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

Why is the Medicaid comparison limited to West 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. West 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.

Southern Highlands Community Mental Health Center, Inc. (NPI 1962772228)

Field	Value
Entity Type	Organization
Organization	Southern Highlands Community Mental Health Center, Inc.
Address	200 12th Street Ext
City	Princeton
State	WV
ZIP	24740
Taxonomy	Counselor
NPI Enumerated	January 4, 2012

Payer Source	Total Paid
Medicaid	$22M
Medicare	$0

Key Findings

This provider is effectively single‑payer: there is no Medicare billing on file and all reported revenue is Medicaid-based, with total Medicaid revenue of $22M. The absence of Medicare activity indicates services and reimbursement structures are focused on Medicaid programs and waiver services rather than traditional fee‑for‑service Medicare lines.

Revenue is extremely concentrated in a small set of Medicaid services: the precomputed top three codes (S5125, T2021, G9002) account for 91.1% of this provider's total Medicaid revenue. S5125 alone represents $14.3M (65.2% of Medicaid revenue) and T2021 contributes $4.8M (21.9%), leaving G9002 at $896.7K (4.1%), so a handful of service lines drive nearly the entire topline.

The code mix (dominant S5125 – attendant care services; per 15 minutes, and T2021 – day habilitation, waiver; per 15 minutes) indicates an operational focus on community‑based personal care and habilitation services under Medicaid waiver programs. High volumes of per‑15‑minute attendant care and day habilitation point to ongoing, direct support and habilitation workflows (in‑home or center‑based), while G9002 (coordinated care fee, maintenance rate) suggests bundled or coordination payments layered onto those waiver services.

Competitive standing varies by code: for S5125 the provider ranks #15 of 43 in-state and sits in the 67th percentile, which the data labels as typical, unremarkable volume—meaning the provider is a solid regional participant in attendant care but not a market leader. By contrast, for T2021 the provider ranks #8 of 57 and is in the 88th percentile (also described as typical, unremarkable volume), indicating a relatively strong position statewide in day habilitation compared with peers.

G9002 (coordinated care fee) contributes a much smaller share ($896.7K, 4.1% of Medicaid revenue) and ranks #46 of 123 in-state at the 63th percentile, again labeled typical; this suggests care coordination fees are present but not a primary revenue driver for this organization. The presence of G9002 as part of the top three nevertheless signals the provider participates in maintenance/coordination payment structures tied to waiver services.

Ancillary service lines provide operational depth beyond the top two codes: the provider reports $783K from A0120 non‑emergency transportation (11.9K claims, rank #9 of 50, 84th percentile), $480.2K from T1016 case management (10.9K claims, rank #13 of 96, 87th percentile), and $173.4K from A0160 per‑mile transport (7.2K claims, rank #27 of 112, 77th percentile). These transportation and case management revenues are consistent with a full service‑line supporting Medicaid waiver clients and indicate logistical capacity to move and manage beneficiaries as part of their care model.

Service diversity is limited relative to total revenue: beyond the top three codes the remaining line items are small (examples include T1005 respite at $229.4K and T1003 LPN/LVN services at $172.7K), so the business is operationally concentrated and could be sensitive to policy or unit‑rate changes for its dominant waiver services. T1005 in particular is low relative to peers (rank #27 of 29, 7th percentile) despite being present, which suggests respite is not a major growth area for this provider.

The provider has an established operational tenure: the NPI was enumerated on 2012-01-04 (~14 years ago), indicating more than a decade of activity in the Medicaid space. That longevity, combined with concentrated but high dollar volumes in attendant care and day habilitation, points to an experienced, specialized vendor entrenched in waiver and community‑based service delivery within the state.

Medicaid: Complete Services Breakdown

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5125	Attendant care services; per 15 minutes	25,720	$560	$14.3M
T2021	Day habilitation, waiver; per 15 minutes	35,930	$130	$4.8M
G9002	Coordinated care fee, maintenance rate	4,350	$210	$896.7K
A0120	Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems	11,860	$70	$783K
T1016	Case management, each 15 minutes	10,910	$40	$480.2K
T1005	Respite care services, up to 15 minutes	470	$490	$229.4K
A0160	Non-emergency transportation: per mile - case worker or social worker	7,230	$20	$173.4K
T1003	Lpn/lvn services, up to 15 minutes	3,600	$50	$172.7K
T2024	Service assessment/plan of care development, waiver	1,210	$60	$75.9K
T1002	Rn services, up to 15 minutes	1,470	$30	$36.7K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. West Virginia Distribution

Southern Highlands Community Mental Health Center, Inc. — 0 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — West Virginia

Full comparison — all codes billed, vs. West Virginia median

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5125	Attendant care services; per 15 minutes	15	40	14,820	$750	$30.5M
T2021	Day habilitation, waiver; per 15 minutes	8	60	6,490	$120	$2.2M
T1005	Respite care services, up to 15 minutes	27	30	2,980	$250	$1.5M
G9002	Coordinated care fee, maintenance rate	46	120	2,950	$150	$901.9K
T1003	Lpn/lvn services, up to 15 minutes	14	30	2,070	$90	$522.7K
T1016	Case management, each 15 minutes	13	100	2,790	$90	$496.2K
A0160	Non-emergency transportation: per mile - case worker or social worker	27	110	2,030	$50	$278.8K
T1002	Rn services, up to 15 minutes	95	150	1,980	$40	$232.6K
A0120	Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems	9	50	1,390	$30	$183.1K
T2024	Service assessment/plan of care development, waiver	20	50	760	$50	$95.5K

Nearby Providers

Other providers in the same ZIP code as Southern Highlands Community Mental Health Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Voca Corporation Of West Virginia, Inc.	WV	Developmental Disabilities Clinic/Center	$0	$178.3M
Southern Highlands Community Mental Health Center, Inc.	WV	Community/Behavioral Health Agency	$0	$44.2M
Princeton Community Hospital Assn., Inc.	WV	General Acute Care Hospital	$0	$41M
Princeton Community Hospital Assn Inc.	WV	Urology Physician	$0	$15.4M
Bluestone Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$12.1M
Princeton Rescue Squad Inc	WV	Land Ambulance	$1.1M	$10.4M
Foot And Ankle Clinic Of The Virginias Inc	WV	Podiatrist	$0	$5.5M
Bradley Hoffman	WV	Foot & Ankle Surgery Podiatrist	$4.9M	$0
Beautiful Minds Counseling Center	WV	Mental Health Counselor	$0	$4.1M
Bluefield Gastroenterology PLLC	WV	Specialist	$0	$4M

Southern Highlands Community Mental Health Center, Inc. — Billing Profile & Reimbursement Data

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Southern Highlands Community Mental Health Center, 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

Nearby Providers

Frequently Asked Questions

References