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.

Southern Highlands Community Mental Health Center, Inc. (NPI 1740234673)

Field	Value
Entity Type	Organization
Organization	Southern Highlands Community Mental Health Center, Inc.
Address	200 12th Street Extension
City	Princeton
State	WV
ZIP	24740
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	May 22, 2006

Payer Source	Total Paid
Medicaid	$44.2M
Medicare	$0

Key Findings

This provider effectively operates as a Medicaid-only billing entity: there is no Medicare billing on file and lifetime Medicaid revenue is $44.2M. The absence of Medicare activity indicates the organization is heavily dependent on Medicaid as its primary payer and likely focuses its administrative and clinical workflows around Medicaid program rules and reimbursements.

Revenue is concentrated in a small set of community behavioral-health services: the precomputed top-three Medicaid codes (H2036, H0040, H2015) account for 44.5% of total Medicaid revenue. Those top drivers combine per-diem substance use and assertive community treatment (H2036, H0040) with time-based community support (H2015), signaling an operational emphasis on intensive community-based behavioral health and substance-use programming.

The code mix shows heavy delivery of time-based and case-management services: H2015 (per 15 minutes) and T1017 (targeted case management, each 15 minutes) have very large claim counts and rank at the top of in-state peers. T1017 ranks #1 of 112 providers in-state (100th percentile; extreme outlier, far above typical state volume for this code) and H2015 ranks #1 of 6 providers in-state (100th percentile; notably above typical state volume for this code), which together point to a practice model built around frequent, short-interval service contacts and intensive case coordination.

The organization holds dominant in-state positions for multiple core behavioral-health services, while other codes are more typical in volume: H2015 and T1017 are state-leading services (100th percentile labels), H0031 (mental health assessment) ranks #2 of 119 (99th percentile; extreme outlier), and H0004 (behavioral health counseling) ranks #12 of 166 (93th percentile; notably above typical state volume). These rank/percentile signals indicate the provider is a major statewide player for community support, targeted case management, and non-physician assessments, rather than being a modest or occasional vendor for those services.

Ambulatory evaluation-and-management and telehealth are also important to the mix: 99213 and 99214 together generate multi-million-dollar revenue ($2.6M and $2.6M respectively) and rank in the 98th percentile for in-state providers, while Q3014 (telehealth originating site facility fee) produced $777.9K and ranks #2 of 80 providers in-state (99th percentile; notably above typical state volume). High volume in 99213/99214 plus substantial Q3014 activity suggests the provider maintains a robust outpatient visit workflow and significant telehealth utilization as part of its service delivery.

The provider’s service mix includes substantial substance-use program billing alongside behavioral therapy: H2036 (substance-use per diem) generated $8.6M (19.4% of total Medicaid revenue) and H0036 (community psychiatric supportive treatment) generated $4.2M (9.4% of total Medicaid revenue), while H0004 (behavioral health counseling) produced $5.4M (12.1%). H2036 ranks #12 of 35 in-state (68th percentile; typical, unremarkable volume for this code), so although substance-use services are a large revenue source, the provider is especially notable for its counseling, case management, and community-support volumes rather than being uniquely dominant in substance-use per-diem billing.

The organization has a long operational tenure that supports the scale observed in Medicaid: the NPI was enumerated on 2006-05-22 (~20 years ago). That longevity, together with $44.2M in lifetime Medicaid revenue and multiple top-state rankings, suggests an established community/behavioral health agency with entrenched Medicaid-facing capacity for sustained, time-based community services.

Medicaid: Complete Services Breakdown

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

21 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2036	Alcohol and/or other drug treatment program, per diem	44,530	$190	$8.6M
H0040	Assertive community treatment program, per diem	71,350	$80	$5.7M
H2015	Comprehensive community support services, per 15 minutes	122,880	$40	$5.4M
H0004	Behavioral health counseling and therapy, per 15 minutes	70,650	$80	$5.4M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	9,710	$430	$4.2M
H0031	Mental health assessment, by non-physician	18,320	$160	$2.9M
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…	53,940	$50	$2.6M
T1017	Targeted case management, each 15 minutes	64,460	$40	$2.6M
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…	36,280	$70	$2.6M
T1040	Medicaid certified community behavioral health clinic services, per diem	6,270	$240	$1.5M

Showing 1–10 of 21

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

Southern Highlands Community Mental Health Center, Inc. — 10 of 21 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

21 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2036	Alcohol and/or other drug treatment program, per diem	12	40	29,190	$210	$7.8M
H0040	Assertive community treatment program, per diem	7	10	71,630	$80	$6.8M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	5	20	2,650	$460	$2.9M
H2015	Comprehensive community support services, per 15 minutes	1	10	14,470	$50	$1.6M
H0038	Self‑help/peer services, per 15 minutes	13	60	3,310	$110	$1.6M
H0004	Behavioral health counseling and therapy, per 15 minutes	12	170	8,500	$80	$1.5M
T1040	Medicaid certified community behavioral health clinic services, per diem	1	10	3,100	$270	$790.4K
H0031	Mental health assessment, by non-physician	2	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…	26	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…	17	1,030	890	$50	$221K

Showing 1–10 of 21

Related Providers

Other providers that share a Tax Identification Number (TIN) with Southern Highlands Community Mental Health Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nancy Davidson	WV	Nurse Practitioner	$16K	$0

Nearby Providers

Other providers in the same ZIP code as Southern Highlands Community Mental Health Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Voca Corporation Of West Virginia, Inc.	WV	Developmental Disabilities Clinic/Center	$0	$178.3M
Princeton Community Hospital Assn., Inc.	WV	General Acute Care Hospital	$0	$41M
Southern Highlands Community Mental Health Center, Inc.	WV	Counselor	$0	$22M
Princeton Community Hospital Assn Inc.	WV	Urology Physician	$0	$15.4M
Bluestone Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$12.1M
Princeton Rescue Squad Inc	WV	Land Ambulance	$1.1M	$10.4M
Foot And Ankle Clinic Of The Virginias Inc	WV	Podiatrist	$0	$5.5M
Bradley Hoffman	WV	Foot & Ankle Surgery Podiatrist	$4.9M	$0
Beautiful Minds Counseling Center	WV	Mental Health Counselor	$0	$4.1M
Bluefield Gastroenterology PLLC	WV	Specialist	$0	$4M

Southern Highlands Community Mental Health Center, Inc. — Billing Profile & Reimbursement Data

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Southern Highlands Community Mental Health Center, 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