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.

Lake Cumberland Reg Mhmr Board, Inc. (NPI 1801922620)

Field	Value
Entity Type	Organization
Organization	Lake Cumberland Reg Mhmr Board, Inc.
Address	130 Southern School Rd
City	Somerset
State	KY
ZIP	42501
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	February 26, 2007

Payer Source	Total Paid
Medicaid	$140.8M
Medicare	$0

Key Findings

LAKE CUMBERLAND REG MHMR BOARD, INC. reports no Medicare billing on file and $140.8M in lifetime Medicaid revenue, making its operations effectively single-payer Medicaid–focused rather than split between Medicare and Medicaid. This concentration creates operational dependence on Medicaid policy and payments for the provider's revenue base.

The provider's Medicaid revenue is highly concentrated: the top three codes T1019, 97535, and T2022 together account for 89.6% of its total Medicaid revenue. Specifically, T1019 represents $80.2M (57.0%), 97535 represents $38.5M (27.3%), and T2022 represents $7.5M (5.3%) of the reported Medicaid revenue.

The mix of high-volume personal care (T1019), therapeutic instruction/rehabilitation services (97535), and monthly case management (T2022) indicates a service line focused on home- and community-based supports, habilitation, and rehabilitation instruction rather than acute inpatient or traditional medical specialty care. Many of the highest-revenue codes are billed per 15 minutes or per visit/month, signaling a labor- and time-intensive delivery model centered on direct care and care coordination.

T1019 is a dominant line for this provider in-state: it accounts for 391.2K claims with $205 avg paid/claim and $80.2M revenue, and the provider ranks #3 of 51 in the state (96th percentile; notably above typical state volume). This combination of very high claim volume and top-tier state ranking identifies the organization as a major personal-care services provider in Kentucky.

97535 similarly shows major in-state scale: 305.6K claims, $126 avg paid/claim, and $38.5M revenue, with a #8 of 305 rank in-state (98th percentile; notably above typical state volume). That rank and volume position the provider as a leading supplier of therapeutic instruction/rehabilitation services within the state Medicaid program.

Beyond the top two codes, the provider participates at more typical levels across supplemental service lines: T2022 (28.7K claims, $261 avg paid/claim, $7.5M revenue) ranks #11 of 81 (88th percentile; typical), S5108 ranks #43 of 101 (58th percentile; typical), T2021 ranks #19 of 150 (88th percentile; typical), T2040 ranks #10 of 43 (79th percentile; typical), and T1005 ranks #10 of 81 (89th percentile; typical). These placements indicate the organization offers a breadth of waiver, habilitation, and home-care supports but does not lead the state across those secondary codes to the same extent as it does for T1019 and 97535.

Unit-payment patterns show differing economics by service: T2022 has the highest avg paid/claim at $261, T1019 averages $205 paid/claim, and 97535 averages $126 paid/claim. Combined with the claim volumes (e.g., 391.2K claims for T1019 and 305.6K claims for 97535), this suggests the provider relies on very high utilization of lower-unit-value personal-care and therapy sessions alongside lower-volume, higher-unit-value case management services.

The organization has an NPI enumerated on 2007-02-26 (~19 years ago), indicating long tenure in the market. This established presence likely underpins its high-volume positions for core services and suggests a mature operational footprint in Kentucky's Medicaid service network.

Medicaid: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	391,210	$210	$80.2M
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	305,620	$130	$38.5M
T2022	Case management, per month	28,710	$260	$7.5M
S5108	Home care training to home care client, per 15 minutes	59,390	$100	$6M
T2021	Day habilitation, waiver; per 15 minutes	54,590	$70	$3.5M
T2040	Financial management, self-directed, waiver; per 15 minutes	30,750	$100	$3.2M
T1005	Respite care services, up to 15 minutes	28,790	$70	$1.9M

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

Lake Cumberland Reg Mhmr Board, Inc. — 2 of 7 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

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5108	Home care training to home care client, per 15 minutes	43	100	43,820	$140	$16.6M
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	3	50	13,600	$140	$11.1M
T2022	Case management, per month	11	80	7,120	$290	$4.1M
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	8	310	830	$120	$3.7M
T2040	Financial management, self-directed, waiver; per 15 minutes	10	40	14,910	$160	$3.5M
T2021	Day habilitation, waiver; per 15 minutes	19	150	16,130	$70	$1.7M
T1005	Respite care services, up to 15 minutes	10	80	2,880	$70	$799.2K

Nearby Providers

Other providers in the same ZIP code as Lake Cumberland Reg Mhmr Board, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Brighter Futures Therapy Center, LLC	KY	Case Manager/Care Coordinator	$0	$38.3M
Lake Cumberland Regional Mhmr Board Outpatient	KY	Community/Behavioral Health Agency	$0	$31.2M
Broadening Horizons, Inc.	KY	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$22.4M
Serenity Foundations, LLC	KY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$20.1M
Community Opportunities, Inc.	KY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$14.1M
Wecare Medical Homemakers, LLC D.b.a. Hope Of Ky	KY	Developmentally Disabled Services Day Training Agency	$0	$13.2M
Mindsight PLLC	KY	Professional Counselor	$0	$13M
Somerset Mental Health, Psc	KY	Community/Behavioral Health Agency	$0	$12.3M
Lake Cumberland Recovery Inc	KY	Substance Abuse Rehabilitation Facility	$0	$10.8M
John Newcomb	KY	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$10.5M

Lake Cumberland Reg Mhmr Board, Inc. — Billing Profile & Reimbursement Data

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Lake Cumberland Reg Mhmr Board, 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