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.

Somerset Mental Health, Psc (NPI 1891722146)

Field	Value
Entity Type	Organization
Organization	Somerset Mental Health, Psc
Address	149 Enterprise Dr
City	Somerset
State	KY
ZIP	42501
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	June 26, 2006

Payer Source	Total Paid
Medicaid	$12.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

20 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…	63,220	$70	$4.3M
T2023	Targeted case management; per month	10,160	$320	$3.2M
H0031	Mental health assessment, by non-physician	23,410	$60	$1.5M
T2022	Case management, per month	3,370	$340	$1.1M
H0004	Behavioral health counseling and therapy, per 15 minutes	5,850	$70	$409.4K
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…	11,690	$40	$409K
H0032	Mental health service plan development by non-physician	5,460	$60	$333.2K
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…	6,060	$50	$272.7K
99354	N/A	4,040	$60	$226.2K
H0002	Behavioral health screening to determine eligibility for admission to treatment program	2,880	$60	$175.7K

Showing 1–10 of 20

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

Somerset Mental Health, Psc — 2 of 20 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

20 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2022	Case management, per month	53	80	7,120	$290	$4.1M
H0004	Behavioral health counseling and therapy, per 15 minutes	50	180	1,320	$220	$1.9M
H2020	Therapeutic behavioral services, per diem	112	130	1,730	$180	$1.2M
T2023	Targeted case management; per month	42	530	530	$300	$1.1M
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…	19	1,270	760	$80	$447.2K
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…	2,061	3,340	1,020	$30	$296K
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…	1,529	2,460	580	$40	$245K
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…	58	600	600	$40	$207.8K
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…	36	500	250	$60	$152.8K
99354	N/A	28	170	470	$50	$151K

Showing 1–10 of 20

Nearby Providers

Other providers in the same ZIP code as Somerset Mental Health, Psc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lake Cumberland Reg Mhmr Board, Inc.	KY	Community/Behavioral Health Agency	$0	$140.8M
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
Lake Cumberland Recovery Inc	KY	Substance Abuse Rehabilitation Facility	$0	$10.8M
John Newcomb	KY	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$10.5M

Somerset Mental Health, Psc — Billing Profile & Reimbursement Data

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Somerset Mental Health, Psc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References