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

Why is the Medicaid comparison limited to North Carolina 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. North Carolina (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.

Hughes Behavioral And Mental Health Services Inc. (NPI 1922298942)

Field	Value
Entity Type	Organization
Organization	Hughes Behavioral And Mental Health Services Inc.
Address	1307 Union Rd Ste 105
City	Gastonia
State	NC
ZIP	28054
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	July 26, 2007

Payer Source	Total Paid
Medicaid	$59.8M
Medicare	$0

Key Findings

HUGHES BEHAVIORAL AND MENTAL HEALTH SERVICES INC. is effectively a Medicaid-focused provider: it has no Medicare billing on file and reports $59.8M in lifetime Medicaid revenue, indicating its operations and revenue base are overwhelmingly driven by Medicaid-funded developmental disability and habilitation services. The absence of Medicare activity makes this entity functionally single-payer (Medicaid) for the available claims data.

Revenue concentration is high: the precomputed top 3 Medicaid codes account for 82.4% of this provider's total Medicaid revenue, showing the organization's financial performance depends heavily on a small set of habilitation and community support service lines rather than a broad mix of Medicaid codes. This level of concentration suggests business risk is linked to reimbursement or policy changes affecting those few codes.

The single largest revenue driver is T2013 (Habilitation, educational, waiver; per hour), which generated $32.2M and represents 53.8% of the provider’s Medicaid revenue. The provider ranks #12 of 185 in-state for T2013 (94th percentile), a position described as notably above typical state volume; this indicates the organization is a major in-state provider of hour-based waiver habilitation services and likely operates substantial day- and community-based habilitation capacity.

T2012 (Habilitation, educational; waiver, per diem) is the second major code at $12.8M (21.3% of Medicaid revenue) and the provider ranks #15 of 110 in-state (87th percentile). This per-diem habilitation volume is characterized as typical/unremarkable for the state but still contributes materially to the provider’s revenue mix, reflecting a mix of per-hour and per-diem habilitation billing models in their service delivery.

H2015 (Comprehensive community support services, per 15 minutes) and T2020 (Day habilitation, waiver; per diem) together contribute meaningful but smaller shares ($4.3M and $4.1M, 7.2% and 6.8% respectively), demonstrating the provider supplements core habilitation offerings with community support and day habilitation programs. H2015 ranks #34 of 251 (87th percentile) and T2020 ranks #23 of 48 (53th percentile), suggesting community support services are a relatively strong line while day habilitation is a more modest, mid-market presence.

Several other Medicaid codes show elevated in-state standing that point to service breadth: S5150 (unskilled respite care) produced $3.0M (5.0% of revenue) and ranks #14 of 168 (92th percentile), while T2025 and H2025 provide additional niche revenue ($1.7M and $1.5M). These rankings indicate the provider offers a portfolio of waiver-related supports beyond core habilitation, with above-typical volume for multiple ancillary codes.

A few codes are notable for extreme relative positioning in the statewide distribution: T2013TF (no description available) posts $106.3K and ranks #3 of 42 providers (95th percentile), explicitly described as notably above typical state volume, which may reflect a specialized sub-service or modifier-driven billing stream that is unusually concentrated at this provider compared with peers. Conversely, H2016 (Comprehensive community support services, per diem) is low-volume for this provider ($118.5K, 0.2% of revenue) and ranks in the 5th percentile, indicating that certain per-diem community support modalities are not a material part of this organization’s footprint.

The provider's NPI was enumerated ~19 years ago (2007-07-26), indicating long tenure in the market; combined with high-ranking positions on several waiver-related codes, this suggests established capability and continuity in delivering developmental disability and waiver services in North Carolina. The longevity reinforces the interpretation that their large T2013 capacity is an intentional, long-standing service-line focus rather than a recent anomaly.

Medicaid: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2013	Habilitation, educational, waiver; per hour	211,790	$150	$32.2M
T2012	Habilitation, educational; waiver, per diem	62,840	$200	$12.8M
H2015	Comprehensive community support services, per 15 minutes	41,340	$100	$4.3M
T2020	Day habilitation, waiver; per diem	25,600	$160	$4.1M
S5150	Unskilled respite care, not hospice; per 15 minutes	33,820	$90	$3M
T2025	Waiver services; not otherwise specified (nos)	6,690	$260	$1.7M
H2025	Ongoing support to maintain employment, per 15 minutes	14,690	$100	$1.5M
H2016	Comprehensive community support services, per diem	660	$180	$118.5K
T2013TF	N/A	720	$150	$106.3K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Carolina Distribution

Hughes Behavioral And Mental Health Services Inc. — 1 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. North Carolina median

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2013	Habilitation, educational, waiver; per hour	12	190	29,090	$150	$9.1M
H2016	Comprehensive community support services, per diem	62	70	28,040	$220	$8.2M
T2020	Day habilitation, waiver; per diem	23	50	22,570	$180	$6.2M
T2012	Habilitation, educational; waiver, per diem	15	110	21,340	$180	$6.1M
H2015	Comprehensive community support services, per 15 minutes	34	250	10,060	$130	$2.4M
H2025	Ongoing support to maintain employment, per 15 minutes	16	60	6,380	$120	$1.3M
S5150	Unskilled respite care, not hospice; per 15 minutes	14	170	4,310	$80	$958.4K
T2025	Waiver services; not otherwise specified (nos)	14	80	1,420	$170	$562K
T2013TF	N/A	3	40	190	$170	$51.8K

Nearby Providers

Other providers in the same ZIP code as Hughes Behavioral And Mental Health Services Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Comprehab LLC	NC	Physical Therapist	$0	$129.7M
Gaston Memorial Hospital, Incorporated	NC	General Acute Care Hospital	$0	$49.2M
Carolina Therapeutic Services, Inc	NC	Community/Behavioral Health Agency	$0	$46.7M
Partners Behavioral Health Management	NC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$43.7M
Center For Emotional Health	NC	Addiction Psychiatry Physician	$0	$40.1M
Bayada Home Health Care, Inc.	NC	Home Health Agency	$0	$32.9M
Support Incorporated	NC	Community/Behavioral Health Agency	$0	$19.1M
Gastonia Physician Services, PLLC	NC	Emergency Medicine Physician	$0	$15.8M
Gaston Adolescent Center, Inc.	NC	Community/Behavioral Health Agency	$0	$14.4M
Touchpoint Healthcare Services Inc	NC	In Home Supportive Care Agency	$0	$11.1M

Hughes Behavioral And Mental Health Services Inc. — Billing Profile & Reimbursement Data

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Hughes Behavioral And Mental Health Services Inc. — Billing Profile & Reimbursement Data

Sign up for Hughes Behavioral And Mental Health Services Inc. — 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