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

Why is the Medicaid comparison limited to Kentucky 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. Kentucky (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.

Mountain Comprehensive Care Center, Inc. (NPI 1760491674)

Field	Value
Entity Type	Organization
Organization	Mountain Comprehensive Care Center, Inc.
Address	104 S Front Ave
City	Prestonsburg
State	KY
ZIP	41653
Taxonomy	Mental Health Counselor
NPI Enumerated	August 7, 2006

Payer Source	Total Paid
Medicaid	$243M
Medicare	$0

Key Findings

This provider is effectively single‑payer: there is no Medicare billing on file while lifetime Medicaid revenue totals $243M, indicating the organization's entire documented federal billing footprint in this dataset is concentrated in Medicaid. Analysts should treat Medicaid policy and state contract changes as the primary revenue levers for this entity given the absence of Medicare activity.

Revenue concentration is high: the precomputed top 3 Medicaid codes (90837, H2019, T2023) account for 50.4% of the provider's total Medicaid revenue. Specifically, 90837 generated $45M (18.6%), H2019 generated $43.1M (17.8%), and T2023 generated $33.8M (14.0%), making these three codes the dominant revenue drivers.

The code mix indicates an operation focused on outpatient psychotherapy and intensive community behavioral health supports: high-volume psychotherapy codes (90837, 90832, 90834) appear alongside targeted behavioral therapies (H2019), targeted case management (T2023), and comprehensive community supports (H2015). This combination of service lines suggests an integrated behavioral health model that delivers individual psychotherapy, in‑home or community therapeutic services, and monthly case management.

State-level competitive standing is dominant for multiple high-revenue services: the provider ranks #1 in-state for 90837 (1 of 1266, 100th percentile; extreme outlier), H2019 (1 of 47, 100th percentile; extreme outlier), and T2023 (1 of 525, 100th percentile; extreme outlier). Several other codes also show top-tier positioning (for example, 90887, H0031, H0002, H0032 all rank #1 at the 100th percentile), signaling this organization is a major statewide player for many behavioral health and case management services.

Operational scale is reflected in claim volumes and paid rates: 90837 shows 608.4K claims at a $74 avg paid/claim yielding $45M revenue, H2019 shows 223.2K claims at a $193 avg paid/claim yielding $43.1M revenue, and 90832 shows 285.6K claims at a $38 avg paid/claim yielding $10.9M revenue. These very large claim counts across both longer psychotherapy sessions and per‑15‑minute therapeutic codes imply a high-volume delivery model with significant administrative throughput.

The provider’s service mix includes substance use and residential treatment lines in addition to psychotherapy and case management: H0011 (acute detoxification residential) produced $16.5M (6.8%), H0015 (intensive outpatient) produced $6.5M (2.7%), and H0018 (short-term residential, per diem) produced $5.5M (2.3%). The presence of both detoxification/residential codes and ambulatory psychotherapy indicates diversified behavioral health programming spanning outpatient and higher‑acuity services.

Concentration risk and strategic opportunity are both evident: with 50.4% of Medicaid revenue concentrated in three codes, changes to reimbursement policy, utilization management, or program eligibility for psychotherapy, therapeutic behavioral services, or case management could materially affect revenue. Conversely, the provider’s dominant state rankings and deep claim volumes position it to negotiate program contracts and participate in Medicaid value‑based initiatives tied to behavioral health.

Established tenure supports sustained operations: the provider NPI was enumerated on 2006-08-07 (~20 years ago), consistent with a mature organization that has built large-scale Medicaid delivery and billing processes over time. This longevity, combined with the pattern of high-volume, high-rank codes, reinforces the view of a longstanding, scale-focused behavioral health provider in Kentucky.

Medicaid: Complete Services Breakdown

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

41 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	608,390	$70	$45M
H2019	Therapeutic behavioral services, per 15 minutes	223,170	$190	$43.1M
T2023	Targeted case management; per month	107,310	$320	$33.8M
90887	In this service, the provider interprets or explains the results of psychiatric exams, medical exams, other procedures, or information about the patient’s care to the patient’s family members or…	293,430	$80	$22M
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	67,730	$240	$16.5M
H0038	Self‑help/peer services, per 15 minutes	225,710	$50	$11.3M
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…	285,640	$40	$10.9M
H2015	Comprehensive community support services, per 15 minutes	147,240	$70	$10.3M
90834	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…	125,720	$60	$7.2M
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	56,770	$120	$6.5M

Showing 1–10 of 41

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Mountain Comprehensive Care Center, Inc. — 20 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

41 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	10	70	7,180	$270	$6.8M
H2034	Alcohol and/or drug abuse halfway house services, per diem	17	40	3,120	$220	$3M
S9485	Crisis intervention mental health services, per diem	3	10	7,960	$280	$2.5M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	6	50	4,480	$220	$2.4M
H0004	Behavioral health counseling and therapy, per 15 minutes	43	180	1,320	$220	$1.9M
H2019	Therapeutic behavioral services, per 15 minutes	1	50	820	$190	$1.7M
T2023	Targeted case management; per month	1	530	530	$300	$1.1M
H2021	Community-based wrap-around services, per 15 minutes	2	30	2,140	$130	$1M
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	4	230	1,750	$110	$793.5K
H0038	Self‑help/peer services, per 15 minutes	2	320	3,070	$50	$678.3K

Showing 1–10 of 41

Related Providers

Other providers that share a Tax Identification Number (TIN) with Mountain Comprehensive Care Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mountain Comprehensive Care Center, Inc.	KY	Federally Qualified Health Center (FQHC)	$0	$12.8M
Randall Mann	KY	Optometrist	$38K	$542.8K
Umar Murad	KY	Family Medicine Physician	$133.2K	$0
Samantha Hudson	KY	Psychiatric/Mental Health Nurse Practitioner	$6.2K	$96.3K
Laura Fieser	KY	Clinical Social Worker	$70.2K	$0

Nearby Providers

Other providers in the same ZIP code as Mountain Comprehensive Care Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mountain Comprehensive Care Center	KY	Case Management Agency	$0	$65.1M
Big Sandy Area Agency On Aging	KY	Supports Brokerage Agency	$0	$56.2M
Arh Tug Valley Health Services, Inc.	KY	General Acute Care Hospital	$0	$33.8M
Highlands Hospital Corp	KY	Cardiovascular Disease Physician	$0	$15.9M
Jt Associates, Inc	KY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$7.6M
Commonwealth Counseling Centers LLC	KY	Substance Abuse Rehabilitation Facility	$0	$7.1M
Alan Hyden	KY	Pediatric Dentistry	$0	$6.4M
East Kentucky Rehabilitation Center	KY	Substance Use Disorder Rehabilitation Clinic/Center	$0	$6M
Eastern Kentucky Tender Care Pediatrics LLC	KY	Rural Health Clinic/Center	$0	$5.2M
Floyd Emergency Group, LLC	KY	Emergency Medicine Physician	$0	$4.2M

Mountain Comprehensive Care Center, Inc. — Billing Profile & Reimbursement Data

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Mountain Comprehensive Care 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