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.

Appalachian Community Care LLC (NPI 1558750406)

Field	Value
Entity Type	Organization
Organization	Appalachian Community Care LLC
Address	255 Church St Ste 101
City	Pikeville
State	KY
ZIP	41501
Taxonomy	Professional Counselor
NPI Enumerated	January 15, 2015

Payer Source	Total Paid
Medicaid	$13.1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	52,410	$80	$4M
T2023	Targeted case management; per month	11,130	$300	$3.3M
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	48,080	$40	$1.9M
H0031	Mental health assessment, by non-physician	14,150	$60	$877.5K
T1007	Alcohol and/or substance abuse services, treatment plan development and/or modification	8,550	$60	$496.1K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	10,260	$50	$461.7K
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…	13,900	$30	$458.7K
H0001	Alcohol and/or drug assessment	6,400	$70	$448.1K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	4,080	$90	$359.1K
H0032	Mental health service plan development by non-physician	4,670	$60	$275.3K

Showing 1–10 of 19

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

Appalachian Community Care LLC — 7 of 18 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

19 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2023	Targeted case management; per month	39	530	530	$300	$1.1M
H0038	Self‑help/peer services, per 15 minutes	149	320	3,070	$50	$678.3K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	90	340	2,700	$40	$673.3K
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…	27	1,270	760	$80	$447.2K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	120	3,340	1,020	$30	$296K
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…	52	600	600	$40	$207.8K
90834	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…	49	500	250	$60	$152.8K
H0031	Mental health assessment, by non-physician	9	170	170	$70	$145.9K
T1007	Alcohol and/or substance abuse services, treatment plan development and/or modification	10	220	340	$60	$114.8K
H0032	Mental health service plan development by non-physician	30	380	160	$70	$107.8K

Showing 1–10 of 19

Nearby Providers

Other providers in the same ZIP code as Appalachian Community Care LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pikeville Medical Center Inc	KY	General Acute Care Hospital	$0	$181.5M
Pikeville Medical Center Inc.	KY	Multi-Specialty Clinic/Center	$0	$34.2M
Dungarvin Kentucky, LLC - Pikeville	KY	Developmentally Disabled Services Day Training Agency	$0	$16.3M
Joshua Raleigh	KY	Pediatric Dentistry	$0	$7.8M
Bhg Xxv, LLC	KY	Substance Use Disorder Rehabilitation Clinic/Center	$228K	$6.3M
Renew Residential Treatment Services	KY	Substance Abuse Rehabilitation Facility	$0	$4.9M
Stepping Stones LLC	KY	Substance Use Disorder Rehabilitation Clinic/Center	$0	$4.6M
Chad Street	KY	Oral and Maxillofacial Surgery (Dentist)	$0	$3.8M
Sujata Gutti	KY	Neurology Physician	$82.9K	$3.7M
Addiction Recovery Care LLC	KY	Substance Abuse Rehabilitation Facility	$0	$3.7M

Appalachian Community Care LLC — Billing Profile & Reimbursement Data

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Appalachian Community Care LLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References