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 Kentucky for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Kentucky 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. Kentucky (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.

Kentucky River Community Care, Inc (NPI 1528017142)

Field	Value
Entity Type	Organization
Organization	Kentucky River Community Care, Inc
Address	115 Rockwood Ln
City	Hazard
State	KY
ZIP	41701
Taxonomy	Mental Health Counselor
NPI Enumerated	May 9, 2006

Payer Source	Total Paid
Medicaid	$104M
Medicare	$0

Key Findings

This entity is effectively single-payer in scope: there is no Medicare billing on file and all reported federal payer revenue is Medicaid-only, with total Medicaid revenue of $104M. The absence of Medicare activity combined with large Medicaid receipts indicates the provider’s operations are concentrated on Medicaid-covered behavioral health services rather than Medicare populations.

Revenue is highly concentrated in a few service lines: the precomputed top three Medicaid codes (H2015, H2020, T2023) account for 53.4% of the provider’s Medicaid revenue. Specifically, H2015 generated $19.7M (19.0%), H2020 generated $18.7M (18.0%), and T2023 generated $17M (16.4%), showing reliance on comprehensive community support, therapeutic behavioral services, and targeted case management.

The code mix points to a large-scale, community-based behavioral health operation that combines frequent unit-based direct services with ongoing care coordination. High-volume 15-minute unit codes such as H2015 (273.3K claims) and H2021 (105.1K claims), plus per-diem and monthly codes like H2020 (102.6K claims) and T2023 (55.3K claims), suggest the provider delivers both time-based treatment encounters and longer-term case management/administrative enrollment.

KENTUCKY RIVER COMMUNITY CARE is a statewide dominant provider for multiple core service lines: H2015 and H2020 each rank #1 in-state (100th percentile; extreme outlier, far above typical state volume for these codes), and H2021 also ranks #1 of 27 providers (100th percentile; extreme outlier). Those #1 rankings indicate the organization captures outsized market share for community support, therapeutic behavioral, and wrap-around services relative to in-state peers.

Other codes further confirm its competitive standing across related services: T2023 ranks #6 of 525 providers in-state (99th percentile; extreme outlier) while psychotherapy code 90837 produced $10M and ranks #10 of 1266 providers (99th percentile; extreme outlier). These high ranks and percentiles across both case management and direct psychotherapy suggest integrated delivery capacity at scale rather than isolated high volumes in a single modality.

The provider also shows notable service diversification in crisis and telehealth channels. S9484 (crisis intervention, per hour) ranks #1 of 8 providers (100th percentile) and Q3014 (telehealth originating site facility fee) ranks #2 of 67 providers (98th percentile), indicating both a leading crisis response footprint and a significant role as an originating site for telehealth visits in-state.

Several secondary codes reflect robust throughput of shorter-session and support services: H0038 (68.5K claims, $2.5M), 90887 (61.7K claims, $5.6M), and 90853 (59K claims, $1.5M) each rank in high percentiles (97–98th) and point to extensive use of peer/self-help, family/caregiver communications, and group psychotherapy as part of its care mix. These tallies reinforce that the organization delivers a broad menu of behavioral health services across individual, family, group, and peer modalities.

The NPI tenure shows this operation is well-established: the provider was enumerated on 2006-05-09 (~20 years ago). Combined with the large Medicaid footprint and repeated top-state rankings, the longevity supports the view of an established regional behavioral health provider with sustained Medicaid-focused operations and specialized expertise in community support and case management services.

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
H2015	Comprehensive community support services, per 15 minutes	273,300	$70	$19.7M
H2020	Therapeutic behavioral services, per diem	102,620	$180	$18.7M
T2023	Targeted case management; per month	55,330	$310	$17M
H2021	Community-based wrap-around services, per 15 minutes	105,150	$140	$14.5M
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…	115,250	$90	$10M
90887	In this service, the provider interprets or explains the results of psychiatric exams, medical exams, other procedures, or information about the patient’s care to the patient’s family members or…	61,690	$90	$5.6M
H0038	Self‑help/peer services, per 15 minutes	68,470	$40	$2.5M
H0032	Mental health service plan development by non-physician	23,860	$90	$2.1M
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	50,660	$40	$2.1M
H0031	Mental health assessment, by non-physician	23,210	$80	$1.9M

Showing 1–10 of 51

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Kentucky providers billing the same CPT/HCPCS codes.

Claims Volume vs. Kentucky Distribution

Kentucky River Community Care, Inc — 15 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

51 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0004	Behavioral health counseling and therapy, per 15 minutes	117	180	1,320	$220	$1.9M
H2019	Therapeutic behavioral services, per 15 minutes	5	50	820	$190	$1.7M
H0040	Assertive community treatment program, per diem	14	10	1,230	$670	$1.4M
H2020	Therapeutic behavioral services, per diem	1	130	1,730	$180	$1.2M
T2023	Targeted case management; per month	6	530	530	$300	$1.1M
H2021	Community-based wrap-around services, per 15 minutes	1	30	2,140	$130	$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…	224	230	1,750	$110	$793.5K
H0038	Self‑help/peer services, per 15 minutes	12	320	3,070	$50	$678.3K
H2015	Comprehensive community support services, per 15 minutes	1	200	1,610	$80	$585.6K
90887	In this service, the provider interprets or explains the results of psychiatric exams, medical exams, other procedures, or information about the patient’s care to the patient’s family members or…	4	140	460	$70	$475.2K

Showing 1–10 of 51

Related Providers

Other providers that share a Tax Identification Number (TIN) with Kentucky River Community Care, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Samantha Lee	KY	Family Nurse Practitioner	$86.5K	$0
Manoj Chandran	KY	Psychiatry Physician	$35.5K	$0
Evelyn Mullins	KY	Psychiatric/Mental Health Nurse Practitioner	$8.1K	$0
Jerry Ward	KY	Clinical Social Worker	$1K	$2.4K
Kevin Deaton	KY	Clinical Social Worker	$940	$0
Robert Thompson	KY	Psychiatric/Mental Health Nurse Practitioner	$930	$0

Nearby Providers

Other providers in the same ZIP code as Kentucky River Community Care, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kentucky River Community Care, Inc	KY	Specialist	$0	$109.1M
Appalachian Regional Healthcare, Inc.	KY	General Acute Care Hospital	$0	$107.9M
Kentucky River Area Dev Dist	KY	Supports Brokerage Agency	$0	$43.4M
Primary Care Centers Of Eastern Kentucky, LLC	KY	Rural Health Clinic/Center	$0	$26.2M
Soaring Potentials Lllp	KY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$20.4M
Bhg Xxvi, LLC	KY	Substance Use Disorder Rehabilitation Clinic/Center	$493.7K	$16.1M
Southern Medical Partners, LLC	KY	Emergency Medicine Physician	$0	$15.6M
Dungarvin Kentucky, LLC - Hazard	KY	Developmentally Disabled Services Day Training Agency	$0	$10.1M
Quantum Healthcare Associates Inc	KY	General Practice Physician	$0	$9.1M
Community Alternatives Kentucky, Inc.	KY	Case Management Agency	$0	$7.6M

Kentucky River Community Care, Inc — Billing Profile & Reimbursement Data

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Kentucky River Community Care, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References