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.

Northwood Health Systems Inc (NPI 1649277559)

Field	Value
Entity Type	Organization
Organization	Northwood Health Systems Inc
Address	1819 Wood St
City	Wheeling
State	WV
ZIP	26003
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	July 7, 2005

Payer Source	Total Paid
Medicaid	$52.5M
Medicare	$0

Key Findings

NORTHWOOD HEALTH SYSTEMS INC reports no Medicare billing on file and $52.5M in lifetime Medicaid revenue, making it effectively a Medicaid-focused provider rather than a dual-payer operation. This concentration on Medicaid suggests strategic dependence on state payer programs for the bulk of its reimbursement and operational scale.

Revenue concentration is extreme: the precomputed top 3 Medicaid codes account for 84.2% of the provider's total Medicaid revenue, with H0036 alone representing $30M (57.2% of Medicaid revenue). Such a profile indicates the organization’s financial performance is heavily driven by a very narrow set of service lines.

The service mix is centered on time-based community behavioral health interventions: H0036 (Community psychiatric supportive treatment, face-to-face, per 15 minutes) has 49.3K claims and $30M revenue, H0004 (Behavioral health counseling and therapy, per 15 minutes) has 87.4K claims and $8.2M revenue, and H0040 (Assertive community treatment program, per diem) has 58.2K claims and $5.9M revenue. Together these codes point to high-volume, frequent-contact outpatient and community-based psychiatric services rather than inpatient or primarily physician-driven procedures.

Competitive standing varies by code: the provider is a clear statewide leader on H0036 (ranks #1 of 24 providers in-state; 100th percentile; labeled an extreme outlier), is notably high-volume on H0004 (ranks #9 of 166; 95th percentile; notably above typical state volume), but is unremarkable for H0040 (ranks #9 of 12; 27th percentile; typical, unremarkable volume). This pattern indicates dominance in community psychiatric supportive treatment but only a modest position among assertive community treatment providers.

Beyond the top three, NORTHWOOD shows meaningful support services and program codes: H2015 (Comprehensive community support services) contributes $2.3M (4.4% of Medicaid revenue) and ranks #2 of 6 in-state (80th percentile), while H0032 (Mental health service plan development) contributes $1M (2.0%) and ranks #6 of 59 (91st percentile). These secondary codes reinforce a programmatic footprint that combines care planning and community support with direct service delivery.

Clinical billing patterns include significant outpatient E/M activity alongside behavioral services: 99214 and 99213 together account for substantial claim volumes (20.6K and 24.3K claims respectively) and combined revenue of $1.9M and $1.6M. The presence and high state percentile ranks for these E/M codes (99214 ranks #40 of 1031; 96th percentile; 99213 ranks #92 of 1273; 93th percentile) suggest the organization bills a non-trivial amount of clinician time for evaluation and management in addition to non-physician behavioral codes.

Operational risk is elevated by heavy reliance on a single high-volume code mix: with H0036 at $30M (57.2%) and the top three codes at 84.2% of Medicaid revenue, changes in coverage, reimbursement, or utilization for these specific service lines would likely have outsized financial impact. Conversely, smaller revenues from telehealth and transportation (e.g., Q3014 $95.5K and A0120 $71.2K) indicate limited diversification into ancillary revenue streams.

NORTHWOOD’s NPI has been enumerated since 2005-07-07 (~21 years ago), indicating a long-tenured presence in the state marketplace; combined with its high-volume standing on several behavioral codes, the provider appears to be an established community behavioral health operator with deep programmatic billing activity concentrated in Medicaid.

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
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	49,300	$610	$30M
H0004	Behavioral health counseling and therapy, per 15 minutes	87,430	$90	$8.2M
H0040	Assertive community treatment program, per diem	58,210	$100	$5.9M
H2015	Comprehensive community support services, per 15 minutes	36,470	$60	$2.3M
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…	20,580	$90	$1.9M
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…	24,340	$70	$1.6M
H0032	Mental health service plan development by non-physician	7,340	$140	$1M
H0031	Mental health assessment, by non-physician	4,070	$170	$683.6K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	2,070	$130	$273.6K
H0038	Self‑help/peer services, per 15 minutes	4,650	$50	$237.3K

Showing 1–10 of 19

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

Northwood Health Systems Inc — 3 of 19 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

19 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0040	Assertive community treatment program, per diem	9	10	71,630	$80	$6.8M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	1	20	2,650	$460	$2.9M
H2015	Comprehensive community support services, per 15 minutes	2	10	14,470	$50	$1.6M
H0038	Self‑help/peer services, per 15 minutes	24	60	3,310	$110	$1.6M
H0004	Behavioral health counseling and therapy, per 15 minutes	9	170	8,500	$80	$1.5M
H0031	Mental health assessment, by non-physician	16	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…	92	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…	40	1,030	890	$50	$221K
A0120	Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems	13	50	1,390	$30	$183.1K
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…	249	310	740	$80	$178.2K

Showing 1–10 of 19

Nearby Providers

Other providers in the same ZIP code as Northwood Health Systems Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northwood Health Systems Inc	WV	Developmentally Disabled Services Day Training Agency	$0	$67.6M
Wheeling Hospital Inc	WV	General Acute Care Hospital	$0	$40.1M
Lorraine Surgical Supply Of West Virginia Inc.	WV	Durable Medical Equipment & Medical Supplies	$0	$34.6M
Russell Nesbitt Services Inc	WV	Respite Care	$0	$29.5M
Florence Crittenton Programs, Inc.	WV	Mental Health Counselor	$0	$14.4M
Wheeling Hospital Inc	WV	Family Medicine Physician	$0	$8.5M
Lifeline Addiction Specialists, PLLC	WV	Multi-Specialty Clinic/Center	$0	$7M
Radiology Associates, Inc	WV	Diagnostic Radiology Physician	$0	$6.7M
Serenity Hills Life Center	WV	Substance Use Disorder Rehabilitation Clinic/Center	$0	$6.1M
Alecto Healthcare Services Wheeling LLC	WV	General Acute Care Hospital	$0	$6M

Northwood Health Systems 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

Nearby Providers

Frequently Asked Questions

References