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.

Valley Comprehensive Community Mental Health Center (NPI 1609295112)

Field	Value
Entity Type	Organization
Organization	Valley Comprehensive Community Mental Health Center
Address	301 Scott Ave
City	Morgantown
State	WV
ZIP	26508
Taxonomy	Respite Care
NPI Enumerated	April 11, 2014

Payer Source	Total Paid
Medicaid	$21.8M
Medicare	$0

Key Findings

VALLEY COMPREHENSIVE COMMUNITY MENTAL HEALTH CENTER is effectively a Medicaid-focused provider: it reports $21.8M in lifetime Medicaid revenue and has no Medicare billing on file. This means payer mix is single-payer in practice, with operational and reimbursement risk concentrated in state Medicaid policy and waiver programs rather than Medicare fee schedules or Part B dynamics.

Revenue concentration is high and narrowly focused: the precomputed top 3 Medicaid codes account for 79.3% of the provider’s total Medicaid revenue, and S5125 alone generates $13.8M (63.1% of Medicaid revenue). This level of concentration indicates the organization’s financial profile is heavily dependent on a small set of community-based service lines.

The code mix and descriptions indicate a service model centered on home- and community-based long-term supports: S5125 (Attendant care services per 15 minutes), T2021 (Day habilitation, waiver), and G9002 (Coordinated care fee, maintenance rate) together dominate revenue. Combined with T1016 (case management) and T1005 (respite care services), the pattern supports an operational emphasis on attendant care, waiver day habilitation, coordination, and episodic respite — consistent with the provider’s Respite Care taxonomy.

Competitive standing is mixed across its top codes: for S5125 the provider ranks #31 of 43 in-state (29th percentile), which is a modest position and not a market-leading volume for that dominant revenue driver. By contrast, for G9002 it ranks #17 of 123 (87th percentile), indicating relatively strong performance in coordinated-care fees and a competitive advantage in that specific reimbursement category.

Several mid-ranked codes reinforce a broad community-support footprint rather than medical specialty billing: T1016 (case management) shows 7.5K claims and $1.5M revenue, ranking #27 of 96 providers (73rd percentile), and 97530 appears with $884K revenue and a #39 of 140 rank (73rd percentile). These placements suggest typical, sustained delivery of rehabilitation and care-management services within the state network rather than exceptional outlier volume.

Some unit-payment characteristics stand out even when volume is moderate: T1005 (Respite care services) posts only ~1K claims but a high average paid/claim of $1096 and $1.1M revenue, while ranking #22 of 29 providers (25th percentile). That combination — relatively low rank but high per-claim payment — indicates the provider bills some higher-reimbursement respite encounters relative to many in-state peers, even if overall volume is limited.

Tenure appears established: the NPI was enumerated on 2014-04-11 (~12 years ago), indicating roughly a decade-plus presence in the state market. This duration, together with concentrated Medicaid revenue, implies institutional experience delivering waiver and community-support services under West Virginia Medicaid arrangements.

Operational risk is concentrated in a few programs and codes: because S5125 drives 63.1% of Medicaid revenue and the top three codes represent 79.3% of revenue, any policy, rate, or utilization change affecting attendant care or waiver payment methodology could materially affect the provider’s financials. Analysts should treat shifts in state waiver rules, attendant-care authorization practices, or coordinated-care fee structures as high-impact variables for this organization.

Medicaid: Complete Services Breakdown

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5125	Attendant care services; per 15 minutes	6,930	$1,990	$13.8M
G9002	Coordinated care fee, maintenance rate	9,810	$210	$2M
T2021	Day habilitation, waiver; per 15 minutes	5,120	$290	$1.5M
T1016	Case management, each 15 minutes	7,520	$200	$1.5M
T1005	Respite care services, up to 15 minutes	1,010	$1,100	$1.1M
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	2,750	$320	$884K
A0160	Non-emergency transportation: per mile - case worker or social worker	1,900	$230	$438.2K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	3,430	$110	$363.5K
A0120	Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems	580	$150	$87.5K
T2024	Service assessment/plan of care development, waiver	1,380	$60	$83K

Showing 1–10 of 11

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

Valley Comprehensive Community Mental Health Center — 0 of 11 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

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5125	Attendant care services; per 15 minutes	31	40	14,820	$750	$30.5M
T2021	Day habilitation, waiver; per 15 minutes	33	60	6,490	$120	$2.2M
T1005	Respite care services, up to 15 minutes	22	30	2,980	$250	$1.5M
G9002	Coordinated care fee, maintenance rate	17	120	2,950	$150	$901.9K
T1016	Case management, each 15 minutes	27	100	2,790	$90	$496.2K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	39	140	790	$90	$469.7K
A0160	Non-emergency transportation: per mile - case worker or social worker	59	110	2,030	$50	$278.8K
T1002	Rn services, up to 15 minutes	101	150	1,980	$40	$232.6K
A0120	Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems	37	50	1,390	$30	$183.1K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	18	80	1,150	$40	$142.7K

Showing 1–10 of 11

Related Providers

Other providers that share a Tax Identification Number (TIN) with Valley Comprehensive Community Mental Health Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Valley Comprehensive Community Mental Health Center	WV	Community/Behavioral Health Agency	$0	$19.4M
Valley Comprehensive Community Mental Health Center, Inc.	WV	Mental Health Counselor	$0	$16.7M

Nearby Providers

Other providers in the same ZIP code as Valley Comprehensive Community Mental Health Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mulberry Street Management Services, Inc.	WV	In Home Supportive Care Agency	$0	$175.6M
West Virginia's Choice	WV	Home Health Agency	$0	$72.7M
Mulberry Street Management Services, Inc.	WV	Community/Behavioral Health Agency	$0	$28.9M
Mulberry Street Management Services, Inc.	WV	Case Management Agency	$0	$8.3M
Baymark Health Services Of West Virginia, Inc.	WV	Substance Use Disorder Rehabilitation Clinic/Center	$80.4K	$7.9M
Dr. Cynthia D. Parks Dds, PLLC	WV	Pediatric Dentistry	$0	$2.7M
West Virginia Choice	WV	Home Health Agency	$0	$2.2M
Health Care Solutions At Home Inc.	WV	Durable Medical Equipment & Medical Supplies	$0	$1.4M
John Hancox	WV	MOHS-Micrographic Surgery Physician	$959.7K	$0
David Carlisle	WV	MOHS-Micrographic Surgery Physician	$638.7K	$0

Valley Comprehensive Community Mental Health Center — Billing Profile & Reimbursement Data

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Valley Comprehensive Community Mental Health Center — 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