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 Virginia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to 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. 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.

Western Tidewater Community Mental (NPI 1689615296)

Field	Value
Entity Type	Organization
Organization	Western Tidewater Community Mental
Address	7025 Harbour View Blvd Ste 119
City	Suffolk
State	VA
ZIP	23435
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	June 8, 2006

Payer Source	Total Paid
Medicaid	$84.4M
Medicare	$0

Key Findings

WESTERN TIDEWATER COMMUNITY MENTAL is effectively a single-payer Medicaid provider: it reports no Medicare billing on file and $84.4M in lifetime Medicaid revenue, indicating its scale and payer concentration is concentrated entirely in Medicaid rather than split across Medicare and Medicaid. Analysts should treat this entity as a Medicaid-focused community mental health center rather than a mixed payer outpatient provider.

Revenue is heavily concentrated in a small set of service lines: the top three Medicaid codes (H0023, T1017, H2022) together account for 60.5% of the provider’s total Medicaid revenue. Individually those top drivers are H0023 ($29.3M, 35.0%), T1017 ($11.8M, 14.1%), and H2022 ($9.5M, 11.3%), so payers and contracting teams should focus on those codes when assessing financial exposure or negotiating rates.

The code mix signals a community-based, case-management and outreach operational model: H0023 (behavioral health outreach), T1017 (targeted case management), and H2022 (community-based wrap-around, per diem) are the largest revenue sources, pointing to an emphasis on outreach, ongoing case management, and per-diem wrap-around services rather than primarily short office visits or medical management. This pattern is consistent with a Mental Health Clinic/Center that delivers community outreach and longitudinal support to high-need populations.

Despite the top-3 codes being described as typical state volume, the provider shows exceptionally high volume in psychotherapy and group therapeutic modalities. Codes such as 90837 (31.9K claims, $3.1M; 99th percentile, extreme outlier) and 97150 (46.3K claims, $4.3M; 99th percentile, notably above typical state volume) and 90791 (6K claims, $707.1K; 98th percentile, extreme outlier) point to substantial capacity and throughput for long psychotherapy sessions, group therapy supervision, and initial psychiatric evaluations. These extreme/above-typical volumes suggest clinical capacity and footprint that far exceed most in-state peers for these specific services.

The provider also maintains a strong assertive community treatment and crisis-service footprint: H0040 (assertive community treatment, per diem) contributes $6.1M (7.2%) and ranks #3 of 38 providers in-state (95th percentile, typical), while H0039 and H2011 appear among billed crisis/face-to-face codes. Combined with H2022 per-diem wrap-around services, this indicates sustained investment in intensive community and crisis interventions beyond standard outpatient care.

Competitive standing is mixed by code: for its three revenue-driving codes the provider ranks in mid-to-high statewide percentiles but is described as "typical, unremarkable" for H0023 (84th), T1017 (69th), and H2022 (80th), meaning it is a meaningful Medicaid revenue generator but not uniquely dominant across those lines. Conversely, for psychotherapy and group therapy lines the provider is an outlier (90837 and 97150 at the 99th percentile, 90791 at the 98th percentile), marking it as a major local provider for intensive therapy services while more typical on outreach and case management. Payers should therefore treat contracting and utilization management decisions on a code-by-code basis.

Tenure and operational stability are evident: the provider’s NPI was enumerated on 2006-06-08 (~20 years ago), which, combined with the high Medicaid lifetime revenue ($84.4M) and large claim volumes on multiple behavioral health codes, suggests an established, long-running community mental health operation with deep engagement in Medicaid populations. This longevity supports assumptions of operational continuity when planning network or programmatic relationships.

For reviewers and auditors, two practical attention areas emerge: first, revenue concentration — 60.5% of Medicaid revenue comes from the top three codes — creates financial sensitivity to rate or utilization changes on those services; second, extreme-volume psychotherapy and group-service codes (90837, 97150, 90791) warrant focused review in contracting, utilization management, and capacity planning given their outlier status relative to peers. These observations are operational and contractual flags rather than assessments of clinical appropriateness.

Medicaid: Complete Services Breakdown

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

40 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0023	Alcohol and/or drug outreach	87,070	$340	$29.3M
T1017	Targeted case management, each 15 minutes	34,360	$340	$11.8M
H2022	Community-based wrap-around services, per diem	12,200	$780	$9.5M
H0040	Assertive community treatment program, per diem	30,940	$200	$6.1M
H2019	Therapeutic behavioral services, per 15 minutes	9,530	$450	$4.3M
97150	In this procedure, the provider supervises and directs therapeutic procedures like exercise therapy for a group of patients.	46,280	$90	$4.3M
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…	31,920	$100	$3.1M
H2017	Psychosocial rehabilitation services, per 15 minutes	60,020	$50	$2.7M
H0046	Mental health services, not otherwise specified	21,720	$90	$2M
H0039	Assertive community treatment, face-to-face, per 15 minutes	2,150	$680	$1.5M

Showing 1–10 of 40

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Virginia providers billing the same CPT/HCPCS codes.

Claims Volume vs. Virginia Distribution

Western Tidewater Community Mental — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

40 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2022	Community-based wrap-around services, per diem	28	140	4,450	$1,150	$15.3M
H0023	Alcohol and/or drug outreach	9	50	33,630	$320	$15M
T1017	Targeted case management, each 15 minutes	15	50	23,860	$330	$9.4M
H0046	Mental health services, not otherwise specified	91	510	6,100	$190	$2.8M
H0040	Assertive community treatment program, per diem	3	40	10,830	$200	$2.7M
97150	In this procedure, the provider supervises and directs therapeutic procedures like exercise therapy for a group of patients.	4	200	2,840	$320	$2.4M
H0039	Assertive community treatment, face-to-face, per 15 minutes	19	30	2,740	$530	$2M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	49	150	5,420	$110	$1.9M
H2017	Psychosocial rehabilitation services, per 15 minutes	14	100	15,920	$60	$1.9M
S9482	Family stabilization services, per 15 minutes	96	180	650	$1,070	$1.7M

Showing 1–10 of 40

Nearby Providers

Other providers in the same ZIP code as Western Tidewater Community Mental, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Aa&g Group Home,llc.	VA	Developmentally Disabled Services Day Training Agency	$0	$10.8M
5 Star Residential Care	VA	Community/Behavioral Health Agency	$0	$10.6M
Bon Secours Surgery Center At Harbour View, LLC	VA	Ambulatory Surgical Clinic/Center	$3.2M	$226.1K
Snehal Damle	VA	Hematology & Oncology Physician	$1.5M	$0
John Mansoor	VA	Rheumatology Physician	$767.7K	$0
Megan Eshbaugh	VA	Rheumatology Physician	$697.6K	$0
Julianne Orlowski	VA	Rheumatology Physician	$687.7K	$0
Roshan Morbia	VA	Plastic Surgery Physician	$421.2K	$0
Raman Unnikrishnan	VA	Urology Physician	$358.8K	$0
Robert Baer	VA	Dermatology Physician	$338.5K	$0

Western Tidewater Community Mental — Billing Profile & Reimbursement Data

Sign up for Western Tidewater Community Mental — Billing Profile & Reimbursement Data policy alerts

Western Tidewater Community Mental — Billing Profile & Reimbursement Data

Sign up for Western Tidewater Community Mental — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References