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 (NPI 1881890606)

Field	Value
Entity Type	Organization
Organization	Mountain Comprehensive Care Center
Address	104 S Front Ave
City	Prestonsburg
State	KY
ZIP	41653
Taxonomy	Case Management Agency
NPI Enumerated	June 27, 2007

Payer Source	Total Paid
Medicaid	$65.1M
Medicare	$0

Key Findings

This provider is effectively single-payer at scale: there is no Medicare billing on file while Medicaid revenue totals $65.1M, so the practice’s entire reported fee-for-service activity is driven by Medicaid programs rather than Medicare. Analysts should treat payer risk and contracting exposure as concentrated within Medicaid reimbursement and waiver arrangements.

Revenue concentration is very high: the top 3 Medicaid codes (T1019, 97535, T2022) account for 85.0% of this provider's total Medicaid revenue, with T1019 alone representing $35.4M (54.4%), 97535 $14.9M (22.9%), and T2022 $5M (7.7%). This level of concentration means a small set of service lines determines most of the financial performance.

The code mix signals a home- and community-based services operator focused on direct personal care and skills training: T1019 is for personal care services per 15 minutes, 97535 is instructional/rehabilitation training, and T2022 is monthly case management. Large volumes in per-15-minute personal care and training codes imply a labor- and visit-heavy delivery model that depends on high claim counts and many short-duration encounters.

Operational scale is substantial in unit volume: T1019 appears on 340.5K claims and 97535 on 204.3K claims, indicating a high-frequency service model that will require robust scheduling, workforce management, and billing operations to sustain payment flows. Those claim counts reinforce that revenue is driven by high encounter volume rather than high unit prices.

Competitive standing within Kentucky varies by service line: for T1019 the provider ranks #4 of 51 providers in-state (94th percentile; notably above typical state volume for this code), indicating it is a major in-state presence for personal care services. For 97535 it ranks #12 of 305 providers in-state (96th percentile; typical, unremarkable volume for this code) and for T2022 it ranks #19 of 81 (78th percentile; typical, unremarkable volume), which together suggest dominance in personal care but a more modest position in case management and training relative to the full set of in-state providers.

There is measurable diversification beyond the top three but at much lower scale: S5108 ($4.6M, 7.1%), T2040 ($2M, 3.1%), and T1005 ($1.6M, 2.4%) represent ancillary home-care training, financial management for waiver participants, and respite services respectively. These secondary lines appear consistent with a comprehensive waiver/home- and community-based service portfolio, but none approach the revenue weight of T1019 or 97535.

Concentration creates policy and reimbursement vulnerability: because T1019 alone is 54.4% of Medicaid revenue and the top three codes collectively drive 85.0% of Medicaid revenue, changes to eligibility, authorization patterns, or unit reimbursement for these codes could materially affect overall revenue. Payer-management and contract protections around those specific service codes would be central to revenue risk mitigation.

The provider is well-established: its NPI was enumerated on 2007-06-27 (~19 years ago), indicating long tenure in the market and time to build the billing, staffing, and referral networks necessary to support the high claim volumes reported across its core Medicaid service lines.

Medicaid: Complete Services Breakdown

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

8 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…	340,520	$100	$35.4M
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	204,340	$70	$14.9M
T2022	Case management, per month	17,850	$280	$5M
S5108	Home care training to home care client, per 15 minutes	50,590	$90	$4.6M
T2040	Financial management, self-directed, waiver; per 15 minutes	19,850	$100	$2M
T1005	Respite care services, up to 15 minutes	30,020	$50	$1.6M
T2021	Day habilitation, waiver; per 15 minutes	23,040	$60	$1.4M
T2016	Habilitation, residential, waiver; per diem	900	$160	$147.4K

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 — 1 of 8 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

8 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	45	100	43,820	$140	$16.6M
T2016	Habilitation, residential, waiver; per diem	143	150	42,680	$190	$11.3M
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…	4	50	13,600	$140	$11.1M
T2022	Case management, per month	19	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.	12	310	830	$120	$3.7M
T2040	Financial management, self-directed, waiver; per 15 minutes	18	40	14,910	$160	$3.5M
T2021	Day habilitation, waiver; per 15 minutes	56	150	16,130	$70	$1.7M
T1005	Respite care services, up to 15 minutes	9	80	2,880	$70	$799.2K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mountain Comprehensive Care Center, Inc.	KY	Mental Health Counselor	$0	$243M
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 — Billing Profile & Reimbursement Data

Sign up for Mountain Comprehensive Care Center — Billing Profile & Reimbursement Data policy alerts

Mountain Comprehensive Care Center — Billing Profile & Reimbursement Data

Sign up for Mountain Comprehensive Care Center — 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