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

Why is the Medicaid comparison limited to Virginia 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. Virginia (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.

New River Valley Community Services (NPI 1942304126)

Field	Value
Entity Type	Organization
Organization	New River Valley Community Services
Address	700 University City Blvd
City	Blacksburg
State	VA
ZIP	24060
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	September 11, 2006

Payer Source	Total Paid
Medicaid	$193.7M
Medicare	$0

Key Findings

NEW RIVER VALLEY COMMUNITY SERVICES is effectively a Medicaid-centric provider: it reports no Medicare billing on file and $193.7M in lifetime Medicaid revenue, indicating a single-payer concentration that will shape payer negotiations and utilization monitoring. Analysts should treat this entity as materially dependent on Medicaid policy and reimbursement changes rather than Medicare trends.

Revenue is highly concentrated in a few service lines: the precomputed top three Medicaid codes account for 59.2% of this provider’s total Medicaid revenue, driven by H0023 ($67.6M, 35.7%), T2033 ($30.5M, 16.1%), and H0039 ($14.2M, 7.5%). This level of concentration means changes to coverage or rates for these specific codes would disproportionately affect overall revenue.

The top codes define the business model: H0023’s prominence (199.4K claims) signals a large behavioral health outreach operation focused on planned, population-targeted engagement, while T2033 volume (102.3K claims) indicates significant residential waiver services delivered on a per-diem basis. Together with high-volume H0039 and H0040 activity, the mix points to a combined model of community outreach, residential placement, and intensive assertive community treatment rather than a primarily clinic-based outpatient practice.

NEW RIVER is a statewide outlier and dominant competitor for several community-based service codes: it ranks #1 in-state for H0023 and T2033 (both 100th percentile; labeled extreme outlier) and #1 for H0040 (100th percentile; extreme outlier), while H0039 ranks #3 of 31 providers (93rd percentile; notably above typical). These rankings indicate the provider is a major in-state delivery system for outreach, residential waiver care, and ACT services, far above typical peer volumes.

Beyond its top three drivers, the provider also shows unusually large volume in outpatient and rehabilitative services: 90837 has 47.6K claims and $5.4M revenue (2.9%) and ranks #4 of 1,337 providers (100th percentile; extreme outlier), H2017 shows 100.4K claims and $4.4M (2.3%) ranking #2 of 97 (99th percentile), and 90791 ranks #9 of 612 (99th percentile). This pattern suggests the organization operates both high-volume psychotherapy/assessment capacity and sizable psychosocial rehabilitation programs in parallel with its residential and outreach lines.

Operationally, the code mix combines per-diem residential billing and high-volume per-15-minute or per-encounter services (e.g., H0039, H0040, T1017), implying a staffing model that likely includes mobile/field teams, residential program staff, and frequent short-interval contact billing. The presence of large per-diem and per-15-minute revenue streams will make analyses of utilization intensity and staff-to-client ratios particularly relevant for oversight and contracting.

Several codes are labeled as outliers in plain-English terms and should be prioritized for peer benchmarking: H0023, T2033, and H0040 are described as extreme outliers, and H0039 is described as notably above typical state volume. For payers and analysts, these labels confirm the provider’s unusually large share of certain state service markets and identify the specific codes to target for comparative utilization review.

The provider has a long tenure in the Medicaid system, with its NPI enumerated (registered) on 2006-09-11 (~20 years ago), which supports interpreting its high volumes as established operational scale rather than a recent surge. That longevity, combined with dominant in-state rankings, suggests entrenched capacity in the community mental health and residential waiver space rather than a transient programmatic expansion.

Medicaid: Complete Services Breakdown

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

57 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0023	Alcohol and/or drug outreach	199,370	$340	$67.6M
T2033	Residential care, not otherwise specified (nos), waiver; per diem	102,350	$300	$30.5M
H0039	Assertive community treatment, face-to-face, per 15 minutes	9,070	$1,560	$14.2M
H2022	Community-based wrap-around services, per diem	44,930	$300	$13.4M
H0040	Assertive community treatment program, per diem	63,000	$200	$12.6M
T1017	Targeted case management, each 15 minutes	29,420	$350	$10.1M
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…	47,640	$110	$5.4M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	47,450	$100	$4.5M
H2017	Psychosocial rehabilitation services, per 15 minutes	100,440	$40	$4.4M
H2011	Crisis intervention service, per 15 minutes	6,340	$600	$3.8M

Showing 1–10 of 57

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Virginia Distribution

New River Valley Community Services — 11 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

57 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2033	Residential care, not otherwise specified (nos), waiver; per diem	1	40	6,080	$1,660	$27.6M
H2022	Community-based wrap-around services, per diem	14	140	4,450	$1,150	$15.3M
H0023	Alcohol and/or drug outreach	1	50	33,630	$320	$15M
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	15	30	7,090	$420	$11.5M
T1017	Targeted case management, each 15 minutes	18	50	23,860	$330	$9.4M
S0201	Partial hospitalization services, less than 24 hours, per diem	80	80	1,870	$470	$2.9M
H0046	Mental health services, not otherwise specified	72	510	6,100	$190	$2.8M
H0040	Assertive community treatment program, per diem	1	40	10,830	$200	$2.7M
H0039	Assertive community treatment, face-to-face, per 15 minutes	3	30	2,740	$530	$2M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	15	150	5,420	$110	$1.9M

Showing 1–10 of 57

Nearby Providers

Other providers in the same ZIP code as New River Valley Community Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Montgomery Regional Hospital Inc	VA	General Acute Care Hospital	$0	$17.1M
Joseph Mock	VA	Hematology & Oncology Physician	$1.8M	$0
Daniel Hurd	VA	Dermatology Physician	$1.5M	$5.8K
Sheenu Sheela	VA	Hematology & Oncology Physician	$1.3M	$0
Craig Garofola	VA	Dermatology Physician	$897.2K	$0
Chad Johnston	VA	Dermatology Physician	$662.2K	$8K
Parisa Farhi	VA	Glaucoma Specialist (Ophthalmology) Physician	$545.2K	$0
Maggie Belton	VA	Family Medicine Physician	$494.7K	$5.8K
Jared Brackenrich	VA	Dermatology Physician	$307.6K	$0
Blacksburg Pharmacy Inc	VA	Community/Retail Pharmacy	$263.4K	$0

New River Valley Community Services — Billing Profile & Reimbursement Data

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New River Valley Community Services — 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