attendant care services; per 15 minutes) and the magnitude of revenue indicate the organization primarily delivers labor‑intensive, community‑based attendant care, billing many short time units as its core service line.

Despite the large absolute dollar volume on S5125, the provider is not a statewide outlier on that code: it ranks #21 of 43 providers in‑state (52th percentile; typical, unremarkable volume for this code). In other words, the provider’s dominance in total dollars is driven more by its focus on a high‑revenue code than by being an unusually large claimant relative to in‑state peers on S5125.

The other two top codes are much smaller share contributors: G9002 (3.4K claims, $207 avg paid/claim, $694.1K revenue; 1.6% of Medicaid revenue) and T2021 (6.5K claims, $79 avg paid/claim, $513K revenue; 1.2% of Medicaid revenue). Both codes rank near the middle of their peer distributions (G9002 ranks #58 of 123, 53th percentile; T2021 ranks #29 of 57, 50th percentile) and are characterized as typical, unremarkable volumes, suggesting these services play secondary roles in the provider’s mix.

Claim activity for nursing, case management, and support services appears as complementary lines: T1003 (6.8K claims, $324.3K revenue; ranks #10 of 33, 72th percentile), T1002 (5.9K claims, $297.5K revenue; ranks #32 of 151, 79th percentile), T1016 (3.8K claims, $294.5K revenue; ranks #40 of 96, 59th percentile), and A0160 (2.1K claims, $271.5K revenue; ranks #56 of 112, 50th percentile) indicate the provider bills a range of home/community support and care coordination services in addition to attendant care. These supplemental codes further reflect a service mix oriented to waiver and community‑based supports rather than institutional care.

From a competitive‑standing perspective, the provider is a meaningful but not dominant statewide participant: rankings across its top codes sit near median percentiles or modestly above (several codes labeled typical, unremarkable volume), so the organization appears to serve a stable share of local demand rather than acting as a market leader. Analysts should interpret the large Medicaid dollar total in the context of a concentrated code mix rather than as evidence of broad dominance across service lines.

The provider’s NPI tenure (enumerated on 2014-09-23, registered ~12 years ago) indicates an established presence in the market; combined with $43.5M in Medicaid revenue and heavy dependence on attendant care codes, this suggests operational scale built around long‑standing Medicaid waiver or community‑based contracts. Given the narrow revenue base (top three codes = 97.3%), payer contracting, program edits, or utilization review focused on attendant care could materially affect cash flow and utilization patterns for this entity.

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5125	Attendant care services; per 15 minutes	15,240	$2,700	$41.1M
G9002	Coordinated care fee, maintenance rate	3,350	$210	$694.1K
T2021	Day habilitation, waiver; per 15 minutes	6,490	$80	$513K
T1003	Lpn/lvn services, up to 15 minutes	6,760	$50	$324.3K
T1002	Rn services, up to 15 minutes	5,950	$50	$297.4K
T1016	Case management, each 15 minutes	3,780	$80	$294.4K
A0160	Non-emergency transportation: per mile - case worker or social worker	2,060	$130	$271.5K
T2024	Service assessment/plan of care development, waiver	40	$60	$2.3K

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

Psychological Assessment & Intervention Services, LLC — 0 of 8 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

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5125	Attendant care services; per 15 minutes	21	40	14,820	$750	$30.5M
T2021	Day habilitation, waiver; per 15 minutes	29	60	6,490	$120	$2.2M
G9002	Coordinated care fee, maintenance rate	58	120	2,950	$150	$901.9K
T1003	Lpn/lvn services, up to 15 minutes	10	30	2,070	$90	$522.7K
T1016	Case management, each 15 minutes	40	100	2,790	$90	$496.2K
A0160	Non-emergency transportation: per mile - case worker or social worker	56	110	2,030	$50	$278.8K
T1002	Rn services, up to 15 minutes	32	150	1,980	$40	$232.6K
T2024	Service assessment/plan of care development, waiver	42	50	760	$50	$95.5K

Nearby Providers

Other providers in the same ZIP code as Psychological Assessment & Intervention Services, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Csi Community Services Inc	WV	Community/Behavioral Health Agency	$0	$8.3M
Kci Usa, Inc.	WV	Durable Medical Equipment & Medical Supplies	$0	$6.4M
New Horizons Therapy Services	WV	Community/Behavioral Health Agency	$0	$3.1M
Bridget B Stevens,dds,inc	WV	General Practice Dentistry	$0	$2.5M
National Seating & Mobility, Inc.	WV	Durable Medical Equipment & Medical Supplies	$0	$2.5M
Psychological Assessment And Intervention Services, LLC	WV	Psychologist	$0	$1.3M
Recoveryu	WV	Community/Behavioral Health Agency	$0	$1.3M
Respiratory Therapy Services LLC	WV	Oxygen Equipment & Supplies (DME)	$0	$777.3K
John Lilly	WV	Internal Medicine Physician	$98K	$0
Jonathan Lilly	WV	Family Medicine Physician	$82K	$0

Psychological Assessment & Intervention Services, LLC — Billing Profile & Reimbursement Data

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Psychological Assessment & Intervention Services, LLC — 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