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.

Cumberland River Behavioral Health, Inc (NPI 1902023526)

Field	Value
Entity Type	Organization
Organization	Cumberland River Behavioral Health, Inc
Address	1203 American Greeting Rd
City	Corbin
State	KY
ZIP	40701
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	April 18, 2007

Payer Source	Total Paid
Medicaid	$349.5M
Medicare	$0

Key Findings

CUMBERLAND RIVER BEHAVIORAL HEALTH is effectively a single-payer Medicaid provider: it reports $349.5M in lifetime Medicaid revenue and has no Medicare billing on file. This concentration means Medicaid entirely drives the measurable payer mix and financial scale for this entity.

Revenue is highly concentrated in a very small set of services: the precomputed top three Medicaid codes account for 64.7% of the provider's Medicaid revenue. Specifically, 97535 contributes $120.3M (34.6%), T1019 contributes $81M (23.3%), and S5108 contributes $23.5M (6.8%), highlighting reliance on a few high-volume service lines.

The code mix for the top revenue drivers indicates an operational emphasis on home- and community-based habilitation and personal care: 97535 (therapeutic instruction/rehabilitation), T1019 (personal care services), and S5108 (home care training) together suggest large-scale delivery of hands-on caregiver support, ADL assistance, and skills training. The presence of many psychotherapy and behavioral codes elsewhere in the top lines shows these functional supports are provided alongside clinical behavioral-health services.

For several of its highest-revenue codes the provider ranks at or near the top of in-state peers, signaling a dominant competitive position in specific service niches. 97535 ranks #3 of 305 in-state (99th percentile; extreme outlier) and T1019 ranks #1 of 51 in-state (100th percentile; notably above typical state volume), indicating the provider is a major statewide supplier of both therapeutic instruction and personal care.

CUMBERLAND RIVER also shows exceptional statewide scale in psychotherapy and intensive behavioral services: 90837 generated $19.5M (5.6%) and ranks #4 of 1266 in-state (100th percentile; extreme outlier), while H2020 generated $10.4M (3.0%) and ranks #2 of 125 (99th percentile; extreme outlier). These placements imply the organization manages a very large psychotherapy caseload and provides high-volume therapeutic behavioral services compared with peers.

The provider reports substantial case management and habilitation/waiver activity across several codes, which supports a broad service footprint for people with long-term support needs. Examples include T2016 ($22.7M, 6.5%) ranked #13 of 146 (92nd percentile), T2022 ($20M, 5.7%) ranked #3 of 81 (98th percentile; notably above typical), and T2023 ($9.6M, 2.7%) ranked #11 of 525 (98th percentile; extreme outlier), indicating above-typical to extreme-volume participation in per-month and per-diem waiver services.

A mix of high-volume per-diem and per-15-minute codes (for example, H2020 $10.4M; H2019 $5.6M; T2040 $8.1M; T2021 $5.1M) shows the business model relies on time-intensive, labor-dependent service delivery. This pattern implies significant workforce and scheduling demands (care staff, trainers, case managers) and sensitivity to reimbursement rates tied to minutes or days of service.

The provider has been NPI-enumerated since 2007-04-18 (~19 years ago), which, combined with its outsized in-state ranks on multiple codes, supports the interpretation of a long-established community/behavioral health agency with sustained market presence. Its taxonomy as a Community/Behavioral Health Agency aligns with the observed mix of personal care, habilitation, case management, and psychotherapy services.

Medicaid: Complete Services Breakdown

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

52 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	918,420	$130	$120.3M
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…	437,830	$190	$81M
S5108	Home care training to home care client, per 15 minutes	194,190	$120	$23.5M
T2016	Habilitation, residential, waiver; per diem	137,340	$170	$22.7M
T2022	Case management, per month	74,170	$270	$20M
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…	240,480	$80	$19.5M
H2020	Therapeutic behavioral services, per diem	62,430	$170	$10.4M
T2023	Targeted case management; per month	35,000	$270	$9.6M
T2040	Financial management, self-directed, waiver; per 15 minutes	76,670	$110	$8.1M
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…	92,020	$80	$7.3M

Showing 1–10 of 52

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

Cumberland River Behavioral Health, Inc — 13 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

52 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	24	100	43,820	$140	$16.6M
T2016	Habilitation, residential, waiver; per diem	13	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…	1	50	13,600	$140	$11.1M
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	42	70	7,180	$270	$6.8M
H2018	Psychosocial rehabilitation services, per diem	2	10	7,340	$820	$6.2M
T2022	Case management, per month	3	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.	3	310	830	$120	$3.7M
T2040	Financial management, self-directed, waiver; per 15 minutes	2	40	14,910	$160	$3.5M
H2034	Alcohol and/or drug abuse halfway house services, per diem	11	40	3,120	$220	$3M
S9485	Crisis intervention mental health services, per diem	7	10	7,960	$280	$2.5M

Showing 1–10 of 52

Related Providers

Other providers that share a Tax Identification Number (TIN) with Cumberland River Behavioral Health, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Syed Raza	KY	Psychiatry Physician	$49.5K	$0
Kimberly Cesario	KY	Family Nurse Practitioner	$42.8K	$0
Miranda Elliott	KY	Psychiatric/Mental Health Nurse Practitioner	$7.2K	$0
Timothy Couch	KY	Psychiatric/Mental Health Nurse Practitioner	$6.3K	$0

Nearby Providers

Other providers in the same ZIP code as Cumberland River Behavioral Health, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Baptist Healthcare System, Inc	KY	General Acute Care Hospital	$0	$121.5M
Grace Community Health Center, Inc.	KY	Federally Qualified Health Center (FQHC)	$0	$21.1M
Barnhill Pediatric Dentistry, P.s.c.	KY	Pediatric Dentistry	$0	$13.8M
Bhg Xxxiv, LLC	KY	Substance Use Disorder Rehabilitation Clinic/Center	$156.1K	$6.3M
Cumberland Valley Surgical Center, LLC	KY	Ambulatory Surgical Clinic/Center	$1M	$5.2M
Sav-rite Home Care Inc	KY	Durable Medical Equipment & Medical Supplies	$0	$6.1M
Southeastern Medical Supply LLC	KY	Durable Medical Equipment & Medical Supplies	$0	$6M
Corbin Pediatric Associates Psc	KY	Rural Health Clinic/Center	$0	$4.2M
Green Meadows Wellness Center One, LLC	KY	Clinical Psychologist	$0	$3.3M
Martin Case Management	KY	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$3.1M

Cumberland River Behavioral Health, Inc — Billing Profile & Reimbursement Data

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Cumberland River Behavioral Health, 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