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.

Ohio Valley Physicians Inc (NPI 1639683725)

Field	Value
Entity Type	Organization
Organization	Ohio Valley Physicians Inc
Address	300b 8th St Ste 201
City	Huntington
State	WV
ZIP	25701
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	November 28, 2017

Payer Source	Total Paid
Medicaid	$22.8M
Medicare	$0

Key Findings

OHIO VALLEY PHYSICIANS INC reports no Medicare billing on file and $22.8M in lifetime Medicaid revenue, making it effectively a single-payer (Medicaid) billing entity in the available data. The absence of Medicare claims suggests the organization’s operational and revenue risks are closely tied to Medicaid policy, enrollment, and reimbursement trends rather than Medicare dynamics.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 99.4% of the provider’s total Medicaid revenue. The single largest code is H2036 ($13.9M, 61.1% of Medicaid revenue), followed by H0004 ($7.9M, 34.7%) and H0031 ($824.1K, 3.6%), indicating very narrow revenue drivers rather than a broad mix of billed services.

The code mix points to a core business profile focused on substance-use and outpatient behavioral health services. H2036 (Alcohol and/or other drug treatment program, per diem) and H0004 (Behavioral health counseling and therapy, per 15 minutes) dominate billing, which implies the provider operates program-based SUD services alongside high-volume, time-based counseling visits rather than primarily physician-delivered psychotherapy.

Operational scale is visible in claims and unit payments: H0004 shows 100.1K claims with a $79 avg paid/claim and H2036 shows 62.7K claims with a $222 avg paid/claim, while H0031 records 6.4K claims at $129 avg paid/claim. These volumes reflect a high-throughput counseling model (many short units billed) combined with per-diem SUD program billing, which has implications for staffing, scheduling, and facility utilization.

Competitive standing is mixed across the top codes within West Virginia. For H0004 the provider ranks #6 of 166 in-state (97th percentile; notably above typical state volume), indicating it is a major state-level player for behavioral health counseling by time-based units; by contrast, H2036 ranks #7 of 35 (82th percentile; typical, unremarkable volume) and H0031 ranks #8 of 119 (94th percentile; typical, unremarkable volume), so its per-diem SUD and non-physician assessment activity are strong but not uniquely dominant statewide.

Secondary codes and traditional psychotherapy entries are minimal contributors to revenue, reinforcing the specialized service mix. Examples include 90837 ($68.4K, 0.3% of Medicaid revenue), 87426 ($54.6K, 0.2%), and 90853 ($14.8K, 0.1%), which together represent de minimis shares compared with the provider’s two primary codes and suggest limited reliance on long-form individual psychotherapy or diagnostic testing as revenue drivers.

The provider’s NPI was enumerated on 2017-11-28 (~9 years ago), indicating an established presence in the region long enough to build programmatic capacity in SUD and outpatient counseling. That tenure, combined with the high volume for H0004, points to an operational focus and possible scale in delivering time-based counseling services.

Because H2036 and H0004 together constitute the vast majority of Medicaid revenue within the precomputed top-three mix (H2036 at 61.1% and H0004 at 34.7%), the organization’s financial performance is highly sensitive to Medicaid rate changes, prior authorization policies, or programmatic shifts affecting per-diem SUD payments and 15-minute counseling reimbursement. Analysts should treat changes to those two code lines as primary levers that would materially affect the provider’s revenue profile.

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
H2036	Alcohol and/or other drug treatment program, per diem	62,710	$220	$13.9M
H0004	Behavioral health counseling and therapy, per 15 minutes	100,070	$80	$7.9M
H0031	Mental health assessment, by non-physician	6,390	$130	$824.1K
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…	730	$90	$68.4K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	1,660	$30	$54.6K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	820	$20	$14.8K
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…	50	$60	$3.1K
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…	10	$50	$670

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

Ohio Valley Physicians Inc — 1 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
H2036	Alcohol and/or other drug treatment program, per diem	7	40	29,190	$210	$7.8M
H0004	Behavioral health counseling and therapy, per 15 minutes	6	170	8,500	$80	$1.5M
H0031	Mental health assessment, by non-physician	8	120	620	$160	$312.6K
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…	159	310	740	$80	$178.2K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	54	100	940	$20	$62.4K
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…	180	210	280	$40	$59.2K
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…	200	200	490	$30	$57.7K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	31	190	190	$30	$35.9K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Ohio Valley Physicians Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ohio Valley Physicians Inc	WV	Family Medicine Physician	$0	$43M
Ohio Valley Physicians Inc	OH	Substance Abuse Rehabilitation Facility	$0	$12.9M
Ohio Valley Physicians Inc	WV	Rural Health Clinic/Center	$0	$4.2M
Ohio Valley Physicians	KY	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$3.4M
Ohio Valley Physicians, Inc	WV	Rural Health Clinic/Center	$0	$3.1M
Ohio Valley Physicians Inc	WV	Rural Health Clinic/Center	$0	$2.4M
Jonathan Hess	OH	Family Medicine Physician	$272.3K	$0
Robert Hess	WV	Family Medicine Physician	$187K	$0
Hussein Kashk	OH	Emergency Medicine Physician	$98.9K	$0
Brian Hornsby	WV	Internal Medicine Physician	$88.7K	$0

Nearby Providers

Other providers in the same ZIP code as Ohio Valley Physicians Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cabell Huntington Hospital Inc	WV	General Acute Care Hospital	$0	$94.1M
Autism Service Center	WV	Developmental Disabilities Clinic/Center	$0	$59M
University Physicians & Surgeons, Inc	WV	Internal Medicine Physician	$0	$58.3M
Tri-state Addiction Recovery Resources	WV	Community/Behavioral Health Agency	$0	$29.6M
County Of Cabell	WV	Land Ambulance	$2.6M	$23.3M
Huntington Treatment Center, LLC	WV	Methadone Clinic	$0	$21M
Valley Health Systems Inc	WV	Federally Qualified Health Center (FQHC)	$0	$13.4M
Valley Health Systems Inc	WV	Federally Qualified Health Center (FQHC)	$0	$10.2M
Valley Health Systems Inc	WV	Federally Qualified Health Center (FQHC)	$0	$10.1M
Cabell Huntington Hospital Inc	WV	General Acute Care Hospital	$0	$9.3M

Ohio Valley Physicians 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