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 Health Systems, Inc (NPI 1699257386)

Field	Value
Entity Type	Organization
Organization	Valley Health Systems, Inc
Address	800 20th St
City	Huntington
State	WV
ZIP	25703
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	August 30, 2018

Payer Source	Total Paid
Medicaid	$3.8M
Medicare	$0

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
T1015	Clinic visit/encounter, all-inclusive	19,890	$170	$3.3M
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…	9,760	$30	$283.1K
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…	6,810	$20	$136.2K
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…	4,660	$10	$46.6K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	2,830	$20	$45.3K
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…	470	$40	$17.4K
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…	300	$30	$8.1K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	140	$40	$5.4K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	630	$1	$630
G0470	Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc…	30	$0	$0

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 Health Systems, Inc — 0 of 9 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
T1015	Clinic visit/encounter, all-inclusive	99	390	4,610	$130	$2.2M
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…	219	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…	630	1,030	890	$50	$221K
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…	13	100	940	$20	$62.4K
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…	25	200	490	$30	$57.7K
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…	140	440	110	$60	$57.2K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	83	540	320	$20	$43.2K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	212	310	490	$20	$42K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	43	80	650	$1	$690
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	34	70	130	$1	$40

Showing 1–10 of 11

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Valley Health Systems Inc	WV	Federally Qualified Health Center (FQHC)	$0	$17.2M
Valley Health Systems, Inc	WV	Federally Qualified Health Center (FQHC)	$0	$14.1M
Valley Health Systems Inc	WV	Federally Qualified Health Center (FQHC)	$0	$13.4M
Valley Health Systems Inc	WV	Federally Qualified Health Center (FQHC)	$0	$13.2M
Valley Health Systems, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$11M
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
Valley Health Systems Inc	WV	Federally Qualified Health Center (FQHC)	$0	$8.8M
Valley Health Systems Inc	WV	Federally Qualified Health Center (FQHC)	$0	$8.6M
Valley Health Systems Inc	WV	Clinical Medical Laboratory	$299.4K	$7M

Nearby Providers

Other providers in the same ZIP code as Valley Health Systems, 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
University Physicians & Surgeons, Inc.	WV	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$9.4M
Recovery Resource Group	WV	Community/Behavioral Health Agency	$0	$8.5M
Valley Health Systems Inc	WV	General Practice Physician	$0	$4.7M
Tri-state Allergy, Inc	WV	Allergy Physician	$0	$1.8M
Valley Health Systems Inc	WV	Obstetrics & Gynecology Physician	$0	$1M
Contemplations Behavioral Health Services	WV	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$919.6K
Huntington Physical Therapy Services Inc	WV	Physical Therapist	$0	$843K
Matthew Wilson	WV	Allergy Physician	$578.9K	$0
Joseph De Lapa	WV	Pain Medicine (Anesthesiology) Physician	$105.5K	$0

Valley Health Systems, Inc — Billing Profile & Reimbursement Data

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Valley Health Systems, Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References