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.

Hope For Tomorrow, LLC (NPI 1639733744)

Field	Value
Entity Type	Organization
Organization	Hope For Tomorrow, LLC
Address	3471 Ohio River Rd
City	Point Pleasant
State	WV
ZIP	25550
Taxonomy	Substance Abuse Rehabilitation Facility
NPI Enumerated	April 24, 2019

Payer Source	Total Paid
Medicaid	$25.6M
Medicare	$0

Key Findings

HOPE FOR TOMORROW, LLC is effectively a Medicaid‑focused provider with no Medicare billing on file and a lifetime Medicaid revenue of $25.6M, indicating a single‑payer operational emphasis in public programs rather than a mixed Medicare/Medicaid practice profile. The NPI was enumerated on 2019-04-24 (~7 years ago), so the organization has an established billing history of approximately seven years in state Medicaid data.

Revenue is heavily concentrated in a small set of per‑diem and outpatient codes: H2036 (Alcohol and/or other drug treatment program, per diem) reported $17.4M in revenue (68.1% of Medicaid revenue), H0004 (Behavioral health counseling and therapy, per 15 minutes) reported $3.7M (14.7%), and 99213 (established outpatient E/M) reported $2.3M (9.1%); the precomputed top‑three share accounts for 91.8% of this provider's total Medicaid revenue, underscoring dependence on a narrow set of services.

The code mix (H2036, H0004, 99213) and claim volumes — H2036: 83.7K claims, H0004: 34.4K claims, 99213: 40K claims — point to an operation built around per‑diem substance use disorder treatment with substantial onsite or clinic‑based counseling and frequent short outpatient evaluation and management encounters, consistent with the Substance Abuse Rehabilitation Facility taxonomy. The presence of both high per‑diem volume and high counts of 15‑minute counseling sessions suggests a blended residential and outpatient workflow.

HOPE FOR TOMORROW's competitive standing within West Virginia is mixed by code: for the dominant H2036 it ranks #5 of 35 (88th percentile) and is described as a typical, unremarkable volume despite being in the upper quintile; for 99213 it ranks #49 of 1273 (96th percentile) and is explicitly noted as notably above typical state volume, indicating the provider is a high‑volume deliverer of routine outpatient E/M relative to most in‑state peers. H0004 ranks #30 of 166 (82th percentile) and is characterized as typical, so while counseling is an important revenue stream it is not exceptionally concentrated relative to the state peer set.

Laboratory and monitoring activity is substantial and focused on substance‑use monitoring: 80307 (instrumented presumptive drug tests) had 13.4K claims ($1.1M revenue), 80305 (non‑instrumented presumptive tests) had 14K claims and is flagged as notably above typical state volume (94th percentile), and 82075 (breath alcohol analysis) recorded 5.2K claims. These patterns reinforce a clinical model with routine toxicology and alcohol testing as part of care pathways and utilization monitoring.

Per‑claim payments and revenue composition reinforce the operational picture: H2036 averages $208 paid/claim and drives $17.4M of the $25.6M Medicaid total, while H0004 averages $109/claim and 99213 averages $58/claim, confirming that the per‑diem treatment code is the primary revenue engine by both volume and unit payment. Reliance on a high‑volume per‑diem code creates exposure to any Medicaid policy changes affecting residential treatment reimbursement.

Beyond the top three, several ancillary services show elevated in‑state standing and suggest complementary care processes: 81025 pregnancy testing ranks #10 of 198 (95th percentile) and 80305 ranks high (94th percentile), indicating routine intake and monitoring workflows; conversely many other behavioral health and case management codes sit in typical percentile ranges, implying the provider concentrates revenue in core SUD treatment and screening rather than broader behavioral health service diversification.

Given the Medicaid concentration and the code‑level percentiles, payers and network analysts should view HOPE FOR TOMORROW as a specialized substance use disorder treatment provider with dominant per‑diem billing and above‑average outpatient E/M volume in the state. This profile suggests negotiating and utilization management efforts should focus on H2036 per‑diem utilization and the high throughput of drug/alcohol testing and established outpatient encounters rather than broad primary care or Medicare‑style service lines.

Medicaid: Complete Services Breakdown

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

24 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2036	Alcohol and/or other drug treatment program, per diem	83,660	$210	$17.4M
H0004	Behavioral health counseling and therapy, per 15 minutes	34,400	$110	$3.7M
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…	40,010	$60	$2.3M
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.	13,450	$80	$1.1M
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	4,330	$80	$351K
82075	The lab analyst performs the technical lab test to analyze the quantitative amount of alcohol in a patient’s breath and correlates the measurement to blood alcohol content.	5,240	$20	$125.7K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	13,950	$10	$125.6K
99203	The provider sees a new 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 provider…	1,880	$60	$109.2K
H0031	Mental health assessment, by non-physician	650	$150	$99.1K
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	8,950	$10	$89.5K

Showing 1–10 of 24

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

Hope For Tomorrow, LLC — 2 of 24 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

24 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2036	Alcohol and/or other drug treatment program, per diem	5	40	29,190	$210	$7.8M
H0004	Behavioral health counseling and therapy, per 15 minutes	30	170	8,500	$80	$1.5M
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.	20	110	2,080	$50	$537.1K
H0031	Mental health assessment, by non-physician	57	120	620	$160	$312.6K
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…	49	1,270	1,240	$30	$245K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	200	1,030	890	$50	$221K
82075	The lab analyst performs the technical lab test to analyze the quantitative amount of alcohol in a patient’s breath and correlates the measurement to blood alcohol content.	9	40	900	$20	$214.7K
H0032	Mental health service plan development by non-physician	27	60	280	$80	$141.9K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	206	340	140	$90	$97.5K
T1017	Targeted case management, each 15 minutes	57	110	970	$20	$95.3K

Showing 1–10 of 24

Related Providers

Other providers that share a Tax Identification Number (TIN) with Hope For Tomorrow, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nicole Clendenin	WV	Family Nurse Practitioner	$50.8K	$0

Nearby Providers

Other providers in the same ZIP code as Hope For Tomorrow, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pleasant Valley Hospital, Inc.	WV	Rural Health Clinic/Center	$0	$6.6M
Pleasant Valley Hospital, Inc.	WV	General Acute Care Hospital	$0	$6.6M
New Lifeclinics Inc	WV	Addiction Medicine (Family Medicine) Physician	$0	$6.5M
Mountaineer Laboratories LLC	WV	Clinical Medical Laboratory	$13.8K	$3.7M
Valley Health Systems Inc	WV	Federally Qualified Health Center (FQHC)	$0	$3.4M
County Of Mason	WV	Land Ambulance	$369.8K	$1.9M
Point Pleasant Physician Billing Services	WV	Multi-Specialty Clinic/Center	$0	$2.2M
Mason County Action Group, Inc.	WV	Home Health Agency	$0	$2M
Mason County Emergency Ambulance Service Authority	WV	Ambulance	$0	$1.6M
Mason County Action Group Inc	WV	Home Health Agency	$0	$1.5M

Hope For Tomorrow, LLC — Billing Profile & Reimbursement Data

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Hope For Tomorrow, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References